Knowledge usually helps. But sometimes problems get bigger when you know a lot: That’s the case when it comes to sleep. Most people are aware of the importance of good sleep for health. It is precisely this that can rob them of their sleep. Lying awake at night then becomes a real stress. Falling asleep doesn’t work anymore. Thomas Pollmächer, director of the Center for Mental Health at Klinikum Ingolstadt, who deals with the treatment of sleep problems, knows how to get better sleep.
SZ: According to surveys, every third German citizen starts the day overtired. Many have trouble falling asleep or staying asleep. Apparently very few go to the doctor with it…
Thomas Pollmächer: Most of those affected first try to get their sleep problems under control themselves. The only problem is that it usually doesn’t work when you’re sleeping. If you lie in bed and say, I want to sleep now, you will certainly not fall asleep. This is another reason why people with sleep problems are often so desperate: they cannot find a solution.
Can you help people?
Sleep medicine can now help in many cases. However, it must also be said that there are 90 different diagnoses behind bad sleep. Causes and treatment options vary accordingly. Some people simply have too many worries or are too restless. However, physical illnesses such as the thyroid gland can also be the cause of sleep disorders or mental illnesses such as depression.
What has to happen for people to come to you with their sleep problems?
As doctors, we mostly see people who are not sleeping well due to breathing disorders. If you have such a sleep apnea syndrome, you won’t be able to breathe several times an hour at night. Each of these breathing pauses leads to an arousal reaction, so sleep is not restful. Those affected often do not notice this, many even think that they are sleeping well. They only come because they are tired during the day or because their wife tells them that you snore but now go to the doctor. However, such breathing disorders are by no means the most common sleep disorders.
Rather?
The most common is the usual lack of sleep, insomnia. Subjectively, those affected sleep too little, but often lie in bed much longer than healthy people. You have trouble falling asleep, waking up very early in the morning or lying awake at night. It is estimated that six percent of the population is affected.
And how can you as a doctor help those affected?
When it comes to sleep rhythm and too many worries, we try to counteract this with relaxation techniques, counseling and a sleep diary. The aim is to shorten the time spent in bed and to regularize night sleep – also by developing a sleep ritual and a certain sleep hygiene.
What does that mean?
For body and soul, all signs should be set to sleep. So it should be quiet and dark in the bedroom, and you shouldn’t watch TV or work in bed either, so that the bed remains a place of rest. Sleep often returns to normal relatively quickly. But as different as the diagnoses are, so are our treatment options.
Thomas Pollmächer is President of the German Society for Psychiatry and Psychotherapy, Psychosomatic Medicine and Neurology.
(Photo: DGPPN)
What do you do against the desperation when you still can’t fall asleep?
We first advise our patients to decatastrophize this situation. They are being made to accept that they are no longer sleeping like babies. Also, they shouldn’t keep looking at the clock and shouldn’t fight against lying awake, like: I have to go to sleep now. You can only fall asleep if you’re not upset.
Are medications an option?
Classic sleeping pills do not combat the causes and are therefore not a permanently effective solution. But if a patient is sleeping very badly because of a current situation, for example because he has lost a relative or because he is very scared of exams, then it can make sense to give him a sleeping pill for a week or two.
And if a sleep disorder has existed for a long time?
Then you should first clarify why this error occurs. Basically, a clear diagnosis is required before treatment can begin. This is the only way to find the right therapy, be it behavioral therapy, nocturnal ventilation or a specific medication.
On Wednesday, October 26, 2022, the Süddeutsche Zeitung will host a health forum on “The Overtired Society – Sleep Disorders and Their Treatment” from 7.30 p.m. During the online event, SZ readers can ask their questions. Registration for the live stream: sz-erleben.sueddeutsche.de/sz-veranstaltungen