Sleep hints & tips
The first thing that most people think about when asked how to deal with a sleep problem are sleeping tablets. However they probably come last on the list of interventions.
Sleep hints & tips – Why can’t I sleep?
Careful consideration into the cause behind the sleep disorder is essential. If pain is preventing sleep, pain control should be addressed. If someone has a prostate problem that is causing them to wake umpteen times overnight to go to the toilet, that should also be discussed with a doctor. Stress and anxiety often affect sleep. There may not be an instant solution but there are definitely ways that symptoms can be improved. Symptoms should be discussed with the family doctor. Talking therapies or anxiety medication may be recommended.
Thereafter the basics of sleep hygiene should be considered as there are many day to day habits that may impact on sleep and may be easily rectified.
Sleep hints & tips – small changes
- Caffeine is a stimulant which can keep you awake. It is contained in tea, coffee, some soft-drinks and some medicines eg. decongestants. Its effects can last for many hours, Because of that it should be avoided for 4 to 6 hours before bed.
- Nicotine is also a stimulant with similar effects to caffeine.
- Alcohol tends to make you fall into a deep sleep initially. As its effects wear off, mild withdrawal symptoms can be enough to waken you up and disrupt sleep. You may also waken up due to dehydration. If you are having problems sleeping you should avoid it for a few hours before going to bed.
- Food – being either too hungry or too full at bedtime can disrupt sleep.
- Exercise – physical exercise is beneficial at reducing insomnia – especially regular moderate intensity aerobic exercise (>150 minutes a week). Strenuous exercise just before bed can make you more alert and make it more difficult to sleep.
- Noise – some people are more affected by others. If you have to sleep in a noisy environment you might benefit from earplugs.
- Room temperature – avoid your room being too hot or too cold.
- Air quality – if your room is stuffy open the window for a bit before going to bed.
- Light – make sure your room is dark, by using thick curtains, or you could try a sleep mask.
- Mattress and pillows – make sure your bed is comfortable.
Sleep Hygiene – Bedtime routine
For people with difficulty sleeping having a relaxing routine for an hour or more before bed can help. For example, stop working, have a non-caffeinated drink and a snack. Consider activities that help you relax. You could have a bath, listen to music or read a book.
Consider using a relaxation technique like mediation or guided relaxation. Relaxation is a skill that can be learned with practise. There are lots of resources you can use eg. the apps Headspace or Calm.
Use your bedroom only for sleeping in. Don’t be tempted to lie in bed and watch TV. If you can’t sleep, get up and go to another room. Go back to bed when you start to feel sleepy. This can be really hard to do but is effective if you stick it out.
Medical Treatments for insomnia
Drug treatments for sleep disorders are controversial. There are plenty of drugs available eg. diazepam, nitrazepam or the more modern “Z-drugs” Zolpidem and Zopiclone. They do help people to fall asleep more quickly and to sleep for longer. Unfortunately people often experience side effects such as difficulty concentrating, sleepiness and tiredness during the day. If used for any length of time people can also experience withdrawal symptoms.
Melatonin is also available on prescription in the UK. It’s license is for people over the age of 55 with poor quality sleep. Melatonin is a hormone secreted by the brain. Its role is to regulate our circadian (day/night) rhythm. You can buy it in pharmacies in some countries for jet lag. In trials some people find it more effective then others. Different people also seem to need very different doses, complicating its use.
Specific treatment are available for certain sleep disorders like sleep apnoea.
Cognitive Behavioural Therapy (CBT) is a highly effective and safe treatment of insomina. The main downside is that it is time consuming. Ease of access to CBT may also be variable depending where you are geographically. Self led courses are available via the internet or in book form.