WELCOME! The Strandfontein Depression and Related Disorders Support Group extends a friendly welcome to you at its monthly meeting 20 May 2013

WELCOME!WELCOME!The Strandfontein Depression and The Strandfontein Depression and Related Disorders Support Group Related Disorders Support Group extends a friendly welcome to you extends a friendly welcome to you at its monthly meetingat its monthly meeting20 May 201320 May 2013

SLEEP AND SLEEP AND INSOMNIAINSOMNIA

Presentation by Presentation by

Dr Adelbert ScholtzDr Adelbert Scholtz(counselling psychologist (counselling psychologist & retired pastor)& retired pastor)

IntroductionIntroductionOne often hears the following One often hears the following

questions:questions: How can I get more sleep?How can I get more sleep? I am still tired when I wake up in I am still tired when I wake up in

the morning – why is that?the morning – why is that? Why do I struggle to fall asleep at Why do I struggle to fall asleep at

night?night? I often wake up in the middle of I often wake up in the middle of

the night and I cannot get back to the night and I cannot get back to sleep. Why?sleep. Why?

Is it OK to take sleeping pills?Is it OK to take sleeping pills?

SLEEP AND SLEEP AND INSOMNIAINSOMNIA

1.1. Why do we sleep?Why do we sleep?2.2. DreamsDreams3.3. Sleeping disordersSleeping disorders4.4. InsomniaInsomnia5.5. Curing insomniaCuring insomnia

1. WHY DO WE SLEEP?1. WHY DO WE SLEEP?

The necessity of The necessity of sleepsleep

What happens What happens when we sleep?when we sleep?

Sleeping phasesSleeping phases

The Necessity of SleepThe Necessity of Sleep

Necessary for physical, psychological & Necessary for physical, psychological & spiritual healthspiritual health

Sleep deficit may lead to serious health Sleep deficit may lead to serious health problemsproblems

Most adults need Most adults need 8 hours per night 8 hours per night

The Necessity of SleepThe Necessity of Sleep

Ps 3: 5 Ps 3: 5 I laid me down and slept; I awaked; for the I laid me down and slept; I awaked; for the LORD sustained me.LORD sustained me.

Ps 4: 8 Ps 4: 8 I will both lay me down in peace, and I will both lay me down in peace, and sleep: for thou, LORD, only makest me dwell in sleep: for thou, LORD, only makest me dwell in safety.safety.

Eccl 5: 12 Eccl 5: 12 The sleep of a labouring man is sweetThe sleep of a labouring man is sweet Prov 6: 9 & 10 Prov 6: 9 & 10 How long wilt thou sleep, o How long wilt thou sleep, o

sluggard? When wilt thou arise out of thy sleep? Yet sluggard? When wilt thou arise out of thy sleep? Yet a little sleep, a little slumber, a little folding of the a little sleep, a little slumber, a little folding of the hands to sleep.hands to sleep.

What happens when we sleep?What happens when we sleep?

Brain cells get detoxifiedBrain cells get detoxified New connections between New connections between

brain cells createdbrain cells created Memories get fixedMemories get fixed Problems get solutionsProblems get solutions Muscles get a chance toMuscles get a chance to

recover with recover with growth hormonesgrowth hormones

Immune system works Immune system works betterbetter

Sleeping PhasesSleeping Phases

1.1. DrowsinessDrowsiness (10 min) – muscles relax, eyes (10 min) – muscles relax, eyes move under eyelids and person is easily move under eyelids and person is easily woken againwoken again


2.2. Light sleepLight sleep – heart rate slows down, eye – heart rate slows down, eye movements stop, brain waves become movements stop, brain waves become slower & body temperature drops. About slower & body temperature drops. About half the night is spent in light sleep.half the night is spent in light sleep.


3. 3. Deep sleepDeep sleep – blood supply – blood supply to brain decreases; if to brain decreases; if person is woken he/she is person is woken he/she is disorientated. disorientated. Sleepwalking Sleepwalking (somnambulism) and (somnambulism) and bedwetting (enuresis) bedwetting (enuresis) occur during this phase.occur during this phase.


