Busy schedules and long working hours is what defines most people’s lifestyle. Even at the end of the long day, many retire home with worries and thoughts of unfinished work. The result of this is sleepless nights.

However, lack of good sleep is a health problem with far-reaching consequences. The body requires good sleep to function well.

According to Gerald Ruzindana, a naturopathic doctor at Amazon Complementary Therapy in Remera, Kigali, explains that this is because the body gets tired after work and needs time to rest to be able to perform better the following day.

However, if one disturbs their mental being, it affects the general body functioning, including specific glands that are supposed to be in balance to induce good sleep.

Ruzindana adds that the reason people’s behaviour affects sleeping patterns is because the melatonin hormone, which is secreted from the brain to sustain or give sleep, is mostly stimulated in darkness.

"If one doesn’t find a nice environment that favours sleep, they will not get sleep,” he says.

For example, Ruzindana says leaving the lights on, or even using different gadgets such as a phone or computer while in bed, is another reason that causes sleeping disorders.

"One can sleep during the night and during daytime depending on one’s schedule. All that is needed is to know what to do to sustain good sleep,” he adds.

Factors that hinder sleep

Prof Joseph Mucumbisti, a pediatrician and president of Rwanda Heart Foundation, explains that there are various factors that can hinder sleep, such as psychological factors relating to particular diseases, including non-communicable diseases like diabetes and hypertension.

For one to revert to a normal routine of sleeping, he says, correcting such problems is the way forward.

"First, ruling out the collative factors can help solve the situation if one has certain problems. This makes it easier for such people to get help as far as sleeping is concerned,” he says.

Mucumbisti notes that consulting the right expert to correct problems such as high blood pressure, managing sugar levels and taking medication as prescribed by a physician is always important, are helpful in handling sleeping disorders.

However, Ruzindana points out that there are certain factors that are physiological. These are to do with other disorders relating to stress, anxiety as well as body trauma. Here, he says, psychological adjustment is all that is needed to rectify the situation.

Charles Mudenge, a psychiatrist at University Teaching Hospital, Kigali (CHUK) in Butare, says before treating any kind of sleeping disorders, first establish the real cause.

"The best approach is to understand the different problems one may be having. The way one is helped, therefore, differs depending on their issues,” he says.

Mudenge notes that when one is having sleeping disorders, it affects their general wellbeing.

He says, for instance, one is likely to experience frequent headaches and dizziness due to lack of sleep. "This compromises performance at work.”

Therefore, Mudenge advises that one should seek medical attention whenever they experience sleeping disorders, and should not resort to any remedy without first visiting a specialist to know the real cause.

Rachna Pande, an internal medicine specialist, says other factors that can bring about sleeping disorders include bed-wetting or nocturnal frequencies of urination.

"All these can be brought about due to underlying medical disorders, but also exist as a primary condition. Childhood traumatic experience like domestic disputes among elders and child abuse can also result in sleeping disorders,” she says.

Types of sleeping disorders

Pande notes that common sleep disorders are insomnia, which is lack of sleep or disturbed sleep; hypersomnia, excess sleeping; and narcolepsy, a rare disorder where a person falls asleep at an inappropriate time and place, in other words, a condition where one has no control over their sleep.

She explains that loss of muscle tone or temporary paralysis accompanies excess sleeping.

In obstructive sleep apnoea, Pande says sleep is disturbed due to upper airways being obstructed causing snoring, while somnambulism, on the other hand, is another disorder which is walking while asleep (sleep walking).

Insomnia is the most common sleep disorder, says Ian Shyaka, a general practitioner at Rwanda Military Hospital, Kanombe.

He notes that while almost everyone has an occasional night of poor sleep, approximately 10 per cent of adults have chronic insomnia, and it’s more common in women.

Common symptoms of insomnia, he says include difficulty falling asleep or staying asleep, variable sleep such as several nights of poor sleep followed by a night of better sleep, daytime fatigue or sleepiness, forgetfulness, poor concentration, irritability, anxiety, depression, reduced motivation or energy, increased errors or accidents and ongoing worry about sleep.

