It seems so simple. Everyone does it! It’s all we want to do after a long day. And yet, all too often quality sleep is elusive, especially when we are stressed. The heavy feeling behind the eyes, the brain that struggles to string together a logical sentence, and the absolute fatigue determined to keep us unmotivated and unproductive.

Sleep deprivation

We’ve all been there at some point, but for some of us it is a constant struggle. In fact, somewhere between ten and thirty per cent of people suffer from chronic insomnia – that’s up to nearly one in three! Some of us like to kid ourselves about how bad our sleep really is, and it can be a good idea to track your sleep for a few days using a sleep diary.

Most adults need 7-9 hours of sleep per night, should be able to fall asleep within half an hour of going to bed, and their sleep should be generally uninterrupted. For those of us with young children waking in the night, a good night sleep sounds like a long-forgotten dream! But following the suggestions below will still give you the best quality sleep possible.

Why does how much sleep you get matter?

Poor sleep can cause tiredness, memory difficulty, poor concentration, low attention levels, feelings of sadness, or irritability. This can obviously have a big impact on how we perform at work, our patience with our children, and our motivation in general.

Studies have also linked a lack of sleep or interrupted sleep to weight gain & obesity, high blood pressure and heart disease, depression, and the onset of diabetes.

What can we do about it?

Many people resort to using medications to help them sleep, but there are usually other much better options to try first. Some medications can provide some short term help, but there is very poor evidence that they help in the long term, and overall do more harm than good. So, let’s talk about what else we can do.

Note that here I am discussing primary sleep problems, which means that the difficulties sleeping are not caused by another health issue. The strategies discussed in this post don’t necessarily apply if you have an underlying sleep, medical, psychiatric or substance abuse disorder. If you are having difficulties sleeping, I highly recommend you see your doctor to exclude any underlying cause that might need treating.

1/ Make best use of light

Our body naturally goes through times of being more alert and more sleepy, which is called our circadian rhythm. You’ve probably noticed the sleepiness we often feel in the early afternoon, when the last thing we want to do it return to work after our lunch break! The best thing you can do for your circadian rhythm is to avoid bright lights in the evening, especially the last hour before bed, and to have sunlight first thing in the morning. That means no playing with your iphone in bed! If you wake at night you are better off having a digital clock with red numbers to check the time, rather than turning on your bright iPhone screen & confusing your brain. You could experiment with software like F.lux, which can alter the phone screen display at night. This may minimise and eliminate the effect screens have on your sleep.

2/ No drugs!

Caffeine, alcohol and cigarettes all interfere with the quality of sleep, especially if used late in the day. Ok, you can have your coffee (or two) in the morning. But even that may need to go for some. Alcohol can help people fall asleep, but will usually make their sleep more interrupted and less refreshing.

3/ No naps!

As a general rule, naps are not good! I know they feel great at the time, but then you don’t get tired til later, you get less sleep, you need another nap the next day, and so the cycle continues. No naps!

4/ Exercise

Any exercise is great, but not within 1 1/2 hours of bedtime, and for some exercise may need to be as long as four hours before bedtime.

5/ Food

We all know a healthy balanced diet is good for us, but in relation to sleep it is often heavy meals that makes us struggle. Avoid a heavy night time meal too close to bed time. Either try moving the meal earlier in the evening, reducing the size of your evening meal, or even making your midday meal the heaviest of the day.

6/ Be consistent

Your body loves you to be regular with your bed time and wake time. Some of us love to indulge in a bit of extra time on Netflix on a Friday night, and sleep in on the weekend. If you’re sleep is good, then go right ahead and continue this awesome practice! But if you’re struggling to sleep, these inconsistencies are probably making things worse.

7/ Preparation ritual

Your body doesn’t like to be surprised by bed time. You know those nights when you have something that has to be finished by the next day, you push and push, later and later, thoughts racing, finally finish at midnight and jump into bed…… and there is no way that active brain is ready to slow down and sleep yet! The best way to prepare for bed is to have a set of relaxing things you do leading up to bed time every night. It may be something like: have a cup of camomile tea, brush your teeth, wash your face, put your PJs on, read your novel for 10 mins. You might have read this sort of thing in books talking about preparing a baby or toddler for sleep. Well adults are the same – these predictable activities trigger our brain to know that sleep is about to come.

