Sleep

There are a number of reasons why sleep problems can develop, including:

Normal effects of aging. When people get older they tend to sleep less deeply and need less sleep. Often not sleeping becomes a greater cause for worry, frustration and concern, which in turn leads to sleeping less well.

Stress, anxiety and worry. Sleep is easily affected by how someone is feeling. If someone is worrying about something or suffering from stress, they will very often find it hard to get off to sleep.

Surroundings. A bedroom that is too hot or too cold, a bed that is too hard or too soft, and a room that is too noisy or too light can all make a big difference to how well someone sleeps.

Disrupted sleep routine. People who work shifts which change frequently often have difficulty sleeping.

Try not to worry about not getting enough sleep. It may be that you are getting enough, but it is just less than you expect.

Don’t take naps during the day to catch up. This will effect your natural rhythm and only add to your problem.

Remember that our need for sleep is an individual thing and gets less as we get older.

Your bedroom:

• If you’re having difficulty sleeping, one of the first things to look at is your bedroom. You need the right environment to get a good night’s sleep and that means a bedroom that’s pleasant, inviting and welcoming.
• Keep your room completely dark, and if necessary use blackout curtains or an eye mask.
• Make sure your room isn’t too hot. Keep it slightly cool around 16-18°c (60-65°F).
• Keep clutter out of your room. Put the laundry basket in the spare room, bathroom or landing.
• Adorn your bedroom with beautiful things such as photographs of loved ones, artwork that you like, plants and flowers. It will help you feel more connected to the room and look forward to going to bed.
• The foundation of a good sleep is a comfortable bed. The mattress needs to be firm enough to support your spine in correct alignment, but must also conform to your body’s contours. As a rough guide, you should be thinking about replacing your mattress after about seven years.
• Don’t treat your bedroom as an extension of your living room or a study. Avoid having a television or computer in the bedroom.

Your lifestyle:

Often, from the moment when we wake up and check our smart phones, life is non-stop. We put on the radio or television to be given the news as and when it happens, we check our emails constantly throughout the day; we sit at our computers and/or watch television late into the evening. It barely stops and it can be difficult to switch off and wind down, so it’s small wonder many of us have trouble sleeping.

• The brain is not designed to pass rapidly from a state of arousal to sleep. Anything exciting, annoying or upsetting is likely to delay the onset of sleep.
• Work and studying take a great deal of concentration and effort. You need at least a couple of hours relaxing or doing something less stimulating before your brain will be ready to sleep.
• Anything that contains caffeine taken near to bedtime will reduce the quality of sleep. Examples include coffee, tea and cola. It is best not to have any of these drinks within four hours of bedtime. If you are having a bedtime drink try to make sure it is decaffeinated.
• If you are taking medicine it is worth checking with your pharmacist or doctor. Certain drugs for asthma, migraine, pain relief and cold or flu medication are stimulants. Sleeping tablets, whilst they can help in the short term, often cause sleep problems as they interfere with the quality of sleep and can alter sleep patterns. They should only be taken for very short periods.
• Whilst people often feel sleepy after drinking alcohol, the quality of sleep is affected. It is best to avoid drinking large amounts of alcohol close to bedtime if you are having sleep problems. Ensure you empty your bladder before going to bed.

Your diet and exercise:

Protein foods like turkey, steak, chicken, pumpkin seeds, beans and milk are composed of amino acids.
Tryptophan is present in these foods and when it reaches the brain, it converts to an important chemical called serotonin.

Serotonin is a chemical that carries messages between brain cells and other cells. At night-time, serotonin undergoes metabolic change to become melatonin, the chemical that induces sleep. Melatonin is a hormone that helps regulate the body’s circadian rhythm (body clock) and promotes restful sleep. The best way of ensuring optimal melatonin production is to sleep in as dark an environment as possible and also include foods high in tryptophan in your diet.

Exercise can help you enjoy better quality sleep and lower body temperature which also induces better sleep. However, wearing yourself out physically is not particularly likely to induce sleepiness. In fact it can be counter-productive and lead to wakefulness and alertness when trying to sleep.

