In consideration of sleep….

In a way what I’m about to write is more a book review because everything I’m going to point you to are things that struck me while reading Matthew Walker’s exceptional book ‘Why We Sleep’

In an article on self care I recently quoted Walker saying….“Routinely sleeping less than six or seven hours a night demolishes your immune system, more than doubling your risk of cancer. Insufficient sleep is a key lifestyle factor determining whether or not you develop Alzheimer’s disease. Inadequate sleep – even moderate reduction for just one week – disrupts blood sugar levels so profoundly that you would be classified as pre-diabetic…” and the list goes on [from Matthew Walker’s ‘Why We Sleep’ (Page 3)]

When I quoted this I was thinking mainly about how social workers manage themselves away from work in order to maintain a healthy lifestyle in order to improve their ability to, well, live! But more than that how to be productive as social workers, husbands, wives, parents etc etc….

But it got me thinking about sleep and the impact on adults who become users of social services and I pondered, in the myriad of things we ask people about, how often do we ask about sleep. Maybe we do? I worked with older people so I would routinely ask about how well they were sleeping but I don’t think I ever really did anything with this or considered it’s impact. Nothing at least beyond suggesting a trip to the doctor. And Walker would probably say to me that that might be the worst thing to suggest as doctors are quite prone to reach for the sleeping pills to resolve such an issue. And as Walker talks about in his book sleeping pills do not promote the right sort of sleep. They promote (and he puts it much more eloquently than I will here… and in more detail) a medical cosh that doesn’t in anyway reflect the right quality of sleep we require.

Walker suggests (p.148) that lack of sleep doesn’t necessarily throw us into a negative mood state but may well lead to a sea-saw of emotions. He points out that any extremity of emotion, positive or negative, can be dangerous. He points out that depression can lead to feelings of worthlessness and a questioning of the value of ones life. I wonder how often when working with someone with depression we truly understand the impact of lack of sleep. He states that “studies of adolescents have identified a link between sleep disruption and suicidal thoughts, suicide attempts, and, tragically, suicide completion in the days after” (p.148). He also links insufficient sleep to violent acts in children across the age range and within the adult prison population.

Psychiatrist, Walker says, has always considered that sleep disruption is a consequence of mental illness rather than exploring whether it is actually a factor, or the factor, causing it (p.149).

In relation to older generations and thinking about my particular area of interest dementia Walker points out that “lack of sleep is fast becoming recognised as a key lifestyle factor determining whether or not you will develop Alzheimer’s disease” (p. 157). He explains that deep sleep deteriorates with age and a lack of this type of sleep is linked to a decline in memory. He notes that poor sleep often precedes the onset of Alzheimers but this isn’t often picked up. To compound the problem he says that 60 percent of patients with Alzheimers have at least one clinical sleep disorder with insomnia being particularly common. Note also that this will have an impact on the care giver in terms of the quality of their sleep with all of the negative impact on health that goes with that (p.158).

I would definitely recommend his book in terms of both your own self care and thinking about the care of others. It is illuminating, fascinating, and a real call to arms with regard to improving sleep quality.

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