"People with insomnia have an impaired sense of sleep that may be related to a problem with the body’s sleep-arousal system, which normally helps you feel awake after sleeping and feel tired before going to bed,” Shyaka adds.

He however, explains that one consequence of poor sleep is that one becomes concerned about sleep-deprivation and suffers from more sleep loss.

"This concern may grow as one is unable to sleep, which in turn makes it increasingly difficult to fall asleep,” he says.

Remedies

Mucumbisti says different types of therapies are ideal in restoring or maintaining good sleep. Physical-related therapies are healthy for people who are stressed.

"Depending on one’s needs, giving them the right exercise and therapies is important. For instance, people who are overweight need to be given exercises that will not affect them so that with time they can feel better,” he says.

To avoid sleeping disorders, Mucumbisti says general body wellness is important. Different forms of relaxation such as going to a sauna, doing yoga, getting a massage or reflexology, among others, promote relaxation, which fosters good sleep.

"When tired and stressed at the same time, one can spend more than two days without sleeping. This is more common where people have gadgets such as phones or computers in their room,” says Ruzindana.

He adds that spending time in bars drinking or even reading can affect sleep.

On the other hand, Ruzindana points out that exercises help in refreshing the body, enabling it to become less tense.

He says massage eases tension and relaxes the muscles, which in turn regain their elasticity and ensures good sleep. "Basic physical exercises like walking, swimming, cycling and jogging are also important.”

Benefits of sleep

Pande says hours of sleeping vary from person to person, depending on one’s daily routine, meal time, sleep-wake habits, presence or absence of stress, but on an average 7-8 hours of sound sleep is good for health.

"Sound sleep rejuvenates the cells of the body. It helps in repair of dead tissues. The entire body relaxes with a good sleep, physically and mentally. This helps in prevention and management of chronic diseases like hypertension and heart problems,” she says.

Pande adds that good sleep also helps various body systems to relax and improves their efficiency.

In children, she says sleep is even more important as the growth hormone is released during sleep. Therefore with advancing age, she says, the duration of sleep is also reduced progressively.

To get a good sleep, Celestine Karangwa, a physiotherapist at TCM Technology Clinic in Kisementi, Kigali, says one should eat at least two hours before going to bed.

"Avoid caffeine and alcohol before sleeping. Also avoid drinking a lot of water before sleeping. Shutting down all electronic gadgets at least 30 minutes before sleeping ensures a good night sleep,” he says.

Karangwa also notes that good sleep makes one feel better and relaxed, and boosts a person’s mood.

Additionally, adequate sleep is a key part of a healthy lifestyle and benefits the heart and mind.

However, Karangwa notes that one’s bedroom should have a comfortable ambiance and the bedding should also be comfortable.

"Loose and comfortable bed clothes, preferably made of cotton, help in getting better sleep,” he adds.

He says a balanced diet is also helpful in forming good sleeping habits.

"However, one should stay away from heavy meals, which sometimes lead to heart burn, stress, frequent urination in night or fear of incontinence. Use of alcohol or caffeine in excess before sleeping also affects the quality sleep,” Karangwa says.

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EXPERT SHARE TIPS

Venuste Muhamyankaka, president of Rwanda Nutritionists Society Foods such as fish, whole rice, milk, yogurt and bananas enhance or sustain sleep. Dairy products when taken before going to bed facilitate good sleep due to the tryptophan in them. Also eating a snack containing protein before sleep induces sleep.

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Raymond Awazi, pediatrician A child who has sleeping disorders is more likely to be sick. First ruling out the cause is important to ensure they regain good sleep. If a child has no problem, keeping consistent times for bed is advisable. A warm and a gentle massage helps induce sleep in children.

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Celestine Karangwa, physiotherapistLack of sleep can have diverse effects on the brain. There are radical changes that occur when a person is growing up such as tremendous hormonal shifts and brain development. If they don’t get enough sleep, it can affect their behavior.

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Emmanuel Ssemwanga, gynecologist/obstetrician at La Croix Du Sud Hospital For pregnant women, bad sleeping habits like sleeping on the back can affect the growing fetus. For instance, the weight of the uterus compresses blood vessels known as vena cava, which disrupts the blood flow to the fetus. Also laying on the right side is not recommended.