Lifestyle- sleep

Insomnia is a problem with sleep. This may be with initiating or getting to sleep, waking in the middle of sleep or waking up feeling unrested. Insomnia is common and can affect people at different times during their lives and for different reasons. Everyone is different and needs different amounts of sleep. Nevertheless adequate sleep is essential in maintaining good health and preventing serious mental and physical illness across a wide range of bodily systems.

People with insomnia may have trouble getting to sleep, may wake in the night or early in the morning. As a result they may feel tired or grumpy during the day. They make lack energy or concentration and can sometimes make mistakes as a result of fatigue.

Often people can identify why they are not sleeping, They may struggle to get to sleep because they are ruminating over what has happened during the day, they may wake worried about things that have happened or may never happen. Sometimes people wake up because of physical problems. Such as joint pain or needing to visit the toilet.

Most people do not require further investigation of their sleep problems and will be able to take simple steps with some support. In some cases further investigation is indicated. This is particularly pertinent in patients with obesity or lung disease who suffer from day time somnolence (sleepiness), headaches or very loud snoring.

Medicines are not usually indicated in sleep problems but occasionally can be helpful. Whilst alcohol may help initiate sleep it often disrupts sleep later in the night.

Good habits are an important part of establishing a good sleeping pattern. These include trying to go to sleep at about the same time each day, avoiding caffeine and nicotine after lunchtime. It is also important to try and keep the bedroom cool and dark, avoid using computers or mobile phones in the hour before retiring.

Getting to Sleep

Many people struggle to get to sleep. Try and establish a good bedtime routine;

Aim to go to sleep at about the same time every day (if shift work allows)
Avoid using electronic devices in the hour before you go to bed and try and avoid having electronic devices in the bedroom
Do not try and force yourself to sleep, if you can’t get to sleep do something else, such as reading or meditating and try again later.
Keep your room dark and relatively cool. Use a hot water bottle if necessary rather han turning up the heat.
Avoid exercise just before going to bed.
Try using relaxation techniques such as meditation
Consider working with a psychologist or counsellor to address problems that may be causing poor sleep
Try using the the 4-7-8 technique. Dr Andrew Weil, pioneered this technique; the 4-7-8 technique. All you have to do is lightly touch the ridge of tissue behind your top front teeth with your tongue, exhale completely, and then adopt the following breathing pattern:

- Breathe in through your nose quietly for a count of 4

- Hold your breath for a count of seven

- Blow air out through your mouth for a count of 8, making a 'whoosh' sound

- Repeat the process three more times

Staying Asleep

Many people wake up sometime after they have dropped off to sleep. This may be because of stress they are concerned about or it may be due to a physical problem such as joint pain. In .

Try and establish a good bedtime routine;

Avoid caffeine or nicotine after 2pm in the day.
Avoid alcohol before going to bed, whilst it may help you get to sleep it often disrupts sleep later in the night.
Try to take regular exercise (ideally for 30 minutes if you can manage it!) on most days of the week.
Try to resolve the problems that have arisen during the day before going to bed.
It may help to keep a notebook beside the bed so that you can jot down any thoughts that occur.
If you are troubled by physical pain try to ensure you have taken pain relief prior to going to bed. Ask your doctor or pharmacist about the most appropriate medication.

There are numerous apps that are purported to improve sleep quality. Below are links to just a couple;

Sleepio https://www.sleepio.com

Headspace

Again this is more complex than your average app and may help you manage sleep as well as the stresses of everyday life!

https://www.headspace.com

For more information try;

The Sleep Foundation https://sleepfoundation.org/insomnia/content/treatment

The Sleep School https://www.thesleepschool.org