sleep 2

Sleep is just one thing that affects our physical and emotional wellbeing.This guide has been designed to give you insight into how sleep works and what you can do to improve yours. If you’re experiencing long-term sleep problems, or you’re finding that your overall health is suffering, it’s wise to speak to your GP.

Getting a better night’s sleep

Opinions on how much sleep we need vary widely; some experts believe that adults should get at least eight hours per night, while others believe that it depends on an individual’s unique physiological and psychological makeup. But it’s not only the amount of sleep we get that’s important – the quality of our sleep matters too. Nearly one third of the UK population suffers from insomnia from time to time, and roughly 30% of these consider themselves to be ‘severely sleep deprived’ on a regular basis.

A prolonged lack of sleep has a serious impact on many aspects of our physical and mental wellbeing. It’s also difficult to manage stress when we’re tired, because sleep is crucial to our ability to put things into perspective. We all know what it feels like when we’re so tired that we can’t think straight, and normal every day stressors can feel overwhelming and impossible to resolve. Yet when we’re rested, we might find the same stressors ‘not such a big deal’. This content is designed to give you a few ideas for improving your sleep and there’s also a suggested reading list at the end of this guide.

How much sleep do we need?

Although there’s no universal agreement as to how much sleep human beings need, it’s acknowledged that the amount we require lessens as we age:

  • Newborns need an average of 18 hours of sleep per day including naps
  • Toddlers and preschoolers require an average of 13 hours of sleep per day including naps
  • Children aged 5 to 12 require an average of 11 hours of sleep per day
  • Teenagers need more sleep than adults which is partly due to hormonal changes and continued growth, so they need an average of 10 hours a day
  • Most adults require between 7.5 and 9 hours of sleep per night for optimum health, although everyone is different. Some people are at their best on 10 hours per night while others manage perfectly well on less than 7
  • Adults over the age of 65 require less sleep than any other age group and an average of between 6 and 7 hours of sleep per day (including short naps) seems to be the norm
  • Because everyone is different, needing more or less sleep than other people isn’t necessarily an indication that something’s wrong. The real test is whether or not you generally feel rested and refreshed on waking. If not, it’s likely that your sleep could be improved.

Time management

How can I tell if I’m not getting enough sleep?

You might not be getting enough sleep if you:

  • Regularly need an alarm clock to wake up on time 
  • Automatically hit the snooze button, or miss your wake-up call altogethe
  • Feel cranky most mornings upon rising
  • Find it difficult to get out of bed and get going
  • Find it hard to concentrate during the day
  • Feel a strong urge to nap during the day, especially in the afternoons
  • Feel sluggish or disorientated in the afternoon
  • Become very sleepy after heavy meals
  • Fall asleep in front of the television most evenings.

What is insomnia?

The term doesn’t just apply to not being able to fall asleep easily – it’s rather more complex than that. Whilst missing a few nights of quality sleep when we’re under stress is not uncommon, longer term sleep problems over weeks or months should be addressed as a matter of urgency.

The four main types of insomnia are:

  • Chronic difficulties falling asleep
  • You may feel physically tired but your mind is ‘whirring’ with thoughts and worries
  • Dfficulty staying asleep. You frequently wake up for no discernible reason multiple times in the night
  • Waking up well before the alarm goes off and being unable to fall back to quality sleep
  • Generally poor quality sleep and waking up feeling as if you’ve not slept at all.

What causes sleep problems?

Despite the widespread assumption that sleep problems are caused solely by stress, other less obvious factors can play a role. Keeping in mind that making adjustments to your lifestyle can have a huge impact on your sleep, it’s worth asking your GP or other specialist for advice if you suspect that your sleep problems are related to an underlying health condition.

  • Some food additives and/or a diet high in sugar
  • Obesity (apart from the general health risks, obesity is also a risk factor in sleep apnoea and snoring)
  • Some health problems such as liver damage, or an underactive thyroid
  • Eating a heavy meal shortly before bedtime
  • Caffeine in beverages or hidden in food
  • Particular prescription or over the counter medications (some of which contain caffeine)
  • Alcohol and recrational drug use
  • Watching television or using electronic devices just before bedtime
  • Depression, anxiety and other mental health issues
  • Hormonal changes including female and male menopause
  • A young baby or small children in the household
  • Ambient noise from within the house or outside, such as a loudly ticking alarm clock, noisy neighbours
  • A room that’s too cold or too hot 
  • An old or uncomfortable mattress and unsupportive pillows
  • A partner who doesn’t sleep well or who snores
  • Sleep disorders such as sleep apnoea.

