Do You Struggle with

Have you ever woken at 3am and started to toss and turn, frustrated that you aren’t able to fall back to sleep quickly? Then you start thinking about all that you must do tomorrow and all you didn’t get done today. After another hour, you think about how tired you will feel the next day and end up progressively annoyed about being awake?

Or perhaps you’re a busy working mum and after everything you’ve done all day, you stay up a little later just to try to have some time to yourself. Despite being exhausted while you stay up, when you finally go to bed, you suddenly find yourself wide awake and unable to sleep. Both scenarios are forms of insomnia, which is the inability to initiate or maintain a full and refreshing night’s sleep.

This type of insomnia, when it is not associated with another problem such as a mental health disorder (anxiety or depression), can be amenable to some tips to help promote a good night’s sleep.

1. LIMIT THE USE OF SMARTPHONES, TABLETS AND COMPUTERS FOR AN HOUR BEFORE BED.

For the sleep process to be enabled, several things need to come together, including the hormonal regulation of our body and our behaviours leading up to sleep and as we go to bed. As the sun goes down, our body produces the hormone melatonin. This keeps us in our natural rhythm and promotes the sleepy feeling, preparing us for bed. The release of melatonin can be inhibited by bright lights, smartphones, tablets and computers, which is why the first tip is to limit the use of these devices in the hour before bed and dim the lights if possible.

2. HAVE SOME WIND DOWN TIME, TO BECOME SLEEPY BEFORE ATTEMPTING TO SLEEP.

It is not helpful in the late evening to rush from one thing to another and another and then go straight to bed, if you’re not already sleepy. You will simply be awake and stressed in bed. So, it’s important to have some wind down time, to clear your head and to become sleepy before attempting to sleep. This can be helped by having ‘the worry list’ sorted before bed, so that as you go to bed, you can tell yourself ‘that has already been dealt with’ when your mind starts racing again. Cognitive behavioural therapy (CBT) can help to lessen these thoughts, as well as reducing negative thoughts associated with insomnia itself.

3. REGULATE BODY TEMPERATURE IN READINESS FOR SLEEP.

Our body regulates its temperature very carefully during the 24-hour period, cooling down in preparedness for sleep.

Thus, if the room is too hot or too cold, it makes it very difficult to sleep. One thing that can help lower our temperature a little in readiness for sleep, is the warmth of a bath or shower, after which the body cools down. So, to regulate temperature, have a warm bath, don’t exercise too close to bed (within three hours) as it heats up the body. Play close attention to layering of clothing and environmental control so that you are not too hot or too cold.

4. KEEP A CONSISTENT BEDTIME AND BEDTIME ROUTINE.

Apart from our hormonal regulation to enable sleep, there is also the behavioural element that is the learned mindset to sleep. This is learning and recognising that the bed is a relaxing place where only sleep occurs. For some insomniacs, the bed becomes their battleground, one of endless frustration and even dread. So, for a start, re-establishing this relationship involves keeping a consistent bedtime and bedtime routine as well as having no TV or computer in the bedroom.

For those who lay awake unable to initiate sleep, limit this time to 30 minutes before getting back out of bed and undertaking a non-stimulating activity (e.g. reading elsewhere or meditation/quiet time) until feeling sleepy again. Then go back to bed to try to sleep when you are relaxed, yawning and sleepy again. This cycle can be repeated as often as necessary to reestablish this relationship of sleep to bed.

5. STOP CHECKING THE CLOCK.

Other things to change would be to stop any checking on the time if you remain awake or wake in the night and thus remove any vigilant attention given to the sleeplessness itself.

6. LIMIT CAFFEINE AND ALCOHOL.

There are other lifestyle factors that can contribute to insomnia. The stimulating effect of coffee in the evening can last up to five to six hours and can delay the body clock which reduces the amount of deep sleep.

Alcohol may make you drowsy and help you fall asleep but it interrupts the rapid eye movement (REM) sleep. Disruptions in REM sleep may cause daytime drowsiness and poor concentration. It can also suppress breathing and contribute to sleep apnoea.

7. DON’T SACRIFICE YOUR SLEEP.

When sleep is absent, it has a global effect on one’s health and productivity. But it is also something that is often sacrificed in pursuit of work, family or leisure time. Try to put yourself and your sleep at the top of the list, rather than the bottom. Remember any persistent insomnia, especially that associated with anxiety or a low mood, should be discussed with your local doctor.

Dr Tammra Warby is a General Practitioner with a PhD in Virology. She has worked in emergency medicine and general practice in chronic disease management including diabetes, paediatrics, mental health, preventative medicine, skin cancer checks and surgery. Tammra works at Foxwell Medical, and can also be contactable via Twitter.