The important thing is to exercise because it makes you feel fitter and better, and if you are experiencing sleep difficulties, the more you exercise, the more likely you are to improve your sleeping patterns. Regular exercise (taken sensibly, according to your level of fitness) is, of course, good for your overall health and there is increasing evidence that it helps combat stress and improves your mood.

Stressful lifestyles, working late, and watching intense TV shows or the news are some of the factors that can contribute to the mind racing and being unable to wind down. It is essential to understand the importance of being relaxed before bed and apply effective relaxation techniques in order to experience deep restful sleep.

Relax your body. This can be done in bed and works by relaxing separate groups of muscles. It is also effective to visualise each set of muscles being relaxed as you go through the exercise:

• Start with your feet. Tense the muscles of your feet by contracting and holding for 7-10 seconds. Don’t strain the muscle.
• Visualise the muscle being tensed and feel the build-up of tension.
• Release each muscle abruptly, then relax, allowing the body to go limp before going on to the next muscle. Keep all other muscles relaxed whilst working on a particular muscle.
• Move on to muscles in your calves, thighs etc right up to your face.

Breathe. The effects of deep breathing can bring about a physiological response in the body. It can normalise the heart rate and help calm you.

As well as relaxing before bed, you can use this breathing exercise whenever anything upsetting happens throughout the day. It can be done anywhere because you don’t have to lie on your back.

1. Sit up with your back straight and place the tip of your tongue just behind your upper front teeth, and keep it there throughout the entire exercise
2. Practise exhaling with your tongue in this position. It will be easier if you purse your lips
3. Now close your mouth and inhale through your nose for four seconds (counting one thousand, two thousand etc.)
4. Hold your breath for seven seconds, then exhale through your mouth, taking eight seconds to exhale completely.
5. Repeat three to four times and try to be accurate with the counting
6. Do this every evening before bed.

Have a regular time to go to bed and stick to it. If you can’t sleep on one particular night, don’t worry. Instead, practise a relaxation exercise.

Cognitive Behavioural Therapy (CBT) is commonly prescribed for depression but clinical trials have shown it is an effective long-term solution for insomniacs.

CBT helps you identify the negative attitudes and beliefs that hinder your sleep, and replaces them with positive thoughts, effectively ‘unlearning’ the negative beliefs.

When a person has anxious thoughts, their heart rate goes up and in turn the mind starts to ‘race’. This happens to someone who worries about something when they’re trying to get to sleep. Instead of being calm and subdued, their brains are too aroused to sleep. And to make matters worse, once their brain is stimulated in this way, other worries are activated, making sleep even harder to achieve. As a
pattern sets in, sleep becomes a thing of anxiety.

The following might help. Get out of bed and sit somewhere quiet and comfortable with a pen and paper.

1. Write down the problem(s) you are thinking about
2. Taking each problem, write down everything you can possibly think you might do to solve the problem
3. Choose the most helpful solution and write down all the steps you are going to need to take to do it. Write as much as you can
4. Write down any obstacles and how you might tackle them
5. When you are finished say to yourself firmly, “OK, that’s it for now. I can’t do any more about it at this time of night. I am not going to let myself worry about it until the morning”
6. Spend at least half an hour winding down, reading a paper or listening to some music. When you start to feel sleepy, go back to bed
7. If you still find yourself worrying, keep saying to yourself, “I’ve dealt with my worry for now. Worrying about it now will not help. I’ll deal with it tomorrow”
8. If you don’t drop off to sleep within 15-30 minutes, get up and do something else relaxing.

• Have a bedtime routine and wind down before bedtime, going to sleep and getting up at a regular time
• Get up if you are worrying or are not asleep after 30 minutes, and do something relaxing
• Exercise regularly but not late in the evening
• Make sure your bed and bedroom are comfortable
• Check whether medicines you are taking may affect your sleep
• Don’t worry about not getting enough sleep or lie in bed worrying about other problems
• Don’t use your bed for things other than sleep
• Don’t eat or drink caffeine close to bedtime, and cut down during the day.