Herbal sleeping tablets – are they safe to use?

Some experts believe that herbal sleeping tablets are effective while others have questioned their impact. In other words, the jury is still out. As with anything we ingest, care should be taken when choosing what type to take. Despite being ‘natural’, all herbal sleep aids contain active ingredients and may even be psychologically addictive. It’s also important to note that herbal sleep aids are not designed to replace good sleep practice. Before taking a non-prescription natural sleep aid, consider the following

  • Sleep aids may not be the answer: Using cognitive behavioural therapy (CBT) techniques can help you to fall asleep more quickly while making it less likely you’ll wake in the night with intrusive thoughts. For more information on CBT techniques have a look at the suggested reading list at the end of this guide.
  • Product claims can be misleading. Be a smart consumer and do your homework before you buy. Don’t just rely on a product’s marketing but look for objective, research-based information to evaluate the product’s claims. It’s wise to ask your pharmacist what he/she might recommend for your particular circumstances – they’re impartial professionals and will be able to help you make the best decision.
  • Possible side effects exist. Although natural sleep aids may appear to be harmless, some people experience headaches, dizziness, gastrointestinal problems or ironically, even sleeplessness as a result of taking them. Also, be aware that some natural sleep aids are not safe to take if you’re pregnant or breastfeeding, or if you have an existing health condition such as liver disease or heart problems.
  • Drug interactions are possible. Some natural sleep aids can interfere with medications (some antidepressants), and the effects of alcohol may also be amplified when taking them. Check with your doctor if you’re thinking of taking a natural remedy to make sure that it won’t interact with any other medications you’re taking.

sleep 5

What can I do to improve my sleep?

Before making any changes to your sleeping habits, it’s important that you speak with your GP especially if you’ve been experiencing sleep problems for more than a few weeks or you’ve noticed any new health problems or symptoms. For example, extreme fatigue without an obvious reason can signify an underlying health condition such as low blood iron so do get yourself checked out by your doctor.

Eat sleep friendly foods

Eating a well-balanced diet on a daily basis is an important factor in getting good quality sleep – it’s not simply about avoiding caffeine, alcohol and sugar before bedtime. There are a range of foods you can choose from to promote better sleep, including those which contain magnesium, one of nature’s natural stress relievers.

Magnesium has a calming effect on the nervous system, meaning that if you’re deficient in it, (and most of us are!) your sympathetic nervous system may be in overdrive which creates a vicious cycle (overdrive equates to less resistance to stress and vice versa). It’s believed that a lack of magnesium may also alter electrical activity in the brain causing agitated sleep and frequent waking.

A recent study of people with poor sleep quality as measured with the Pittsburg Sleep Quality Index found that taking a magnesium supplement decreased chronic inflammatory stress levels and improved overall sleep quality. The researchers also found that when adding magnesium to participants’ diets, they saw a decrease in such activity, effectively reducing stress and helping the individuals to relax. In the study, lower magnesium levels were also associated with a higher body mass index, indicating the connection between high body fat percentage and decreased magnesium levels.

Foods rich in magnesium are plentiful, and include:

  • Strawberries, blackberries, oranges, raisins, kiwi fruit and bananas
  • Pistachios, cashews, almonds, macadamia and brazil nuts
  • Peppers, broccoli, brussels sprouts, spinach and watercress 
  • Pumpkin seeds, sunflower seeds, oatmeal, long grain rice and barley.

You might also consider taking a dietary supplement but speak with your doctor or pharmacist before doing so.

Exercise during the day or early evening

If you have problems falling asleep at night, consider exercising during the day and not close to bedtime. Even 20 minutes of walking or swimming can help you to fall asleep more easily when it’s time for bed. But avoid strenuous exercise three hours or less before you go to bed – it can leave you wide awake and overly alert.

