| Q: |
Why can caffeine make sleeping difficult?
|
| A: |
Caffeine is a stimulant found in coffee, tea, cocoa, and
chocolate, and is an additive in many soft drinks and drugs. It keeps
you alert and on the go. Some people are more sensitive to it than
others. Caffeine blocks the action of adenosine and reduces its sleep-inducing effects in the brain. Caffeine reduces
total sleep time and also reduces the amount of slow wave sleep.
|
| Q: |
How can I cut down on my caffeine intake?
|
| A: |
Caffeine enters the bloodstream within 15 minutes of ingestion
(for example, drinking a cup of coffee) and shows peak blood levels
between 30–60 minutes. To eliminate half the concentration of caffeine
in blood takes about 3–5 hours. If you are having difficulty sleeping,
cut down on your caffeine intake. Try not to drink any products
containing caffeine 4–6 hours before going to bed.
|
| Q: |
I’m a smoker. What effect does nicotine have on my ability to sleep?
|
| A: |
Like caffeine, nicotine is a stimulant. Nicotine withdrawal can
occur in heavy smokers once they have gone to bed, and may lead to sleep
disruption and nightmares. Generally, it is best to smoke the last
cigarette at least half an hour before going to bed to avoid the
stimulating effect of nicotine.
|
| Q: |
What effect does alcohol have on sleep?
|
| A: |
Alcohol may make you feel sleepy initially. Larger quantities
lead to increased slow wave sleep and suppression of REM sleep early in
the night. Later on, a rebound increase in REM sleep can occur as well
as more wakenings. This results in unrefreshing sleep. Try to restrict
your last alcohol intake to your evening meal.
|
The effect of drugs on sleep
Many drugs affect the
quality and quantity of sleep we experience, and it is important to be
aware of those that are fairly commonly prescribed. Sleeping pills of
the benzodiazepine class can suppress slow wave sleep. Many
antidepressants can lead to a reduction in REM sleep and some may induce
either insomnia or excessive sleepiness. Drug withdrawal can cause a
rebound increase in the stage of sleep that was previously suppressed
and lead to sleep disturbances. Marijuana in the immediate short term
results in minimal sleep disruption with only a slight reduction in REM
sleep. Chronic ingestion produces long-term suppression of slow wave
sleep. Amphetamines, cocaine, and even drugs used in decongestant
mixtures and “sinus relief” tablets, such as pseudoephedrine, can lead
to insomnia and significant sleep disturbances.
Table
| Drug | Effect on sleep |
|---|
|
Alcohol
| Suppresses REM sleep; increases frequency of wakenings. |
|
Beta-blockers
| Suppress REM sleep; can cause nightmares and increase daytime sleepiness. |
|
Benzodiazepines
| Decrease slow wave sleep; can lead to daytime drowsiness, and memory and mood impairment. |
|
Fluoxetine
| Affects REM sleep and can cause insomnia. |
|
Phenytoin
| Suppresses REM sleep and increases sleepiness. |
|
Pseudoephedrine
| Can cause insomnia and sleep disturbances. |
|
Salbutamol
| Can cause insomnia; improves sleep if asthma is controlled. |
|
Steroids
| Can cause sleep disruption and insomnia. |
|
Simvastatin
| Can lead to insomnia. |
|
Theophylline
| Increases light sleep; can result in sleep disturbances and insomnia. |