3. 3. Deep sleepDeep sleep – – People who develop a sleep deficit (shift People who develop a sleep deficit (shift

workers &tc) need more deep sleepworkers &tc) need more deep sleep Alcohol & drugs Alcohol & drugs

may interfere with may interfere with deep deep sleep – they only sleep – they only cause a cause a stuporstupor


4. 4. REM sleepREM sleep (REM = (REM = Rapid Eye Movement) Rapid Eye Movement) – this phase starts for – this phase starts for the first time 70 – 90 the first time 70 – 90 minutes after going to minutes after going to bed; this is when the bed; this is when the person dreamsperson dreams


After the first episode of REM sleep the cycle After the first episode of REM sleep the cycle of light sleep, deep sleep and REM sleep starts of light sleep, deep sleep and REM sleep starts over again and may be repeated 3 or 4 timesover again and may be repeated 3 or 4 times

People Sleep Less NowadaysPeople Sleep Less Nowadays

Our ancestors in Our ancestors in agragrian societies agragrian societies slept 9 hours per nightslept 9 hours per night

In industrialised In industrialised societies people sleep 7 societies people sleep 7 hours per night due to hours per night due to pressure on their timepressure on their time

Result: social problems Result: social problems (crime, violence, drug (crime, violence, drug abuse, &tc)abuse, &tc)

2. DREAMS2. DREAMS1.1. Description of dreamsDescription of dreams

2.2. Functions of dreamsFunctions of dreams

3.3. NightmaresNightmares

Description of DreamsDescription of DreamsA dream may be A dream may be described as a series of described as a series of images, sounds and images, sounds and emotions that are being emotions that are being experienced during experienced during sleep, accompanied by sleep, accompanied by rapid eye movements rapid eye movements in the sleeping person. in the sleeping person. Dreams usually take Dreams usually take between 5 and 40 between 5 and 40 minutes.minutes.

Dreams in the BibleDreams in the Bible Jacob’s dream (Gen 28:12) Jacob’s dream (Gen 28:12) Joseph’s dreams (Gen 37: 5 – 11)Joseph’s dreams (Gen 37: 5 – 11) The dreams of the baker, the butler and the The dreams of the baker, the butler and the

Pharaoh’s dreams, which were interpreted by Joseph Pharaoh’s dreams, which were interpreted by Joseph (Gen 40 en 41)(Gen 40 en 41)

King Nebuchadnezzar’s dream, which was explained King Nebuchadnezzar’s dream, which was explained by Daniel (Dan 2)by Daniel (Dan 2)

The dreams of Joseph, Mary’s husband (Matt 1: 20, The dreams of Joseph, Mary’s husband (Matt 1: 20, 2: 13 and 19) 2: 13 and 19)

The dream of Pilate’s wife (Matt 27: 19). The dream of Pilate’s wife (Matt 27: 19). All these dreams were seen as predictions of the future All these dreams were seen as predictions of the future and revelations from God.and revelations from God.

Are Dreams Signs?Are Dreams Signs?

Almost all known religions see dreams as divine Almost all known religions see dreams as divine revelations or communications from the spirit revelations or communications from the spirit world world

Meanings for these dreams were sought and Meanings for these dreams were sought and often utilised in healing often utilised in healing the sickthe sick

People today still regard People today still regard dreams as dreams as containing containing special special symbols, messages symbols, messages and and meanings. Many books meanings. Many books written written on this topicon this topic

Why do we Dream?Why do we Dream?

Dreams: efforts of the brain to make Dreams: efforts of the brain to make sense of the chaotic signals and images sense of the chaotic signals and images that circulate through the brain during REM-sleep.that circulate through the brain during REM-sleep.

Emotions being experienced mostly during dreams are Emotions being experienced mostly during dreams are fear and anxiety; dreams are perhaps a method to fear and anxiety; dreams are perhaps a method to process these negative feelings and to lessen stress levelsprocess these negative feelings and to lessen stress levels

Sleeping person receives various stimuli from his Sleeping person receives various stimuli from his environment, especially sounds. Dreams may be an environment, especially sounds. Dreams may be an endeavour to make sense thereof. Certain stimuli, such a endeavour to make sense thereof. Certain stimuli, such a baby crying or an alarm clock going off will actually baby crying or an alarm clock going off will actually awaken the sleeping person. awaken the sleeping person.

