Sleep
Most people have trouble sleeping at one time or another, and it is thought that a
third of people in the UK have bouts of insomnia – sustained difficulty getting to
sleep or staying asleep for long enough to feel refreshed in the morning.
Types of sleep problem
• Falling asleep: this is the most common problem. Some people take hours to
fall asleep, but then sleep well
• Maintaining sleep: waking up in the night and having difficulty falling asleep
again
• Waking up too early
• Poor quality sleep: light, disturbed sleep which does not leave people feeling
refreshed
How much sleep do we need?
The amount of sleep we need varies from one individual to another; school age
children need around 10 hours while healthy adults need an average of 7-9 hours a
night. People tend to sleep less, and be light sleepers, as they get older.
What stops us sleeping?
There are many possible causes of insomnia:
Stressful events: Some people’s insomnia starts in response to a stressful event
and continues even after the stress has been resolved. Sleep is easily affected by
how we feel.
• Worry about work, money, health etc.
• Death or illness of a loved one
• Environmental factors – noise, sleeping in a room that is too hot/cold or
light/dark, working away from home and having to sleep in hotels, an
uncomfortable bed
Shift work: Working changing shifts prevents a regular sleep pattern.
Psychiatric problems: Sleep can be affected by underlying mental health
problems, including:
• Mood disorders, such as depression or bipolar disorder
• Anxiety disorders, such as generalised anxiety, panic disorders, or posttraumatic stress disorder
• Psychotic disorders, such as schizophrenia
Physical conditions: Insomnia may be caused by an underlying physical condition
such as:
• Heart disease, such as angina or heart failure
• Respiratory disease, such as asthma
• Neurological disease, such as Alzheimer’s or Parkinson’s disease
• Hormone problems, such as an overactive thyroid
• Gastrointestinal disease, such as irritable bowel syndrome
• Joint/muscle problems and chronic pain
• Sleep disorders, such as sleep apnoea, narcolepsy or restless leg syndrome
Drug and substance misuse: Including the misuse of alcohol, recreational drugs,
caffeine and nicotine.
Medication: Some prescribed or over-the-counter medication can also cause
insomnia, including:
• Antidepressants
• Epilepsy medication
• High blood pressure medication
• Hormone treatment
• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Some medicines for asthma, such as salbutamol, salmeterol, theophylline
Consequences of insomnia
Sleep is important – it helps to build up our immune systems, stabilise mood,
lowers the risk of obesity, enhances attention and alertness and helps our ability to
handle stress. An occasional bad night will only result in feeling tired the next day,
but several sleepless nights may results in:Difficulty concentrating
Feeling tired all the time
Morning headaches
An inability to function normally, e.g.
being clumsy, groggy or forgetful
More vulnerability to health problems
Stress and worrying
Being irritable
Falling asleep during the day
Tips for a good nights sleep
• Try to stick to a regular sleep schedule - set a regular bedtime and wake up
at the same time every day
• Don’t nap – a nap can be a great way to recharge but it can make insomnia
worse. If insomnia is a problem for you and you feel tired during the day, take a
walk, get some fresh air, or do a puzzle for a short time. If you must nap, do it
in the early afternoon and limit it to 30 minutes.
• Make your bedroom more sleep-friendly – If you can’t avoid or eliminate
noise, try masking it with a fan, soothing music/sounds or white noise, or try
earplugs. Even dim lights – especially those from TV or computer screens – can
confuse the body clock, so use heavy shades/curtains to block light from
windows or try an eye mask.
• Sleep in a comfortable bed - If you often wake up with a sore back or aching
neck, you may need to invest in a new mattress or try a different pillow.
• Try to relax before going to bed - Many people use TV to fall asleep or relax
at the end of the day, but TV actually stimulates the mind rather than relaxing
it. If your favourite show is on at night, record it to watch earlier the next day.
Instead of watching TV before bed, try reading a light book/magazine, take a
bath, listen to soft music, do some easy stretches or make simple preparations
for the next day.
• Food and drink – Avoid eating a heavy meal late at night, though eating a
light snack (such as a turkey sandwich or a small bowl of whole grain cereal)
can calm the brain and help you sleep. Avoid alcohol before bed as it reduces
your sleep quality, and drink less caffeine – it can cause sleep problems up to
10-12 hours after drinking it!
Hypersomnia
Hypersomnia is excessive daytime sleepiness or/and prolonged night time sleep. It
can result from a physical problem, medication or medication withdrawal, another
sleep disorder or drug/alcohol abuse. If you think you have hypersomnia see your
GP.
Seeking further help
If you have long-term trouble sleeping, see your GP. They will first diagnose and
treat any underlying health condition, and advise you on changes you can make to
sleep better. They may then prescribe a short course of sleeping tablets, or
cognitive behavioural treatments.
Useful websites
NHS insomnia information www.nhs.uk/conditions/insomnia/Pages/Introduction.aspx
The Mental Health Foundation Guide to a Better Sleep http://mentalhealth.org.uk/content/assets/PDF/publications/MHF-Sleep-PocketGuide-2011.pdf