Are you tired of counting sheep?

31 October 2010 - 11:05 By Claire Keeton
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The silence, white sheets and curtains covering non-existent windows at the three sleep rooms at Wits University send out subliminal messages that it's time to slumber.

But the volunteers who enter the sleep laboratory are more likely to be counting sheep because they mostly have sleeping disorders, an increasingly common problem in South Africa. An estimated 30% of the population have sleeping problems and the ways people tackle them usually make them worse.

That bogeyman insomnia - "psychological-physiological insomnia", to be precise - causes problems for many people. Chairman of the SA Society of Sleep, DrKevin Rosman, says that this type of insomnia is the most common in his practice. And it is often caused by "obstructive sleep apnoea" - a sleeping disorder that disrupts breathing and may be a warning sign of heart disease.

Like other sleep clinics, Vincent Pallotti Hospital's sleep lab in Cape Town has equipment to do full sleep studies. Electrodes are attached to the head and the body, along with a nasal canister, respiratory belt and oxygen-monitoring device. (Surely anyone who can sleep with all this doesn't need to be there.)

The results show how much time a patient spends in each state of sleep:

  • Rapid eye movement (REM) sleep during which time you dream; and
  • Non-REM sleep, which has four stages.

Wits physiologist Stella Iacovides, who manages the Wits sleep lab, says that primary insomnia (sleeplessness that cannot be attributed to a medical, psychological or environmental cause) is rare - unlike psycho-physiological or secondary insomnia.

"The vast majority of people have secondary insomnia from stress, pain, post-traumatic stress, psychological reasons and living conditions like cold and noise," she says.

Rosman says that usually some stress or life event, like a death of a loved one, sets this off.

Chronic insomnia leads to fatigue and distress during the day, says the manager of the Cape Sleep Clinic, Dr Brian Govender.

"It's all about switching off the brain at night. People who are highly stressed, for example, running their own business, struggle to switch off."

He says the younger generation is also prone to "bad sleep hygiene" or habits, such as keeping on their cellphones during the night.

The fix for sound sleep is to establish good sleeping habits so that getting into bed equals sleep.

Rosman says: "You have to condition your reflex so that getting into bed is the final reflex to sleep. You must have an appropriate and regular time," he says.

To sleep well the specialists recommend:

  • A bedtime routine, for instance, taking out the dog or having a bath;
  • Going to bed at the right time to get about seven-and-a-half to eight hours of sleep;
  • A cool, quiet room without any form of music.
  • No exercise before bedtime; and
  • No caffeine and avoiding alcohol or eating big meals immediately before bedtime.
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