MHM Magazine

28 | MENTALHEALTHMATTERS | Issue 2 | 2021 MHM E .J.Cossman once said that “The best bridge between despair and hope is a good night’s sleep.” Poor sleep is a common symptom, often overlooked or not fully managed. There can be multiple causes of poor sleep and if incorrectly managed at the outset, may become a self-perpetuating problem, and increasingly difficult to treat. Clinicians should be vigilant for signs that patients are not sleeping enough and have a systematic approach to finding and treating the cause rather than only the symptom. ASSESSMENT OF POOR SLEEP: A good history is vital. Key points include: Onset – chronic/acute? Recurrent/new problem? Duration and quality of sleep - Not everyone sleeps eight hours. Change in duration of sleep is a better indication of inadequate sleep than asking how many hours they sleep. Trigger – Was there a stressor; environmental factors (e/g: noise or shift work); change in medication or new illness? Environmental Causes - Do they work long hours and have limited time to sleep. Is there a new baby crying, a snoring partner or a broken bedspring? Ask about shift work as disturbances in the THE BRIDGE BETWEEN HOPE AND DESPAIR: SCREENING FOR SLEEP DIFFICULTIES By Dr Lisa Galvin Psychiatrist Johannesburg mentalhealth@drlisagalvin.co.za