Wakey wakey… Coping with sleep deprivation

17 Jan

Greetings faithful reader. Let’s play a little game I like to call “Have you ever…?” Have you ever loaded up the car, put the keys in the ignition ready to head out for a play date only to realise that your most precious cargo is still in his cot inside the house? Have you ever hurled abuse at your life partner for hiding the TV remote only to open your handbag and find said remote sitting in the compartment that normally houses your mobile phone? Have you ever stared blankly at a pregnant customer asking for a headache tablet that is safe for her to use? You know that there is some sort of medication she can take; you think it might start with a ‘p’. What’s it called again? Have you ever had an entire conversation with Janet from your mother’s group only to walk away and remember that her name is actually Sarah, you do Pilates together and she in fact has no children? If you answered yes to any of these questions then you are either a few letters short of an alphabet, or more likely you’re a few z’s short of a decent sleep.

Everyone warns you, but no one can truly prepare you for the reality of postnatal sleep deprivation. Having suffered from insomnia for most of my adult life I thought the sleepless nights with a newborn would be a breeze. Sleep deprivation, or the reduced length of sleep due to an externally imposed restriction of the opportunity to sleep, was a whole new ballgame. Many people say that sleep deprivation is like torture. I’m here to tell these people that they are mistaken. Sleep deprivation is not like torture, it is torture – a tactic favoured by the KGB and the Japanese in PoW camps during World War Two. While I’m fairly sure Boy Wonder isn’t working for the Mossad or CIA, his recent night-time activities have transformed me into a perpetually exhausted zombielike being. So why is sleep so important?

As human beings we spend one third of our lives sleeping. The consequences of not getting enough sleep are pretty clear. If you’ve ever pulled an all-nighter or had to deal with a screaming baby at all hours, you would be familiar with these consequences – forgetfulness, grogginess, grumpiness and reduced awareness. As mother Fiona Sugden wrote in a recent post on Mama Mia, “It is a first world problem, but long-term sleep deprivation can be a serious one for many people.” Losing sleep affects mental agility and response time. Studies show that chronic sleep deprivation leads to a decrease in performance equivalent to a blood alcohol level of 0.05%. The Chernobyl nuclear accident, the Exxon Valdez oil spill and the Challenger space shuttle disaster have all been attributed to human errors in which sleep-deprivation played a role. While raising a child may not be the same as running a nuclear power plant, trying to operate a child while sleep deprived is not without its own dangers.

A new baby typically results in 400-750 hours of lost sleep for parents in the first year. While there isn’t much you can do to change the quantity of sleep you get, it is possible to manage the quality of sleep you get. Here are a few things you can do to improve your sleep.

1. Listen to your body

Most bodily processes including the sleep-wake cycle are controlled by an internal ‘clock’ within the brain. To get quality sleep you need to obey your clock.

  • Don’t ignore tiredness. If you find yourself falling asleep on the couch or in the rocking chair in your baby’s nursery, GO TO BED.
  • Create a relaxing bedtime routine. Once you’ve established a regular bedtime routine for your baby, do the same for yourself. About an hour before bed, turn off the TV and put aside the work you’ve brought home. Make a cup of herbal tea or warm milk, take a warm bath, curl up with a good book, anything as long as it is relaxing.
  • Don’t force yourself to fall asleep if you’re not ready. If you haven’t fallen asleep after 30 minutes, get up, go to another room and listen to some soothing music or read until you feel sleepy.
  • Get enough early morning sunshine. Exposure to light during early waking hours helps to set your body clock.

2. Make your bedroom more inviting

Quality sleep is more likely if your bedroom is a restful and comfortable place.

  • Keep your bedroom at a comfortable temperature. To drop off we must cool off, which is why those hot summer nights can cause a bad night’s sleep.
  • Block out light and noise which can wake you from a light sleep. If noise is a problem, consider purchasing a sound machine or even just a pair of earplugs. Don’t worry, you will still hear your baby. Parents are hardwired to hear their offspring’s cries.
  • Use your bed only for sleep and sex. If you are in the habit of paying bills or watching TV in bed, stop. You should associate your bed only with bedtime activities. Remember: Try to clear your mind; don’t use bedtime to solve your daily problems.

3. Just say no!

Some people resort to medications or ‘social drugs’ in the mistaken belief that sleep will be more likely. Here’s why you should just say no:

  • A cup of coffee or a cigarette in the afternoon can delay sleep onset even hours later, and more than a couple of standard drinks may make your sleep more restless. Don’t forget that caffeine may also be found in chocolate, soft drinks, and various medications.
  • Sleeping pills may also be more of a hindrance than help. They may cause daytime sleepiness, and may also have a ‘rebound’ effect whereby falling asleep without them tends to be even harder.