Don’t give in to early evening drowsiness

If you find yourself getting sleepy well before bedtime do something mildly stimulating such as washing the dishes, doing the ironing or reading a magazine. Giving in to drowsiness by going to bed too early may cause you to wake in the night and have trouble getting back to sleep. If you like to have a shower or bath before bed, make sure that it’s not too hot as high temperatures stimulate blood flow, making it more difficult to fall asleep. You might also like to consider using a few drops of essential oil in your bath such as lavender or sandalwood; both have been proven to promote better sleep.

Consider replacing your mattress, pillows and bed linen

A general rule of thumb is that mattresses should be replaced at least every 8-10 years. Even if your mattress is relatively new, inspect it once a year for signs of damage such as rips, soft spots, sagging or protruding springs. You also need to consider how comfortable your mattress is – the real test is whether or not you find yourself tossing and turning during the night to get comfortable. Considering that we spend about one third of our lives in bed, investing in a comfortable, supportive mattress is well worth the money.

Choose the right pillows and bed linen too. Waking with a stiff neck or upper back pain on a regular basis may be a sign that you need a pillow better tailored to your needs. Natural fibres are the most comfortable, and hypoallergenic duvets can make a real difference to the quality of your sleep.

Once you have your new bedding in place, hoover your mattress and wash your pillows at least once a month to control dust mites which can cause breathing problems and allergic reactions (this is especially important with children’s bedding).

Try the ‘tension tamer’

The tension tamer is a technique developed by the Walter Reed Medical Centre in Maryland, USA. It’s been proven to help people to sleep better, and scientific studies have found that it takes an average of four nights of using the technique to see a real difference. Study participants reported falling asleep more quickly, sleeping more soundly and feeling more alert on waking. Here’s how it works:

  • Get into bed, making sure that you’re completely comfortable and not too warm or cold
  • Close your eyes and focus on your breathing, noticing each time you inhale and exhale
  • As you feel yourself relaxing, let your mind wander to the most restful place you’ve ever been to such as a beach, a quiet park, a field of flowers…anywhere you’ve felt at peace and totally comfortable
  • Picture yourself in this place while continuing to notice your breathing. Allow restful images to wash over you; picture the clouds overhead, the air against your skin, the warmth of the sun, the smells and sounds of nature
  • Watch the scene as if it were a film. You’re not emotionally involved, but simply allowing yourself to picture this restful scene. If you find yourself distracted, refocus on the scene and continue to notice your breathing
  • Simply let yourself drift off while enjoying the feeling of total relaxation
  • You’ll soon be asleep and can look forward to feeling refreshed in the morning.

Try lavender for a natural sleep

Scientific evidence suggests that lavender slows the activity of the nervous system which improves sleep quality and promotes relaxation. In fact in one study, people who received a massage with lavender oil felt less anxious and more positive afterwards than those who received a massage without the oil. Try lavender mist on your pillow or duvet, keep a small sachet under your pillow, or invest in an oil burner and add a small amount of oil to it (but not too much or you’ll be overpowered by the smell). If you do use a burner, don’t forget to blow out the candle before you go to sleep.

Set a regular bedtime

Going to bed at the same time every night isn’t just for kids. Sleep is essentially a habit and when we get used to doing something at the same time every night, it soon becomes second nature to us. Readjust your body clock by going to bed when you normally feel tired (not simply a little drowsy). Although we suggest resisting drowsiness early in the evening, don’t resist real tiredness. You might find that the first few nights are restless but stick with it. Stay in bed and just try and relax until you fall asleep. Listening to calming music can be helpful or try the tension tamer technique.

It’s also important not to break the new routine at weekends or on holidays when it’s tempting to stay up late. If, once you’re in your new routine, you’re still finding it difficult to wake up in the morning, go to bed slightly earlier until you’ve found a pattern that suits you.

Keep a pen and paper beside your bed

Waking in the night is common when we’re under stress. We may find ourselves waking without meaning to and once this happens, it’s all too easy to start worrying about things that are bothering us. The cycle then begins; the more we think about our problems, the less likely it is that we’ll fall back to sleep. The less sleep we get, the more we’ll worry in general. Keep a pen and paper by your bed and whenever you wake in the night jot down any worries, thoughts or to do lists. You’ll find that you’ll worry less once you’ve written things down, making it easier for you to get back to sleep. This can take practice but once you’re in the habit, you’ll find that you’ll wake less and worry less.

