Why Can't I sleep at Altitude?

Altitude and sleep

Arriving back in the mountains with a toddler a few weeks ago really emphasised the affect that altitude has on sleep (or lack of!).  In Val d’Isère, resort level is at a moderately high altitude (1850m) and even here affects will be felt. 

Sleep is important for recovery, both physical and mental.  It is when the body's repair work is done.  If you are in the mountains to enjoy alpine activities your body will be working hard and it will need good quality sleep to help replenish and refresh.  

The bad news is that many people don’t sleep well at altitude, especially for the first few days in the mountains.  You'd think that exercising hard in fresh alpine air would mean that you would be out like a light once your head hit the pillow! Unfortunately, deeper stages of sleep and rapid eye movement (REM) sleep are reduced, so we spend more time in a light sleep and overall sleep quality won’t be as good as at sea level. The result is disturbed sleep and vivid dreams which can leave us feeling unrefreshed. 

Poor sleep quality occurs due to a decrease in the amount of oxygen that our bodies receive when we are up high.  Oxygen directly affects the sleep centre in our brain.  Although the percentage of oxygen remains the same at all altitudes (21%), the pressure in the atmosphere decreases as you go higher.  Because of reduced air pressure at high altitude, the volume of air that you breathe contains less oxygen molecules.  As well as decreasing the time we spend in deep sleep and REM cycles, this can also lead to periodic breathing.  This is when the reduced oxygen content of the blood induces breathing instability, with periods of deep and rapid breathing alternating with central apnea (repeated pauses in breathing during sleep).  Although periodic breathing is not so common at resort level, it is not unheard of and will lead to sleep disturbances and frequent awakenings and a feeling of a lack of air.

Sleep is essential for optimum physical performance.  If you are feeling tired and unrefreshed take it easy on the slopes.  Accidents are most likely to happen when you are tired.  Take breaks, ensure that you are well hydrated and follow the tips below to help decrease fatigue and enhance sleep.  

• Decrease your caffeine intake.  We all know that caffeine is a stimulant so to help improve your sleep, cut back on the coffee and avoid caffeine after lunch. 
• Avoid alcohol and tobacco as this infers with oxygen delivery in the body and can impair the sleep related respiratory cycle.  While some people may drink alcohol to help them sleep, the opposite will actually occur, increasing the likelihood of an unsatisfying and restless sleep.  There is also evidence to suggest that alcohol intake may slow your adaption to altitude. 
• Avoid a heavy meal close to bedtime.
• Avoid sleeping in an overheated bedroom.  Let some fresh air in during the day and consider sleeping with a bowl of water next to the radiator to help humidify the room. 
• Try self acupressure when you get into bed.  There is a point called Yin Tang which is situated in between your eye brows.  It helps to calm the mind, reduce agitation and relieve insomnia.  To stimulate this point yourself, close your eyes and apply a medium pressure directly between your eyebrows for 1 - 2 minutes.   

The good news is that your sleep will improve each night that you sleep at altitude.  Most people will find that after 2 - 3 nights their sleep will have significantly improved (it took slightly longer with my toddler!) If you are really struggling to get good quality sleep, despite a period of acclimatization then consider seeking medical advice.  You should also seek medical help if you are experiencing any of the following: 

• Nocturnal choking leading to abrupt awakenings from sleep
• Irregular breathing during sleep
• Excessive sleepiness during the day
• Morning headaches
• Significant mood changes

     Here's to some good quality 'zzzzzzzzzz's'! 

     

     LSA

     Bonne Santé
     info@bonnesantephysio.om

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