Some helpful solutions to your sleep struggles…
It seems that the world is finally waking up to the importance of sleep, especially when it comes to living a healthy, happy life.
But, for the two-thirds of Britons who reportedly suffer with sleep-related problems, sorting out such issues is easier said than done. Here, we speak to insomnia expert Kathryn Pinkham, who runs The Insomnia Clinic, and Ana Noia, Senior Clinical Physiologist in Neurophysiology and Sleep at the Bupa Cromwell Hospital, for some tips on catching those Zzz’s…
1. Increase your sleep appetite
According to Kathryn, when we can’t sleep we become much more focused on it (which figures, right?). Panicked about our lack of shut-eye, we make constant changes to improve the situation – whether that’s going to bed earlier, having longer lie-ins, or reading or watching TV in bed. It means we start spending less time actually sleeping in the bedroom. The result? The connection between bed and sleep becomes weak, and we effectively un-learn how to sleep.
“Improvements can be made by only being in bed for the time you’re sleeping,” explains Kathryn. “Going to bed later and waking up earlier keeps your sleep window very short, and increases your sleep appetite. If you stick to a routine of doing this, your quality of sleep will gradually become better. Instead of lying in bed for hours unable to sleep, start getting into bed when you’re really shattered, and wake when it’s early. Gradually you should be able to increase the hours you’re sleeping.”
2. Stop relying on medication
It’s tempting to reach for the sleeping tablets when you’re anxious about not sleeping, but the cycle is tricky to get out of. “Sleeping tablets are great for a two-week period of stress, or if you’ve found yourself in a new environment and are struggling to adjust,” says Kathryn. “They’ll sedate you and you’ll get respite, but they’re not designed to work longer than that. If you keep taking them, your body will get used to them and they won’t be as effective – so keep them for emergencies and short-term use only.”
3. Find your perfect temperature
Getting your bedroom to the right temperature in the UK can be an arduous task – especially during those extreme summer and winter months. But according to Senior Clinical Physiologist Ana Noia from the Bupa Cromwell Hospital, it’s crucial. “The temperature tends to drop at night, giving your brain a signal that it’s time to sleep. That’s why when we’re on holiday somewhere hot, nodding off can be trickier. Equally, sleeping somewhere too cold isn’t great – if your hands and feet are uncomfortably chilly, you might struggle to sleep at all.”
According to Ana, the ideal temperature is somewhere between 18-21°C but this can vary depending on sex, age and any existing medical conditions (people with underactive thyroids or bad circulation for example, tend to be colder). Work out your happy temperature (that includes pyjamas too – avoid fabrics that irritate, or cause you to overheat) and stick to it.
4. Give apps the cold shoulder
If you’re a smartphone user, you’ll have seen countless devices and apps that promise to ‘measure sleep cycles’. But Anna is dubious. “Equipment like Fitbits aim to record levels of activity, measuring each time you move the device. The way they measure ‘sleep’ is by noting a period of motionless – predicting that’s when we’re sleeping. But there are issues with this – people often wake but don’t move, for example. Just because we’re still doesn’t mean we’re necessarily asleep…
Apps are even less reliable – promising to measure sleep stages, but it’s just not possible (we need to monitor brain activity to measure that).” Instead, stick to measuring daytime activity with your FitBit or Apple Watch, and stop second-guessing your sleep cycles.
5. Check your liquid levels
Caffeine and alcohol are two huge no-no’s when it comes to sleep. “It can take up to six hours for caffeine’s levels to drop to half the dose you originally took, making us anxious and delaying sleep,” explains Ana. Alcohol’s effects are different. “Alcohol depresses the brain and central nervous system, so while it might make you feel sleepy (and find it easier to drop off) you won’t enjoy good quality sleep. When we experience hangovers, most of that is caused by dehydration – that’s what wakes us up in the night, and disrupts sleep. You’ll find yourself experiencing sleep fragmentation, feeling totally exhausted when you wake.”
The solution? Avoid alcohol at bedtime as much as possible, and caffeine after 4pm. It’s worth being mindful of your evening liquid intake in general – even too much water might see you waking in the night.
6. Enforce a blackout
Think back to when you were a child – your bedroom was just for sleeping and playing, right? But as adults, the lines start to blur – with many of of us checking emails, watching TV and even working on laptops in bed. “Working in the bedroom causes us to associate that space with anxiety and pressure, and light exposure from TVs/laptops/tablets can have a hugely detrimental effect on sleep. Because they emit blue light (the light that affects our levels of the sleep-inducing hormone melatonin) it makes it harder to get to sleep in the first place.”
According to Ana, the solution is total darkness – think blackout blinds, no hallway lights, even the light from your alarm clock can be disruptive. And definitely no gadgets. If noise is an issue, try a ‘white noise’ radio station or app instead of ear plugs (you can set them to turn off after 30 minutes, too).
7. Set a routine
Both experts agree this is one of the most important things we can possibly do. As Ana explains; “You’re not going to sleep well every night, but if you maintain your bedtime and ‘rise’ time regularly, eventually you won’t need an alarm clock to wake.” And according to Ana, our jobs are interfering with that. “I see a lot of people with busy lives and jobs, who tend to sleep very little in the week, and then compensate on the weekend – sleeping for hours. It doesn’t help regulating a sleep pattern, and makes it much harder for our body to know when we’re meant to be sleeping. It’s the most difficult rule to follow – especially when you’re tired and want to sleep all day – but following a routineis key.”
8. Assess your exercise regime
We know we should all be practising moderate levels of exercise on a daily basis, but did you know the timing of that gym session can have a detrimental effect on sleep? “It’s best to avoid high-intensity cardio workouts close to bedtime,” advises Ana. “You’ll experience a ‘peak’ of energy afterwards – your temperature rises and you’ll feel a rush of adrenaline which makes getting to sleep harder. The timing of that varies between individuals, but it can last several hours.” Your safest bet? Sticking to a relaxing form of exercise in the evening, like yoga or pilates.”
9. Keep a sleep diary
People sleep badly for a huge number of reasons – from mental health problems, to stress or seemingly ‘insignificant’ factors like having a cough or cold. “I always encourage somebody visiting me to keep a sleep diary – it helps you notice links between lifestyle and sleep you might ordinarily miss,” explains Kathryn. Begin by making a daily note of what you’re eating, drinking, doing (including exercise) and feeling – and how well you slept each night. Are there any similarities? Even if you can’t spot any links, it’s a great tool to show a therapist or doctor.
10. Consider CBT
A recent study indicated that on average, 70% of people with sleep problems will see lasting benefits from CBT (Cognitive Behavioural Therapy). “It’s a programme that requires a lot of motivation, but the effects are relatively fast – typically within four weeks,” says Kathryn. But when you visit a therapist it’s important they know the full picture, so if you have any idea of what’s causing your sleep issues (young children, new pets, any medical problems or particular anxieties) flag it up.
And don’t feel bad if you’re struggling on seven hours, while your partner survives happily on five. “We all need different amounts of sleep,” explains Kathryn. “Some people run fine on just a few hours (men typically need less sleep than women) and others need eight or nine – just work out what’s right for you.”