Welcome to Focus on Fatigue.
With the end of another year close at hand, this is the time when many of us find life is busier than ever. Christmas parties, New Year parties, and a variety of other social functions can make it difficult to find enough time for the all important sleep we need to function at our best. Achieving adequate sleep is even harder for those of us to whom sleep doesn’t come so easily.
In this issue of Focus on Fatigue we will look at some of the aids people may reach for in their quest to get a good night’s sleep and whether they are effective in helping us reach this goal.
InterDynamics would also like to take this opportunity to wish all our Focus on Fatigue subscribers a safe and happy Christmas and New Year period.
The FRMS Team
InterDynamics Pty Ltd
320 Adelaide Street Brisbane Qld 4000
Tel +61 2 8404 0400 Ext 23
Views expressed in articles and links provided are those of the individual authors, and do not necessarily represent the views of InterDynamics (except where directly attributed).
A Little Something to Help Me Sleep
For most people, sleep is a blissful state that comes naturally. We may not get as many hours of sleep as we would like, due to work, family responsibilities, or that late-night television we just had to see. When we do get to bed, however, sleep is usually only minutes away. Unfortunately, this is not always the case. At times when sleep is elusive, or when we need to sleep at times we’d usually be awake, it can be tempting to reach for something not so natural to help us out. Often this is the time when some people take a sleeping pill or drink something alcoholic before going to bed. Just a little something to help them sleep.
But how effective are such measures? Do we sleep better if we have a glass of wine before bed? Will we wake feeling more energetic in the morning if we take a sleeping pill? These are the questions we will examine today.
The soporific effects of alcohol are well known and for a long time many people viewed the consumption of an alcoholic drink before bed, known as a nightcap, as something of a ritual. It was assumed that, because drinking alcohol can help people fall asleep faster, it was an effective way of ensuring a good night’s sleep. Unfortunately, research on the stages of sleep have shown this is not the case.
While alcohol does indeed shorten sleep latency (the amount of time it takes to fall asleep) that’s where the benefits end. Studies on the effects of alcohol on sleep usually split the sleep into two halves. During the first half of the night the body is processing the alcohol. While the person will generally be sleeping soundly at this point, they won’t be cycling smoothly through the different stages of sleep like they normally do. Instead, there is often an increase in stages 3 and 4, also known as slow wave sleep, in this first half of the night. To make room for this slow wave sleep, there is a decrease in REM sleep. The more alcohol the person has consumed, the less REM sleep they are likely to get.
About four or five hours after going to sleep, or half way through the night, the sleeper’s body will finish eliminating the alcohol from their system. This is when the real trouble starts. Studies have noted a rebound effect where the body tries to catch up on the missed REM sleep, but unfortunately it’s often too late. The natural sleep patterns have been disrupted and the person is much more likely to wake up because they’ll spend an increased amount of time in the lighter stages of sleep (Stages 1 and 2).
Overall, the night will generally involve too much light sleep, and not enough slow wave sleep or REM sleep. This means the person is more likely to wake up feeling groggy and sleep deprived.
Having one or two drinks before bed every now and then is less likely to effect sleep than having a drink before bed night after night. There does seem to be a cumulative effect, especially in terms of tolerance. Once a person has had a nightcap for as little as three nights in a row, their body will start to become accustomed and the alcohol will be less likely to make them sleepy which, in this case, was the reason for consumption in the first place. Then, when they stop having that nightly drink, the sudden decrease in alcohol can cause all new disruptions to sleep.
On top of all this, alcohol also effects the core temperature of the body, hormone function and neurochemicals in the brain. Each of these variables can then go on to have their own effects on sleep and sleep quality.
In 2014, a Cochrane Review examined the evidence for using prescription pharmaceuticals in the treatment of shift work disorder. They reviewed studies using such treatments as melatonin, armodafinil, modafinil, and zopiclone.
It was concluded that a number of these medications did succeed in their goal of either increasing sleep length after a night shift, or decreasing sleepiness during a night shift. However, several of the medications had a risk of side effects such as headache, nausea and skin disorders.
The reviewers noted that, considering the high number of workers who perform shift work, the number of trials that fit their criteria for inclusion in the review was very small. More research is needed before the true benefits of these sorts of treatments can be ascertained, including whether the benefits outweigh the potential side effects.
Therefore, it is important that medications aimed at either increasing sleep or decreasing sleepiness be used only under the supervision of a medical professional.
Effective ways to improve sleep
A special report put out by the Harvard Medical School listed the following proven ways in which people can improve the quality of their sleep:
- Cut down on caffeine
- Quit smoking
- Be physically active
- Improve your sleep surroundings (e.g. cool, dark, quiet)
- Keep alcohol consumption moderate (e.g. a maximum of 1-2 glasses with dinner), and do not drink for several hours before going to bed
- Roehrs, T. and Roth, T. (2001) Sleep, sleepiness, and alcohol use. Alcohol Research and Health, 25(2), 101-109.
- Ebrahim, I. O., Shapiro, C. M., Williams, A. J. and Fenwick, P. B. (2013) Alcohol and sleep I: Effects on normal sleep. Alcoholism: Clinical and Experimental Research, 37(4), 539-549.
- Liira, J., Verbeek, J. H., Costa, G., Driscoll, T. R., Sallinen, M., Isotalo, L. K. and Ruotsalainen, J. H. (2014) Pharmacological interventions for sleepiness and sleep disturbances caused by shift work (Review). The Cochrane Collaboration.
- Epstein, L. (Ed.) (2013) Improving Sleep: Harvard Medical School Special Health Report. Harvard University: Boston.
Fonterra Wins Top National Health and Safety Award
Diary giant, Fonterra Co-operative Limited, recently won three awards at the New Zealand Workplace Health and Safety Awards. These included the Supreme Award for the Best Overall Contribution to Improving Workplace Health and Safety in New Zealand and an award for the Best Initiative to Address a Safety Risk.
Fonterra currently uses FAID, an InterDynamics product, to assist them in monitoring tank driver fatigue. Here at InterDynamics, we would like to congratulate Fonterra for these outstanding achievements in the area of workplace health and safety.
You can read more about Fonterra’s achievements at their website.
In the News
You went out with some friends, had a few drinks, came back home and fell asleep immediately. But now it’s super early the morning after and you’re wide awake, feeling like you’ve had the worst night of sleep of your life. What happened? This author spoke with nutritionist Karen Ansel to figure out how exactly alcohol messes with your sleep.
In this short video sleep expert, Dr Michael Breus, talks about the ways in which consuming alcohol close to bedtime affects sleep.