Why do we Dream?Why do we Dream? Brain probably utilises dreams and REM-sleep to Brain probably utilises dreams and REM-sleep to

sift through memories and to erase irrelevant sift through memories and to erase irrelevant memories. New associations between memories memories. New associations between memories and ideas are tested and in this manner creative and ideas are tested and in this manner creative impulses and solutions to problems may appear.impulses and solutions to problems may appear.

Dreams help people Dreams help people to to phantasize about phantasize about matters, matters, which they which they would allow would allow into their into their consciousness during consciousness during

a waking state – a waking state – including sex. including sex.

DreamsDreams

Dreams are Dreams are sometimes repeatedsometimes repeated

People nowadays People nowadays dream in full colourdream in full colour

People with a People with a vitamin B-complex vitamin B-complex deficiency forget deficiency forget their dreams more their dreams more easily than otherseasily than others

Dreams About LossesDreams About Losses

If a loss was traumatic If a loss was traumatic it resurfaces in dreams it resurfaces in dreams – often repeatedly– often repeatedly

Dreams about deceased Dreams about deceased loved ones may still loved ones may still happen years after the happen years after the eventevent

NightmaresNightmares Dreams with a strong Dreams with a strong

unpleasant emotional content unpleasant emotional content – mainly anxiety and fear – mainly anxiety and fear

Deal mainly with danger, Deal mainly with danger, pain, bad experiences or pain, bad experiences or death death

Sometimes caused by heavy Sometimes caused by heavy meals shortly before bed-meals shortly before bed-timetime

Might be a symptom of Might be a symptom of PTSDPTSD

3. SLEEP DISORDERS3. SLEEP DISORDERS

Sleep apneaSleep apnea BruxismBruxism SomnabulismSomnabulism Restless leg Restless leg

syndromesyndrome NarcolepsyNarcolepsy

Sleep ApneaSleep Apnea

A chronic ailment, which A chronic ailment, which causes the sleeping causes the sleeping person to stop breathing person to stop breathing for periods of 10 seconds for periods of 10 seconds or longer and which may or longer and which may occur frequently during occur frequently during the night, disrupting the night, disrupting sleep sleep

The person stays drowsy The person stays drowsy and may fall asleep on and may fall asleep on inappropriate timesinappropriate times

BruxismBruxism

Somebody with this Somebody with this disorder gnashes and disorder gnashes and bites on his teeth bites on his teeth during sleep; this may during sleep; this may cause broken teethcause broken teeth

The reason seems to The reason seems to be excessive stressbe excessive stress

SomnabulismSomnabulism

Mostly children & Mostly children & adolescentsadolescents

During deep sleepDuring deep sleep Sometimes talking in Sometimes talking in

sleepsleep No recollection No recollection

afterwardsafterwards Accidents might happenAccidents might happen

Restless Leg SyndromeRestless Leg Syndrome Mostly in elderly peopleMostly in elderly people Person feels irritating tingling in legs when Person feels irritating tingling in legs when

lying down and has an overpowering urge lying down and has an overpowering urge to move the legs and/or walk aroundto move the legs and/or walk around

Due to iron deficiencyDue to iron deficiency Caused by certain Caused by certain

medications or drug medications or drug withdrawal withdrawal Interferes with sleepInterferes with sleep

NarcolepsyNarcolepsy A neurological disorder; may cause the A neurological disorder; may cause the

person to fall asleep without warning – person to fall asleep without warning – often in inappropriate or even dangerous often in inappropriate or even dangerous situations situations

Takes anything between a few seconds and Takes anything between a few seconds and half-an-hour half-an-hour

May be inherited or May be inherited or result of result of head injurieshead injuries