8/ Screen-free relaxation

Now this is one that most people struggle with these days. When I give this advice to people, I can see this look in their eyes “there is no way on earth you expect me to not use my phone/laptop/TV before bed!!!!”. This is a really important way of preparing your brain for impending sleep. The last couple of hours before bed is also not the time to be tell your husband how you really feel about his annoying habits – save this for a weekend or some other time well away from bed time!

9/ Relaxation strategies

Do you often feel like your brain is on the go all the time, and have trouble switching off? Research shows that people with insomnia tend to have higher cognitive arousal both during the day time and night time.  There are plenty of options for relaxation, and most people can find something which suits them. These include progressive relaxation, breathing exercises, imagery, biofeedback, meditation, and others. I will write a post exploring these in more detail.

10/ What if I really can’t sleep?

It’s best to wait til you are tired before you go to bed. If you find you are not getting tired until very late at night, keep your morning wake time consistent even if you are exhausted, and your sleepy time will in most cases transition to earlier in the evening.  If you’re lying there for more than twenty minutes trying to get to sleep, it’s best to get up for a while. Otherwise you just get more and more frustrated, and wake yourself up more, and enter a vicious cycle. Get up and leave the bedroom – your bedroom is only for sleep and sex. Keep the lights dim, and choose a quiet activity – drawing or reading are good suggestions. And when I say the bedroom is only for sleep and sex, this also excludes pets. Sorry, I know you love your furry friend, but they may be stealing your sleep.

Some of these things might seem really simple. They are! But hardly anyone I know actually follows these suggestions, and most of those that do really do see some great results. The key, like with anything, is consistency. Pick one thing you think you could do better, and find a way to implement that consistently. Once you have that first thing going, if your sleep is still a problem, then pick another one. Just one at a time until you get the results you want. If you are not making improvements in your sleep, consider revisiting your doctor, or seeing a psychologist for a more formalised approach like Cognitive Behavioural Therapy.

You will probably find that some of these things affect you more than others. I find that watching TV right up until bed time usually doesn’t make much difference, so long as it’s not something too depressing or thought provoking. I do find that using my phone close to bed time  can prolong the time it takes me to fall asleep, but I’m not very disciplined with stopping this! But for now my sleep is pretty good, so I’m happy to keep things the way they are for now.

Try the suggestions out, keep a sleep diary, and let me know how you go! You can contact me via e-mail or Facebook.

References:
-Nonpharmacologic Management of Chronic Insomnia, P Harsora and J Kessmann, American Family Physician, 2009, Jan 15;79(2):125-30, http://www.aafp.org/afp/2009/0115/p125.html
-Management of Common Sleep Disorders, K Ramar, E Olson, American Family Physician, 2013, Aug 15;88(4):231-238, http://www.aafp.org/afp/2013/0815/p231.html
-Healthy Sleep Tips, National Sleep Foundation, https://sleepfoundation.org/sleep-tools-tips/healthy-sleep-tips
-Sleep Hygiene, Sleep Disorders Australia, 2006, https://www.sleepoz.org.au/files/fact_sheets/AT09%20-%20Sleep%20Hygiene.pdf
-Insomnia, Sleep Disorders Australia, 2006, https://www.sleepoz.org.au/files/fact_sheets/AT04%20-%20Insomnia.pdf

Published by Dr. Amy Imms

Disclaimer: All advice provided through this website and blog is intended as general advice, and not specific advice to any individual. Every individual is unique and has different needs, so please seek advice from your own health professional for advice tailored to your specific situation. I aim to provide high quality information based upon current research, guidelines and accepted practice. The possibility of error or omission remains, and I am not liable (including liability by reason of negligence) to the users for any loss, damage, cost or expense incurred or arising by reason of any person using or relying on the information and whether caused by reason of error, negligent act, omission or misrepresentation in the information presented or otherwise.

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