Why did you specialise in this subject?
I’ve always been fascinated by what occurs in sleep since I was a student at the Nelson R Mandela School of Medicine in South Africa. I did my research fellowship in sleep in 1992 in Canada and qualified as a specialist neuropsychiatrist in the UK. Most patients I saw had some issue related to sleep, so I decided to make it my life’s work to improve my patients’ sleep problems, as I believe psychological and physical health are intimately related to the amount and quality of sleep we get.
It’s said that a third of the population experiences sleep problems at some point...
It’s true. But this doesn’t mean that one-third of the population has a sleep disorder. Generally, about 12-20 per cent suffer from insomnia. Around 7-15 per cent have disturbed sleep due to neurological or neuropsychiatric disorders, while over 10 per cent have occupational sleep disorders.
If someone has not been feeling well rested after a full night’s sleep for a long time, should they consult a sleep doctor?
There are two elements in establishing whether one has a potential sleep disorder. One is sleep quantity – the amount of sleep they’re getting. The other is quality – whether there’s an underlying cause affecting their sleep despite enough of it. If you’re sleeping enough and are still tired, or feel exhausted when you wake up, then check your sleep environment – whether the temperature, ventilation and sound is conducive to sleeping normally.
But the most vital question is whether you are leading a healthy life. If your environment and lifestyle are optimum then, yes, you should consult a sleep doctor.
Does sleep medication help?
Using medication to assist with sleep is only one part of the treatment. I believe that medication should be used as a means to an end and not be an end in itself. I usually prescribe a short course to help the person get a guaranteed night’s sleep, and once he or she has been sleeping well for a couple of weeks, start them on sleep retraining or cognitive behavioural therapy, which is a proven treatment for insomnia.
The first step is to identify the causes of insomnia. Patients’ sleep patterns are evaluated, taking into account all factors that may be affecting their ability to sleep. This includes keeping a sleep diary for a couple weeks. It helps identify habits of thinking and stress that may be contributing to insomnia.
After identifying the causes, the person begins therapy, which includes stimulus control, sleep hygiene, sleep restriction, relaxation training and cognitive therapy.
How do exercise habits affect sleep? Is it OK to work out in the evening?
It is always best to exercise in the morning. Exercise is very good for sleep and increases the amount of deep sleep we get, which helps to build and restore the body.
Does what and when we eat affect sleep?
Diet is intricately linked to sleep and is now becoming a focus of research. While we know that some foods can aid sleep (simple carbs can assist with sleep onset in the evening) and others cause harm (caffeine can cause insomnia), there is a lack of real knowledge about this aspect.
Any tips to make falling asleep easier?
Keep your room well-ventilated, the temperature from 20-23°C and dark at night.
Give us pointers on improving sleep quality.Try to go to bed and get up about the same time each night and morning.
Make sure the time you set for your bedtime is a time when you are sleepy. Do not go to bed too soon – you may have trouble falling asleep or your sleep may be restless.
Do not nap. Napping can disrupt normal sleep cycles. Try skipping it and see if your regular sleep patterns improve.
Make sure your bedroom is quiet – do not watch television there. Reading is fine.
Establish relaxing-before-bed routines – take a bath, drink a glass of warm milk, or do some light reading.
Develop relaxation techniques, such as yoga, deep breathing, quiet meditation or listening to soft music while trying to sleep.
Avoid troubling news right before bed. Violence in newspapers or on television may make it difficult to fall asleep.
Avoid stimulants. Do not drink anything that contains caffeine (tea, coffee, cola) six hours before bedtime.
Exercise regularly, but be sure to avoid vigorous activity right before bedtime.