Limit your caffeine intake

Many people limit their tea and coffee intake before going to bed but it can be easy to forget that caffeine is also found in chocolate, some painkillers and certain processed foods. Avoid caffeine – in any form – for at least six hours before bedtime. Staying away from alcohol, nicotine and sugary foods before bed will also help you to fall asleep more quickly and reduce the number of times you wake during the night.

Limit the amount of fluid you take in before bedtime

Staying hydrated is important for our physical and emotional health but having to wake in the night to visit the bathroom isn’t great for a good night’s sleep. Caffeine is a diuretic meaning that it can cause us to visit the bathroom more frequently putting us at risk of becoming dehydrated. Some herbal teas which are considered to promote sleep include chamomile, valerian and lemon balm. For maximum effect, drink a cup about 30 minutes before turning in for the night.

Nap only when absolutely necessary

Taking a short nap during the day of up to 20 minutes can be a good way to recharge if you’re particularly tired but regular napping can make things worse for people who suffer from any form of insomnia. If you must take the occasional nap, aim for no more than 20 minutes in the early afternoon.

Make your bedroom a sleep friendly sanctuary

Heavy curtains to keep out the light, a supportive mattress and pillows, and a stable room temperature can really make a difference. If you tend to get too warm at night, consider putting a quiet fan in your bedroom, or beat the cold by investing in some bed socks; you’d be amazed at what a difference these strategies can make. And think about replacing any alarm clocks that tick loudly or shine too brightly. Keep your clock far enough away from the bed so that you can’t see it without making a conscious decision to get up, walk over, and look!

Avoid technology just before bedtime

As tempting as it might be to fall asleep while watching television, avoid the screen at least 45 minutes before you go to sleep. The problem doesn’t necessarily relate to a programme’s content, it’s more about the way in which the brain reacts to moving images and light. Reading a book or magazine, listening to music or doing something non-strenuous such as washing the dishes before bed doesn’t affect the brain like technology does.

This point is also important for children. Keep screens out of their bedrooms and encourage them to read or listen to music before sleeping regardless of whether they generally sleep well or not.

Checking emails, playing video games and surfing the internet can also impact on our sleep due to increased brain activity. As the brain revs up, electrical activity increases and neurons start to race – the exact opposite of what should be happening before sleep. Our bodies also react to any kind of technology by becoming mildly tense even if we think that we’re relaxed. As we become stressed, our bodies release cortisol, a stress hormone produced by the adrenal gland. That ‘glow’ from electronics also works against our natural inclination to sleep. Small amounts of light from electronic devices pass through the retina into the hypothalamus (the area of the brain which controls several sleep activities). This delays the release of sleep inducing melatonin making it very difficult to fall asleep naturally.

How can I help my child to sleep well?

When should you have a baby

Encouraging children to get a better night’s sleep is something that nearly every parent would like to do, but it’s not always easy! If your child is experiencing very disrupted sleep and it’s having an impact on him or her, your first step is to visit your child’s GP to discuss what’s happening. It’s also useful to go to the appointment armed with a list of examples of how your child is being affected and how often he or she is experiencing sleeplessness. Be sure to keep track of any patterns too – does your child seem to have problems sleeping when he or she has had a difficult day? Is there anything happening at school which might be affecting your child? Remember that children can suffer from stress related sleeplessness too.

In some cases, the cause of a child’s sleeplessness may be physical such as an allergy to certain food additives or colourings that you’re not aware of. It’s worth asking your GP for their advice around both physical and emotional causes of sleep problems. Because children’s sleep is such an enormous and complex topic, we suggest that you do a bit of research as well. There are some excellent books on the market (including the four listed here) and it’s always worth looking at trusted resources on the internet.

Additional reading

  • 50 Things You Can Do Today to Manage Insomnia by Wendy Green 
  • The Good Sleep Guide by Sammy Margo 
  • Overcoming Insomnia and Sleep Problems: A Self-Help Guide Using Cognitive Behavioral Technique by Colin A.Espie 
  • The Gentle Sleep Book: For Calm Babies, Toddlers and Pre-schoolers by Sarah Ockwell-Smith 
  • Sleeping Baby, Happy Parents: Simple Steps To Great Baby Sleep by Emma Thomson 
  • The Mental Health Foundation’s report on sleep. A free resource full of interesting facts and useful tips, and it even includes a sleep diary. http://www.mentalhealth.org.uk/publications/sleep-report/

sleep 6