He tried his usual position, hoping to fall asleep but for 18-year-old Jehan, the stress of the impending Advanced Level examination never left his mind. Getting sleep was near impossible. He tried going to bed early, but that had no effect. It was just a phase, Jehan thought, little realising that ‘insomnia’ was making inroads into his academic performance.
A good night’s sleep is a luxury for many teenagers these days, faced with hectic study schedules, exam stress and social demands. The consequences though obvious can be worrying. Insomnia, is a nemesis that we have all faced at some point in our life, but it can evolve into a ‘chronic disease’ that impacts on our daily life. Salvaging those precious hours of sleep is not impossible yet demands a certain degree of commitment.
“Proper sleep hygiene is the remedy for many sleep disorders,” says Professor Hemamali Perera, Professor in Psychological Medicine at the Colombo Medical Faculty. “Improving one’s sleep habits is the most effective way to ensure sound sleep, and this includes the gradual winding down before going to bed.” Teenage sleep disorders, more often than not, arise due to uneven lifestyles, where the normal circadian rhythm of the body is disrupted. The circadian rhythm is an endogenously driven biological clock that determines the timing of sleep. Once the cycle is disrupted the body finds it hard to get back into rhythm – causing restlessness.
 |
| Pic by M.A. Pushpa Kumara |
There are two main stages of sleep: REM (Rapid Eye Movement) and NREM (Non Rapid Eye Movement). REM is further broken down into four more stages that create a procession of events that leads to deep sleep. NREM is in effect deep sleep. The entire duration of sleep depends on the cycling of these stages.
“As humans grow into adolescence the sleep duration shortens, and ideally teenagers need about 8 to 9 hours of sleep, however this is not the case as they spend their nights playing computer games and watching movies while making the excuse of studying,” says Prof. Perera. “Actually they are turning day into night and night into day.” These practices interrupt the normal rhythm and can lead to deteriorating academic performances, as well as chronic disorders.
“Taking sedatives in the form of sleeping pills is not the solution,” Prof. Perera notes. The sensible solution is to practise good sleeping habits that will blanket you to a refreshing sleep, she says. “Teenagers are caught up in a rush close to sleep-time and this doesn’t help in settling the body down – a gradual sequence of events leading up to sleep will cease the restlessness,” says Prof. Perera, giving us guidelines on proper sleep hygiene.
The stress that is usually coupled with teenage years is inevitable and they are most susceptible to emotional distress. Parents should make sure that the teens have proper conditions to study and relax. In Jehan’s case, his parents were accustomed to discussing their business plans as well as financial problems in the evenings and Jehan usually found himself in the middle of the conversation. Prof. Perera states that when the mind is not settled, the body cannot trigger the signal needed for sleep.
Apart from insomnia, there are other sleep disorders which can afflict teenagers and others.
Restless legs syndrome
A common sleep disorder found amongst teens is the ‘Restless Legs Syndrome’ that creates throbbing, pulling, creeping, or other unpleasant sensations in the legs and an uncontrollable and sometimes overwhelming, urge to move them – causing the individual to constantly keep fidgeting. It kicks in as soon you get into bed, while not evident at other times of the day.
“Restless Legs Syndrome is not absolutely pathological,” says Prof. Perera , “but it can lead to insomnia, and disturb the sleep of an individual such as a sibling who’s sharing the bed.” There is no heavy medication for RLS, but having a healthy diet with a sufficient intake of Vitamin E and fomenting the legs with hot water can help.
However, the common factor for all sleep-related disorders is ‘Stress’- eliminating stress can eliminate a lot of problems.
Sleep Apnea
In simplest terms, apnea literally means ‘without breathing’. Sleep Apnea is a condition in which the normal airflow to the body is restricted and the brain is deprived of oxygen for a few seconds – before the person gasps for breath and wakes up. During obstructive sleep apnea, there is no airflow from the nose and mouth to the lungs.
This is because the entrance to the trachea is completely blocked. The cause of the blockage is usually excessive fat. “It is most common in obese teenagers,” says Prof. Perera, “Apnea causes frequent and loud snoring – which is regarded as an early symptom.” Patients are aroused from deep sleep to lighter stages of sleep, and are unaware of the apneas or awakenings.
Children and teens may have enlarged tonsil tissues in their throats, which can lead to obstructive sleep apnea in which case surgery is carried out to remove the tonsils. However, obesity remains the main cause, and methods of reducing weight are also the remedies. If it persists, a polysomnogram may be needed to diagnose the condition.
Narcolepsy
Narcolepsy is a condition which triggers an almost instant sleep attack, causing the patient to fall asleep anywhere and at any time. Narcolepsy is also most common amongst teenagers, and has a tendency to manifest between the ages of 15-25. While the sleep attacks may only last for a short time, the individual is left restless and drowsy for most part of the day.
The uncertainty of occurrence is the major concern, Narcolepsy is a condition that requires medical attention.
While Jehan’s predicament is the first stage of insomnia, many teens may already be near the chronic stage of insomnia. Prof. Perera advises that if signs of restlessness persist for more than a month, and if sleep hygiene has no positive effect, a visit to the doctor is on the cards.
Steps towards better sleep
- Establish a routine: Go to sleep and wake up at about the same time every day -- including on weekends. This rou- tine will put your brain and body on a healthy sleep-wake cycle.
- Avoid playing computer games, watching TV or activities that excite the brain before sleep.
- Avoid coffee, tea or other caffeinated drinks close to bedtime.
- A warm malt-like drink is preferable before bed time.
- Fruits and nuts are also advisable as a light snack.
- A warm bath before bed time is recommended since sleep usually fol- lows the cooling phase of the body’s tempera ture cycle.
- Avoid day-time naps
Be as active as possible during the day.
- Exercise and fitness should be done during the day.
- Read a book out side of bed, and go to bed when you actually feel sleepy.
- Make your bedroom quiet, dark, and a little bit cool – perfect condi- tions which stimulate the body clock to switch to sleep mode.
|
E-mail
