Interview with Deirdre McSwiney, Chief Technologist, Mater Private Hospital, under the care of Dr Catherine Crowe.
What constitutes a ‘normal’ night’s sleep?
Approximately 60 percent of the adult population sleep for 7-8 hours per night; 8 percent sleep for less than 5 hours and about 2 percent sleep for longer than 10 hours.
What is the cause of daytime sleepiness?
Sleep deprivation is the commonest cause of sleepiness. In the case of carers, this is usually due to the conflict between the need to complete various activities and respond to patients’ needs and the need to get sufficient sleep. In a similar way, we know shift work leads to considerable disruption of sleep-wake patterns.
What is sleep deprivation?
The length of time a carer is able to sleep is often different from what he or she requires. Sleep is divided into NREM (non-REM) and REM (rapid eye movement) stages. These consolidate different functions for us, psychologically, cognitively and physically. Loss of NREM sleep causes more daytime sleepiness than loss of REM sleep. The body should sleep for long enough that we feel refreshed on waking up and are able to stay alert during the day.
Does sleep deprivation affect your ability to think clearly?
The simple answer is yes. Our clarity of thinking, over time, can become fuzzed or unclear.
A reduction in NREM sleep can lead to defects in attention, although testing of psychomotor tasks and actions have proved that we do maintain some ability. A shortage of REM sleep is related to disorganised thoughts and memory impairment.
Does sleep deprivation affect you emotionally?
Yes, sleep deprivation does affect us emotionally. All our thoughts have an emotional ‘weight’, so sleep deprivation affects our thinking and our thinking is further compromised within that.
Does sleep deprivation affect your physical health?
There is certainly evidence in publications that sleep deprivation has a knock-on effect on health. These studies show that the optimum level of sleep requirement is six hours at least and that shorter than that carries risks for cardiovascular events (heart attack and stroke). Endocrine levels and blood pressure changes can all be affected by sleep loss and lead eventually to physical health issues.
Sleep deprivation among carers can be especially difficult. For example, a carer is often required to be constantly alert. Because our bodies are actually quite ‘busy’ at night re-organising our systems, sleep deprivation or fragmentation can, for example, lead to insulin resistance and other hormonal changes. This mechanism impairs glucose tolerance during wakefulness, which sometimes results in an increase in appetite that may lead to obesity.
How quickly can you recover from long-term sleep deprivation?
Very quickly! The body has a wonderful ability to recoup and recover from sleep loss. We cannot ‘bank’ sleep but we can repay sleep loss easily.
What steps can you take to recover from sleep deprivation?
Catching up on sleep in the form of napping can be recommended for carers, if it works. Naps should be taken after lunch and quite strictly timed, i.e. 20-25 minutes. Any longer than that eats into our night time complement of sleep.
Some people feel groggy or get a headache if they nap in the afternoon. Is there any way around this?
Headaches or grogginess after napping generally indicates the nap was too long. Shorter timed naps can help this: no more than 20-25 minutes.
If you are in a situation where there is little opportunity to sleep, is there any other way to get the rest you require?
Without being facetious, for carers to try to recover some sleep/rest, there has to be extra support and shared caring. It may be possible to limit feelings of annoyance or frustration at sleep disturbance by using various relaxation or meditative techniques.
Can you suggest ways to fall asleep quickly when there is an opportunity to rest?
Similar to the last point: rest is important during the day, including physical relaxation and ‘time out’ without trying to get to sleep.
Can sleep deprivation cause long term damage? If so, at what point are the effects irreversible?
Any punishment the body takes over a period of a time has effects. We cannot comment on effects being irreversible, as there can be many other combinations of factors before that point is reached.
Is there anything we can do to minimise the impact of sleep deprivation, such as eating certain foods, taking supplements, exercise, or anything else?
Supplements are not necessary if your diet is adequate. The one factor, above all, that aids sleep in all situations is exercise. Regular exercise creates endorphins. However, take care not to exercise too close to bedtime.
What advice can you give to family carers who get very little sleep?
Again, not being flippant but the solution is to get extra help. Shared care is key: roistering of family members, or seeking help from trusted friends, etc.
- Plan for naps during the day to compensate for sleep restriction or deprivation.
- Try to improve your sleeping environment to maximise quality of your rest:
- Avoid stimulants before bed, i.e. caffeine and nicotine.
- Exercise during the day to increase alertness and induce
- Take strictly timed naps if required.
- The use of alcohol to induce sleep is not
All sleep disorders are diagnosed and treated in the Mater Private laboratory. For more information: http://www.materprivate.ie/service/sleep-disorders-clinic/