Sleep

“Why am I so tired?” It’s a question GPs get asked a lot! Feeling tired is something we all experience to varying degrees throughout our lives, and one of the most common causes of tiredness (and the first thing we’ll usually ask you about) are problems with sleep. Life in the 21st century is almost designed to deliberately interfere with our sleep – screens, blurring of the boundaries between work and rest, busy lives – there just don’t seem to be enough hours in the day to get it all done, and so we skimp on sleep.

Sleep problems are common – nearly half of all Australians report poor sleep quality at some stage in their lives. This figure is even more worrying for kids and teens, whose sleep quality has declined alarmingly in the last few decades. The good news is, there are some simple strategies that can help.

Why is sleep so important?
We still don’t really know exactly what sleep is or what it’s for, but there are some clues in the effects we see of poor sleep. We know that sleep is important for: 

• the brain to lay down and organise memories
• the immune system to function normally
• good mental and physical health; poor sleep is associated with an increased risk of cardiovascular disease, diabetes, depression, dementia and injuries through road accidents
• kids and teens, for their growth and development, school performance, relationships, sport and recreation and mental health.

How much sleep do we need?
This can vary from person to person and changes with age but as a general guide:

• Primary school age kids: 9-11 hours
• Teenagers: 8-10 hours
• Adults: 7-9 hours
• Older adults 65+: 7-9 hours

Just as important as the amount is the quality of sleep. This can be harder to assess but again, as a general rule, if you are feeling tired throughout the day, the chances are your sleep quality needs working on. Some other signs of poor sleep quality are:

• It takes more than 30 minutes to fall asleep
• You regularly wake up more than once per night
• It takes more than 20 minutes to fall back asleep if you wake during the night
• You wake up feeling tired, fall asleep during the day, have trouble concentrating or need a lot of caffeine to stay awake
• Increased moodiness or irritability, especially in kids or teens

Causes of poor sleep
Books have been written on the topic of sleep (our favourites are linked below) so we don’t have room for a lot of detail here but in short, some of the causes of poor sleep are:

• Insomnia, which is difficulty falling or staying asleep, the causes of which are many including stress, poor sleep habits, caffeine overuse, screens late at night etc.
• Obstructive sleep apnoea
• Depression/anxiety
• Restless legs syndrome
• Problems with the sleep environment including a bed mate who snores or a noisy, too warm bedroom

Top tips for improving your sleep
It’s important to talk to your GP if you or your child are having problems sleeping, especially if there are signs of poor sleep quality (listed above) and it’s affecting your ability to function well during the day. In the meantime, here are some simple things to try. As with changing any habit, it can take time, maybe up to a few weeks to see improvement:

1. Have a regular sleep pattern
   Try and go to bed at the same time each night, and get up at the same time each morning, even on the weekends.
2. Don’t lie awake for too long
   Some people with poor sleep habits are actually spending too long in bed (awake). If you are not asleep after 20-30 minutes, get up and do something else (not involving a screen). Consider moving your bedtime to slightly later in the evening.
3. Bed is for sleep, not entertainment
   Get the screens out of the bedroom overnight. This is especially important for kids and teens. No phones, computers or TVs. If you’re using your phone as an alarm clock (a common reason given by teens to keep their phone in the bedroom) – buy an old-fashioned clock radio. If you need the phone nearby at night in case of emergency, keep it well out of reach to avoid temptation. Read a book (not too much of a page-turning thriller!) instead.
4. Develop a good bedtime routine
   This will help train your brain that it is nearly time for sleep. Start winding down about an hour or two before bed. Whatever works for you is fine – turning the lights down, a warm bath, reading a book – but definitely ditch the screens during this golden hour. The blue light they emit can interfere with melatonin levels in the brain.
5. Make sure your sleeping environment is comfortable
   You should aim for a reasonably dark, quiet and cool room with comfortable bedding. If your bed mate snores or keeps different hours to you, some delicate negotiating may be required…
6. Avoid caffeine, alcohol or cigarettes
   Alcohol may appear to help you get off to sleep but can actually disrupt your sleep during the night. Caffeine and nicotine are stimulants; if you are a coffee, tea or cola drinker, aim to switch to decaf or herbal tea after about 2pm. And now is always a good time to quit smoking!
7. Don’t lie awake watching the clock
   Sometimes difficulty getting off to sleep, or back to sleep, can be so stressful it makes getting to sleep difficult! Don’t keep checking the time on your phone and turn the clock radio around so you can’t see the time. A couple of nights of poor sleep is not going to cause lasting harm; even though you may not be asleep yet, it might help to reassure yourself that you are still resting. Get up after 20-30 minutes and read a slightly boring book instead (see step 3).
8. Avoid sleeping pills if possible
   These are only ever a short-term solution anyway and can be habit forming or have other unpleasant side-effects. Talk to your doctor about other options.
9. Get help
   If you’re not getting anywhere with these suggestions, and particularly if you are having difficulty functioning during the day or are concerned about your mood, please come and talk to your GP. There may be an underlying cause that can be treated and we have many other strategies that might help, including referral to specialist sleep clinics.