4. INSOMNIA4. INSOMNIA DescriptionDescription CausesCauses EffectsEffects

Description of InsomniaDescription of Insomnia

Sleep disorder: inability to fall asleep or to Sleep disorder: inability to fall asleep or to sleep long enoughsleep long enough

Insomnia – Possible CausesInsomnia – Possible Causes StressStress DepressionDepression PTSDPTSD Blood sugar imbalanceBlood sugar imbalance CaffeineCaffeine AlcoholAlcohol Drugs & medicineDrugs & medicine Sickness & painSickness & pain Poor sleeping habitsPoor sleeping habits Sleeping disordersSleeping disorders

StressStress Stress caused by unhappy relationships, bad Stress caused by unhappy relationships, bad

working conditions and financial worries working conditions and financial worries cause feelings such as anxiety, fear and cause feelings such as anxiety, fear and uncertaintyuncertainty

These may keep you awake at nightThese may keep you awake at night

DepressionDepression Depression is usually caused by –Depression is usually caused by –

An inherited tendency; andAn inherited tendency; and An overdose of stress and/or a An overdose of stress and/or a

big lossbig loss Depression is mostly accompanied Depression is mostly accompanied

by a deficiency of the brain by a deficiency of the brain chemical serotoninchemical serotonin

Serotonin is used to manufacture Serotonin is used to manufacture melatonin, which causes people to melatonin, which causes people to sleepsleep

Post-Traumatic Stress DisorderPost-Traumatic Stress Disorder

PTSD is caused by the shock PTSD is caused by the shock of a life-threatening eventof a life-threatening event

The memory is stored in the The memory is stored in the emotional part of the brain emotional part of the brain

These memories cannot be These memories cannot be switched offswitched off

Characterised by flash-backs, Characterised by flash-backs, nightmares and sleeplessnessnightmares and sleeplessness

Blood Sugar ImbalanceBlood Sugar Imbalance

Excessive blood sugar levels keep you Excessive blood sugar levels keep you awakeawake

Too low blood sugar causes the stress Too low blood sugar causes the stress hormone cortisol to be released and may hormone cortisol to be released and may keep you awakekeep you awake

Low blood sugar Low blood sugar makes you feel makes you feel hungry hungry and keeps and keeps you you awakeawake

CaffeineCaffeine

Caffeine is a stimulant and tends to keep Caffeine is a stimulant and tends to keep you awakeyou awake

If you drink coffee or tea or eat chocolate If you drink coffee or tea or eat chocolate shortly before bed-time, you will struggle to shortly before bed-time, you will struggle to fall asleepfall asleep

AlcoholAlcohol

If you drank a large amount If you drank a large amount of alcohol, you may fall into of alcohol, you may fall into a stupor – without getting a stupor – without getting healthy deep sleephealthy deep sleep

If you drank less alcohol, it If you drank less alcohol, it may act as a stimulant after may act as a stimulant after a while and keep you awake, a while and keep you awake, due to elevated blood sugar due to elevated blood sugar levelslevels

Drugs and MedicineDrugs and Medicine

Drugs and medicine may Drugs and medicine may mess with your brain mess with your brain chemistry and may cause chemistry and may cause insomniainsomnia

If you have been using If you have been using drugs (including sleeping drugs (including sleeping pills) and discontinue pills) and discontinue them, you will experience them, you will experience withdrawal symptoms – withdrawal symptoms – keeping you awakekeeping you awake

Sickness and PainSickness and Pain

Fever, physical discomfort, pain, high blood Fever, physical discomfort, pain, high blood pressure and other ailments may chase your pressure and other ailments may chase your sleep awaysleep away

Poor Sleeping HabitsPoor Sleeping Habits

Going to bed at irregular times (e g shift Going to bed at irregular times (e g shift workers) interferes with your biological workers) interferes with your biological clock and mess with your sleeping patternsclock and mess with your sleeping patterns

Effects of InsomniaEffects of Insomnia

TirednessTiredness Lack of concentrationLack of concentration AccidentsAccidents Your brain may shrinkYour brain may shrink Immune system Immune system

impaired impaired Diabetes or heart diseaseDiabetes or heart disease ObesityObesity Depression & bipolar Depression & bipolar

disorderdisorder

Effects of InsomniaEffects of Insomnia

Keeping somebody Keeping somebody awake is a cruel torture awake is a cruel torture methodmethod

