About 25% of people rarely have trouble sleeping,
50% have trouble occasionally and
25% frequently have insomnia.
For those who have trouble occasionally, stress is a common cause. If it becomes a persistent problem it brings its own troubles as it will result in daytime tiredness and reduced concentration. Worrying about not sleeping makes it more likely you will have trouble sleeping. It is helpful to regard insomnia as just one more problem that has to be dealt with. Analyse it, experiment with different ways of coping and learn from your experiences. The following notes will help you.
1. Avoid activity and stress in the preparation-for-sleep phase. E.g. Wash the dishes, tidy the house earlier in the evening, not on the way to bed.
2. Resolve arguments before retiring so you go to bed happy.
3. Do not take any stimulants before retiring. Do not use nicotine, coffee, cola, strong tea or even chocolate in the few hours before going to bed.
4. Do not have a large meal shortly before retiring. Be particularly wary of some foods e.g. cheese, as some people find them to be a stimulant or initiator of nightmares.
5. Ensure your bedroom is cool and well ventilated.
6. Eliminate as much light and background noise as possible.
7. Consider your mattress, bedclothes and pillow:
a. Are you comfortable?
b. Does the mattress sag?
c. Are the bed-clothes too tight, heavy, small etc?
d. Does the pillow support your head in the most comfortable position?
e. Are you too hot or too cold?
Experiment with some changes even if you cannot afford expensive alterations.
8. Wind down for about an hour before going to bed. This includes turning off your phone or at least putting it away. Stop watching TV especially if it is frightening or exciting.
9. Develop a preparation-for-sleep routine and go to bed about the same time every night: undress, toilet, clean teeth, lie down, sleep.
10. Go to bed to sleep. Do not read, watch TV or study in bed unless it is a normal (short) part of the preparation-for-sleep routine.
11. There is perhaps the one exception to this. Some couples find that sex is a great way to unwind, relax and induce sleep. Though it can be upsetting if it works for one but not the other!
12. Lie down and expect to sleep.
13. If you cannot sleep, try to lie in a relaxed position so your body is resting even if your mind is active.
14. If this is difficult, use gentle, quiet music to occupy your mind without stimulating worrisome thoughts.
15. Some people find that keeping their mind busy doing maths calculations or counting induces sleep. Others find that reciting poems or other memorised literature helps similarly.
16. If this fails and you become restless or irritable get up for 15-30 minutes – walk around the house, listen to the radio, read a book that is not too exciting – but do not turn on bright lights. When you begin to feel tired go back to bed and try again.
17. However short the sleep – get up at your usual time.
18. Do not sleep in the day unless a short afternoon nap is part of your routine.
Tips:
- Set an alarm if you need to but turn the clock away so it is not the first thing you see if you wake in the night.
- If you need to go to the toilet go immediately the urge wakes you. If possible do not turn on the light. Only do what you have to do then go straight back to bed.
- If you are woken by pain or cramp that does not go away by changing position DO NOT lie there suffering. Immediately get up, stretch, walk a little and, if appropriate, take medication. Then lie down again and compose yourself for sleep. Try to do this without putting on the light or checking the time. The aim is to gain comfort as soon as possible but without waking fully. Hopefully, you will wake in the morning with only a hazy recollection of the event.
- If you have cold feet wear bed socks as cold feet will keep you awake. Keep a pair of loose fitting socks nearby so if you wake up you can slip them on without waking up properly. And if it is your hands or head that are cold wear gloves or a woolly hat.
- Earplugs and eyeshades may be useful if you are sleeping with a snoring or wakeful partner who reads in bed.
- If insomnia is a persistent problem practice relaxation techniques so when you have difficulty sleeping you can easily slip into relaxation mode.
- Regular moderate daytime exercise can help you feel more relaxed and tired at bedtime. Try to do something for at least 30 minutes every day that makes you warm and slightly short of breath – but no later than early evening.
- Beds and pillows do wear out and you may not want to know about the 1Kg weight of dust and dust mites that collect! There are dependable reports that sleep patterns improve after replacing bedding that is more than 10 years old.
- Parents of young babies and shift workers have unique problems that are difficult and sometimes impossible to resolve. The best advice is to sleep whenever you are able even if only for 15 minute naps and get back into a normal pattern as soon as and whenever you can.
Misconceptions:
‘I never slept a wink.’
Untrue! You doze at least. An observer may notice you sleeping soundly at times. However, you only remember the times you are awake.
‘I need only 3 hours sleep.’
Perhaps but be careful. Most people need 6-8 hours but can manage on less for limited periods. Chronic sleep deprivation will reduce your efficiency but you may not be aware of it and there may be an increased risk of falling asleep during periods of boredom (e.g. on a long motorway journey).
‘I will be ill if I do not have 8 hours a night.’
There is no direct correlation between short-term sleep deprivation and illness.
‘I keep waking up and cannot sleep soundly all night.’
Yes, we all do. It is normal to wake 4 or 5 times for a few minutes at a time. Do not worry about it. Turn over and drop off to sleep again.
‘I just need a pill to take when I need it.’
An occasional sleeping tablet from your doctor or a sedating type of antihistamine you can buy from a pharmacist can be used but bear in mind it is still in your system during the next day and will slow down your reflexes and mental processes. If used at all, it is best taken after a period of insomnia when you know you can have a lie in and a quiet following day. Sleeping tablets taken more than a few days/week will alter your sleeping pattern and when you stop taking them you may have rebound insomnia that will take a few weeks to resolve – taking more tablets only compounds the problem. This is why there is a risk of dependency.
Be aware that it is possible for sleeping tablets taken at night to impair your driving ability the next day, even though you may feel alert and in control. If you are then involved in an accident or are investigated by the police for another reason you could be charged with driving under the influence of drugs. Look up ‘Drugs and driving: the law’ on the Gov.uk website for more information.
There is no published scientific research about ‘natural’ or herbal drugs so I cannot comment about their role.
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