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Light Sleeping

07/06/2005

Question:

Hello, I am writing on behalf of my girlfriend. She is a very light sleeper. She is often up at nights, to go to the bathroom, or easily awaken by small noises. Then on weekends, she sleeps all day, and the sleep is not much different, but she needs the sleep to function well. What can she do to get better sleep? Remembering that she has been like this since childhood. Also, I don`t know if it`s related, but she has very few bowel movements per week, perhaps 3-4 movements per week, only.

Answer:

Being a “light sleeper” can mean different things to different people and often depends upon one’s own view of just what a “good night’s sleep” is. For example, as we age, it is normal for our sleep patterns to change and we generally become easier to awaken from sleep. However, this does not mean that our sleep is less restful or that we should require more sleep to feel refreshed as we grow older. In contrast, someone who is easy to awaken at night and feels chronic sleepy may have an underlying sleep disorder that needs to be addressed.

Awakening frequently at night can result from a number of different causes. Probably the most common are a long list of factors or conditions that may fragment or disrupt sleep. These can include a poor sleep environment (too noisy, too hot, uncomfortable bed), primary sleep disorders (sleep apnea, periodic limb movement disorder), medical conditions (heartburn, pain, breathing difficulties, diabetes, urinary problems, thyroid disorders, etc.), psychiatric conditions (depression, anxiety), medications, and substance abuse (especially alcohol or nicotine use). Being easy to arouse from sleep may also signify a lack of slow-wave or deep sleep. This type of sleep, which makes up a majority of young children’s sleep but decreases in amount with aging, is usually the time when we are most difficult to awaken. Deep sleep typically occurs in the first 1/3 to 1/2 of the night. It may be reduced or absent due to underlying sleep problems that prevent getting into deep sleep, certain medications, or substance abuse.

The fact that your girlfriend doesn’t sleep well during the week but then sleeps excessively on the weekends also suggests that there may be some problems with insufficient sleep (lack of adequate sleep) during weeknights. Not getting enough sleep chronically is a bad habit to develop and may lead to fatigue, irritability, and even weight gain. Most individuals require around 7-8 hours of sleep per night to function at their best and feel well. The differences you note between her weeknight and weekend sleep could also suggest a circadian rhythm disorder, a problem where her body’s internal rhythms (or biologic clock) are not in synchrony with her life style. This type of problem can also create symptoms of feeling poorly, chronic fatigue, and mood changes.

Given the numerous possibilities mentioned above, your girlfriend would be best served by speaking to her physician about her problems. A thorough history and examination should be performed and possible referral to Sleep Medicine Specialist may be required. Additional testing may be necessary, depending upon the results of the initial evaluation.

In the meantime, it would be reasonable for her to try to practice these simple measures to help her improve her sleep:

  • Maintain a regular wake time, even on days off work and on weekends.
  • Try to go bed only when you are drowsy.
  • Keep a regular schedule. Regular times for meals, medications, chores and other activities help keep the inner clock running smoothly.
  • Avoid napping during the daytime. If you do nap, try to do so at the same time every day and for no more than one hour. Mid-afternoon (no later than 3 PM) is best for most people.
  • Do not spend excessive amounts of time in bed. Use your bed only for sleep, intimacy, and times of illness.
  • A relaxing pre-sleep ritual such as a warm bath, light bedtime snack, or 10 minutes of reading may help. Avoid heavy meals before bedtime.
  • Try to exercise regularly. Vigorous exercise should be limited to earlier in the day, at least six hours before bedtime. Mild exercise should be done no more than 4 hours before bedtime.
  • Avoid ingestion of caffeine within 6 hours per day. “Reasonable” caffeine consumption is considered to be the equivalent of about 1-2 cups of coffee per day.
  • Do not drink alcohol when sleepy. Even a small dose of alcohol can have a significant effect when combined with tiredness and alcohol tends to cause sleep disruption after the first few hours of sleep. Do not drink alcohol while taking sleeping pills or other medications.
  • Avoid the use of nicotine close to bedtime or during the night.

If you would like additional information regarding sleep and sleep disorders, you can obtain it on the American Academy of Sleep Medicine website.  This website also contains a list of Sleep Centers across the country so you can locate one near you if need be. Good luck and here’s to better sleep!

For more information:

Go to the Sleep Disorders health topic.