The use of sleeping pills The use of sleeping pills may shorten your lifemay shorten your life

Children who sleep too Children who sleep too little may have serious little may have serious behavioral problemsbehavioral problems

5. CURING INSOMNIA5. CURING INSOMNIA

Identify the causeIdentify the cause Restore the chemical balance in your brainRestore the chemical balance in your brain Practice sensible Practice sensible

sleeping habitssleeping habits

Identify the CauseIdentify the Cause Is your insomnia due to stress, a sleep Is your insomnia due to stress, a sleep

disorder, a psychological disorder, illness, disorder, a psychological disorder, illness, pain, drugs, caffeine or blood sugar pain, drugs, caffeine or blood sugar problems?problems?

Eliminate the Eliminate the problem – problem – on on your own or with your own or with

the help of the help of a doctor or a doctor or

psychologist psychologist

Correcting the Brain ChemistryCorrecting the Brain Chemistry Get weaned from your sleeping pillsGet weaned from your sleeping pills Use Melatonin or GABA to restore Use Melatonin or GABA to restore

sleeping patternssleeping patterns Use 5-HTP to fight depressionUse 5-HTP to fight depression Supplement with vitamins Supplement with vitamins

& minerals – especially & minerals – especially vitamin B complex & vitamin B complex & magnesiummagnesium

Psychotherapy to Psychotherapy to overcome personal problemsovercome personal problems

Correcting the Brain ChemistryCorrecting the Brain Chemistry

Avoid coffee, tea, chocolates and alcohol Avoid coffee, tea, chocolates and alcohol before bed-timebefore bed-time

It helps to drink a glass of warm milk It helps to drink a glass of warm milk before bed-time, together with a before bed-time, together with a carbohydrate snackcarbohydrate snack

Correcting the Brain ChemistryCorrecting the Brain Chemistry

Eat healthy – fresh Eat healthy – fresh fruit & veggies, fibre fruit & veggies, fibre & drink lots of clean & drink lots of clean waterwater

Take 3 main meals Take 3 main meals and 2 snacks during and 2 snacks during the daythe day

Avoid heartburnAvoid heartburn

Good Sleeping HabitsGood Sleeping Habits

Sleep on a Sleep on a comfortable bed comfortable bed (not too hard or too (not too hard or too soft)soft)

Sleep with a Sleep with a comfortable pillowcomfortable pillow


Your bedroom should be – Your bedroom should be – QuietQuiet DarkDark Not too hot or coldNot too hot or cold Well ventilatedWell ventilated


Keep a strict routine – always go to bed at Keep a strict routine – always go to bed at the same time and wake up at the same timethe same time and wake up at the same time

Keep your Keep your biological clock biological clock in correct in correct working working orderorder


Get sunshine – to help your biological clock Get sunshine – to help your biological clock operate normallyoperate normally


Get EXERCISE –Get EXERCISE – To make you tired To make you tired

and relaxedand relaxed To produce To produce

endorphins, which endorphins, which help you unwindhelp you unwind

Good Sleeping HabitsGood Sleeping Habits Do not use your bedroom for workDo not use your bedroom for work Use your bedroom only for sleep, getting Use your bedroom only for sleep, getting

dressed and making lovedressed and making love Read something relaxing after getting into bed Read something relaxing after getting into bed

to shut down your brainto shut down your brain Get rid of a snoring Get rid of a snoring partner partner


Do not roll around in your bed if you cannot Do not roll around in your bed if you cannot sleep – you will only get agitatedsleep – you will only get agitated

Get up and do something relaxing – read Get up and do something relaxing – read something, watch TV &tcsomething, watch TV &tc

Get back into bed as Get back into bed as soon as soon as you feel drowsyyou feel drowsy

Documents

WELCOME! The Strandfontein Depression and Related Disorders Support Group extends a friendly welcome to you at its monthly meeting 20 May 2013