4. Relaaaxxx

Stress often reduces sleep quality.

  • If random thoughts are keeping you awake, keep a notepad by your bed so that you have a place to unload them until the morning.
  • Move your body with some exercise during the day, making sure to finish up at least three hours before going to bed.
  • Give relaxation exercises such as yoga, progressive muscle relaxation and deep breathing a try. Baby Centre has a great article on relaxation techniques for parents.

5. Miscellaneous suggestions

A few more handy hints include:

  • Avoiding heavy meals close to bedtime.
  • Snoozing for a maximum of 15- to 20-minutes during the day to help improve alertness, sharpen the mind and generally reduce the symptoms of fatigue.
  • Turning your clock to face the wall to prevent you from counting the minutes you are still awake.
  • Reminding yourself that this phase of your life will pass and that one day soon you will experience uninterrupted sleep once more.

Well, it’s time to practice what I preach, shut down the old computer and lie down on that thing with the mattress where you sleep. What’s it called again?

12 Responses to “Wakey wakey… Coping with sleep deprivation”

  1. Colline January 17, 2012 at 12:28 pm #

    What helped me a lot when I had a newborn and a 1 year old was sleeping whenever I could. I would try co-ordinate their daytime naps during the day so that they would sleep at the same time. And then I would sleep with them. The 45 minutes went a long way towards helping me catch up on my sleep.

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  2. Tal Riff January 17, 2012 at 3:10 pm #

    Love your blog! So, so true. Sleep deprivation has been torture for me throughout this pregnancy, resulting in me having multiple breakdowns at work, at the doctor’s office, with my husband and my poor mom. And so I’ve decided to go on mat leave way sooner than I anticipated. Will it help me with what’s to come once baby arrives? I don’t know… I hear that’s a whole other type of exhaustion! Thanks for the tips. 😉

    Like

    • Ren Rubinstein @ PharmaMama.net January 17, 2012 at 10:37 pm #

      Thanks so much Tal. I too started my maternity leave earlier than anticipated. It was absolutely worth it for me. I spent so much time relaxing, sleeping, going to the movies, seeing friends, just doing all the things I knew I may not have a chance to do once bub arrived. These weeks are pretty much going to be the last time in a long time that you can make everything about you so enjoy and rest up!

      Like

  3. David Solomon January 18, 2012 at 6:20 am #

    Just brilliant advise!!

    Like

  4. dj January 18, 2012 at 6:24 am #

    wonderful blog

    Like

  5. bizbriefs January 23, 2012 at 12:02 am #

    So hard to remember what the term “caught up on sleep!” ever really meant. However, I do manage at least a 90-minute nap with Maddie about 6 days a week! Lucky me!

    Like

  6. An Honest Mom January 25, 2012 at 3:45 am #

    Thanks for this great list of tips. I’m working towards my doula certification and doing some video projects with new mothers, so I’ll definitely send them here. Tapping your pharma knowledge: at what point do you think its time to bring in the big pharma guns? I had a complete downfall in month 5 and swear by the Ambien I started taking (as well as finally asking for help and going on Zoloft for my depression). I often recommend that moms who are acutely exhausted should talk to their doctors about a prescription…
    So what do you think? And why Ambien?

    Like

    • Ren Rubinstein @ PharmaMama.net January 26, 2012 at 6:20 am #

      Thanks so much for the feedback.

      When it comes to bringing in the big guns, it really becomes a risk/benefit analysis between doctor and patient. It’s a question I am asked often by my patients and by fellow mums and there is no correct answer. According to the Australian Therapeutic Guidelines, pharmacological treatment may be indicated for the short-term management of acute insomnia, and for chronic insomnia. This is the recommendation only when nonpharmacological strategies such as those described in my article are not effective.

      I absolutely agree that parents who are acutely exhausted go talk to their doctors about management options. As described in my article there are many non-drug ways to treat sleep deprivation and insomnia and as a pharmacist it is my responsibility to guide my patients through these methods. Sometimes non-drug methods do not work for whatever reason, and this is where a discussion between patient and doctor is warranted.

      If a sleeping pill is prescribed, it may either be a benzodiazepine or a non-benzodiazepine drug such as zolpidem (trade name Ambien or Stilnox). Compared with benzodiazepines, zolpidem generally causes less morning sedation and has less disruptive effect on normal sleep patterns. The duration of therapy should be for the shortest time possible, preferably intermittently and for less than two weeks. Also, before starting treatment you should understand the limitations and potential problems of these medications, including the risk of tolerance and dependence with long-term use.

      Like

  7. catherine333 January 27, 2012 at 3:09 pm #

    Brilliant post. Thank you!

    Like

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