Trouble sleeping? You’re not alone. With anxiety , depression, work-related stress , bills, money and relationships keeping us up at night it seems like a full eight hours sleep is but a dream nowadays.
With the clocks going forward this Sunday and the morning sun steadily creeping its way through our curtains earlier, we sought the help of GP and Get The Gloss Expert Dr Anita Sturnham to resync our cycles, show us how to sleep better and help us feel more rested, refreshed and energised going into the new season. Here are her top tips for understanding insomnia better and treating lack of sleep in the most effective way possible.
What is insomnia?
Insomnia simply means poor sleep. Working as a GP, I think it’s one of the most common things patients mention to me and yes, even doctors get Insomnia, highlighting exactly how common the problem is.
UK studies suggest that 30-40% of adults do not get as much sleep as they would like.
Insomnia can mean any of the following:
- Not being able to get off to sleep.
- Waking up too early.
- Waking for long periods in the night.
- Not feeling refreshed after a night's sleep.
If you have poor sleep you may be tired in the daytime, have reduced concentration, become irritable or just not function well. If the insomnia continues, it can increase the risk of developing conditions including diabetes, depression, high blood pressure and strokes.
What is a normal amount of sleep?
Different people need different amounts of sleep. Some people function well and are not tired during the day with just 3-4 hours' sleep a night. Margaret Thatcher claimed to have only slept for 4 hours per night during her entire time as British Prime Minister and apparently only needed this amount to function well. Most people need more than this.
6 - 8 hours per night is the average amount of sleep that most people seem to need. I normally aim for 7- 8 hours and this is what most doctors recommend. However as you become older, it is normal to sleep less. Many people in their 70s sleep less than six hours per night.
So, everyone is different. What is important is that the amount of sleep that you get should be sufficient for you and that you usually feel refreshed and not sleepy during the daytime. Therefore, the strict medical definition of insomnia is ... ‘Difficulty in getting to sleep, difficulty staying asleep, early wakening or non-restorative sleep despite adequate time and opportunity to sleep, resulting in impaired daytime functioning such as poor concentration, mood disturbance, and daytime tiredness.’
What are the causes of poor sleep?
There is usually no single cause of insomnia, but there are a number of factors that can contribute to you getting it.
These are some of the main causes:
- Physical health problems such as sleep apnoea, pain, indigestion, asthma and heart disease.
- Psychological health problems such as stress, anxiety and depression.
- Medicines: poor sleep can be a side-effect of medications such as slimming pills, antidepressants or medicines to treat high blood pressure.
- Travel: jet lag, a temporary condition that can cause disturbed sleep patterns, digestion problems and a lack of energy (fatigue) following air travel across a number of time zones.
- Environmental factors such as noise, an uncomfortable bed or being too hot or cold.
- Lifestyle: poor diet, no regular exercise, not having a regular sleep routine, having daytime naps, eating late at night, drinking excessive amounts of alcohol or smoking. Stimulants such as nicotine can affect sleep.
There are lots of things that you can try to help you to sleep better. Doctors call this ‘Sleep Hygiene.’ If you are having problems with your sleep, try to make some of the changes below. They may make a huge difference.
1. Cut the caffeine: Do not have any food, medicines or drinks that contain caffeine or other stimulants for six hours before bedtime. Some people have found that cutting out caffeine completely helps.
2. Banish the cigarettes: Do not smoke within six hours before bedtime.
3. Bin the booze: Ideally try not to drink alcohol within six hours before bedtime.
4. No late night feasts: Do not have a heavy meal just before bedtime, (although a light snack may be helpful).
5. Exercise helps but not late at night: Do not do any strenuous exercise within four hours of bedtime. This may increase the amount of adrenaline your body produces, making it difficult to get to sleep.
6. Get into a rhythm: Control your body’s sleep rhythm - try to get into a daily routine to establish a sleep pattern. Going to bed at the same time each night and getting up at the same time each morning, even at weekends can help. The body becomes used to rhythms or routines. If you keep to a pattern, you are more likely to sleep well.
7. No matter how tired you are, do not sleep or nap during the day.
8. It is best to go to bed only when sleepy.
9. Turn off the light: Switch the light off as soon as you get into bed.
10. Make your bedroom a sleep haven: The bedroom should be a quiet, relaxing place to sleep. It should not be too hot, cold, or noisy. Earplugs may be useful if you are sleeping with a partner who snores or if you are in a noisy environment.
11. Make sure the bedroom is dark with good curtains: Consider using eyeshades.
12. Don't use the bedroom for activities such as work, eating or watching television.
13. Ditch the phones: Avoid sleeping with your mobile phones by your bed.
14. Change your bed: if it is old or uncomfortable.
15. Stop clock watching: Hide any clocks. Watching the time through the night often makes insomnia worse.
16. Get in the mood: Try to relax and unwind before going to bed.
17. Try going for a gentle walk, then run a bath or have a shower.
18. Reading and having a warm drink (without caffeine) may be relaxing in the late evening.
19. Do not do anything that is mentally demanding within 90 minutes of going to bed - such as studying.
20. If you have an ‘active mind,’ try making a ‘Thoughts Diary.’ You can use this to write down events of the day, things that you are worried about, plans for the rest of the week etc. Sometimes putting thoughts from mind to paper can help you to switch off.
21. Some people find playing soft music is helpful at bedtime. Try a player with a time switch that turns the music off after about 30 minutes.
22. If you cannot get off to sleep after 20 - 30 minutes - then get up. If you can, go into another room and do something else such as reading or watching TV rather than brooding in bed. Go back to bed when sleepy. You can repeat this as often as necessary until you are asleep.
Complimentary therapies: Herbal remedies such as valerian, lavender oils etc. can be helpful. There is no proven scientific evidence that they work, but they may be beneficial in some cases.
If you have tried all of these tips and you still can’t sleep, make an appointment to see your GP. Your doctor may refer you to a psychologist or other health professional for behavioural and/or cognitive therapies.
Sleeping tablets are not usually advised but your doctor may prescribe them to be used short-term in some cases, for example to get over a particularly bad patch.