Do you have a problem sleeping?
We all need a good night’s sleep. All of us will have, at some point in our lives, experienced a sleeping problem and periods where we don’t get enough of it. That’s what we call insomnia. It makes us feel grumpy and poorly, and if it goes on for a long period it affects our physical and mental health. It’s no wonder that many patients see their GP to ask for help with difficulty sleeping.
So what is sleep? It’s a period of unconsciousness during which the body recovers and repairs itself. There are 2 main stages of sleep, Rapid Eye Movement (REM) sleep and non-REM sleep. During REM sleep we are very relaxed and our brain is very active. During non-REM sleep we may move around a little, and hormones are released to repair our bodies. We move between these two stages around 5 times a night. We will often wake when moving between stages, typically for 1-2 minutes every couple of hours or so. We aren’t usually aware of this, but these periods may be much more noticeable if we feel anxious or there is something else going on eg. A snoring partner!
We all need different amounts of sleep. Babies will sleep for 17 hours, older children 9-10, and adults usually around 7-8 hours. Older people will often only have one period of deeper non-REM sleep, after which they wake more easily.
Lack of sleep
The odd night without sleep might make you feel tired the next day, but it will not harm your physical or mental health. If you have several nights with little sleep, you may experience tiredness, falling asleep during the day, lack of concentration, difficulty making decisions or a low mood. This can be dangerous when driving and cause accidents. It also contributes to high blood pressure, obesity and diabetes.
Lack of sleep is often associated with emotional problems, difficulties at work or home, thinking about day-to-day problems, anxiety and worry (eg. Money), and depression. In these cases, it is important to address the underlying reason/stress, otherwise a normal sleep pattern is unlikely to return
There are many everyday reasons for not sleeping well that you can alter to improve your sleep and combat your sleeping problem, including;
- Having a bedroom that is too hot/cold or noisy
- A partner with a different sleep pattern
- Not having a regular bedtime routine
- Not getting enough daytime exercise
- Eating too much late in the day/evening, or going to bed hungry
- Smoking cigarettes or drinking tea/coffee, particularly after mid-afternoon
- An uncomfortable bed
- Drinking alcohol
Looking specifically at alcohol, many people have a drink believing it helps them to sleep. It may well help you to get off to the lighter REM stages of sleep, but overall you get less of the beneficial deep sleep you need and increases waking through the night, so the quality of your sleep is not so good. Alcohol also tends to lower your mood, which in turn will affect your sleep.
Other tips that some people find helpful include
- Taking time to relax before bed.
- Have a regular bedtime routine.
- If something is worrying you, write it down and tell yourself you’ll deal with it tomorrow. If you wake at night worrying about day-to-day problems, leave a pen and paper by your bed.
- If you can’t get off to sleep, get up and do something relaxing for 15 minutes, and then try again.
- Hot milky drinks do work!
- Don’t watch TV in bed, it stimulates your brain.
- Keep bed for sleeping.
- Avoid lie-ins, they make it harder to get off to sleep at night.
Can medication help?
People have been using sleeping tablets for years, but we try to avoid prescribing them because
- They don’t work for long
- They can leave you tired and irritable the next day
- Your body gets tolerant to them quite quickly, so you need higher and higher doses to get the same effect
- People can quite easily get addicted to them
- They can have lots of side effects, effect driving, and cause falls and confusion in older people
There are several remedies available at the chemist without needing a prescription. These often contain antihistamines, usually used for allergies, as one of their side effects is drowsiness. They can sometimes help, but will often leave you feeling sleepy the next morning, which may affect your work or driving. You can also get tolerant to these, so it is best not to use them for a long time.
There are also herbal remedies, often based on Valerian, which may help if you take regularly for 2-3 weeks (but will not work if taken occasionally). They may also cause sleepiness the next morning, and may interact with some blood pressure medication.