The essential sleep guide to prime your body and put insomnia to bed.
Medically reviewed by Dr Juliet McGrattan (MBChB) and words by Annie Hayes
Can’t sleep? If you can’t fall or stay asleep and frequently find yourself tossing and turning until the early hours, you’re certainly not alone in struggling to catch precious Zzz’s. Insomnia is thought to affect around one in three people in the UK, with a quarter of Brits clocking up fewer than five hours a night.
A lack of sleep has huge implications for our mental and physical health; putting us at greater risk of mental health issues like anxiety and depression, impairing our cognitive function, increasing the likelihood of serious medical conditions such as obesity, heart disease and diabetes, and even shortening our life span.
Step away from the sleep meds, because there are natural ways to tackle sleepless nights. We asked Dr Samantha Wild, GP at Bupa UK, and Dr Nerina Ramlakhan, a physiologist and sleep therapist, for their expert tips on drifting off:
What causes sleepless nights?
Most people require around eight hours sleep a night to function at their best – but many fall far short of the mark. The causes of insomnia are as varied as the people who experience them, so it can be extremely difficult to pinpoint precise triggers.
However, if you find that you frequently can’t sleep, any one of the following factors could be to blame:
- Mental health conditions:such as depression, anxiety and stress.
- Physical health problems: including chronic pain or heart problems.
- Temperature: being too hot or too cold can impact sleep quality.
- A poor sleep environment:eg an uncomfortable, light or noisy bedroom.
- Medicines: some medicines can disturb sleep, including antidepressants.
- Lifestyle habits: working late, afternoon naps, and shift work.
‘There’s lots of reasons you’re unable to drift off: you may be feeling anxious, worried or stressed, especially during these uncertain times,’ says Dr Wild. ‘Drinking tea, coffee or energy drinks during the day can impact your sleep at night, too. Whatever the cause of your inability to sleep, there’s a few relaxing things you can try.’
Melatonin and sleepless nights
A reduction in melatonin can lead to sleep issues. Known as the ‘sleep hormone’, melatonin is a hormone that occurs naturally in your body and helps
to regulate your circadian rhythm and sleep patterns. Melatonin is made by the pineal gland in the brain and is released as the sun sets. Levels increase until about 2am and drop off at sunrise. The blue light on our phones and TVs suppresses the production of melatonin and delays its release, leading to difficulties sleeping. Melatonin also decreases naturally as we age.
The causes of insomnia are as varied as the people who experience them, so it can be difficult to pinpoint triggers.
The best way to keep your melatonin stores topped up is to sleep in a pitch black room, dim the lights and avoid screen time at least an hour before bed, as the light from the screens does prevent melatonin from being produced as effectively. It’s also worth investing in blackout blinds or a good eye mask to block out external light.
😴 Melatonin in medication form does exist, but it is mainly used to treat short-term sleep problems in adults aged 55 or older; ask your doctor for details.
What to do when you can’t sleep
Cultivating a relaxing atmosphere is conducive to a good night’s sleep. There are four key elements to this, as outlined by the University of Pennsylvania:
- Keep quiet:if minimal noise isn’t an option – if you have tinnitus, for example – white noise works just as well.
- Focus your attention:this could be a mantra, a mental image, or a breathing pattern.
- Maintain a passive attitude:accept the situation, rather than resist it – and remain at ease if your mind begins to wander.
- Get comfy: this goes without saying, but finding somewhere cosy to get your head down will help you drift off.
Take care of the above to ensure you’re primed and ready for rest. Then, it’s time to fast-track to the land of nod by utilising some tried and tested techniques. Try the following:
- Controlled breathing
Managing your breath can switch off your body’s stress response. Inhale slowly through your nose, and exhale through your mouth. You could count each breath as it passes – making a soft mental note, rather than a solid tally – or simply label each one ‘in’ and ‘out’.
Alternatively, you could try the 4-7-8 method, whereby you inhale for four seconds, hold the breath for seven, and exhale for eight. ‘Breathe deeply from your diaphragm,’ says Dr Ramlakhan. Before you start, ‘tell yourself that it doesn’t matter if you don’t fall asleep – you will just use the time to rest and relax,’ she adds.
Picturing a peaceful image in your mind’s eye might help you drift off. Imagine a relaxing place or experience from your past, or create a new one. Reflect on the details of the setting, adding sensory information – smell, taste, touch, sound – to make it more real.
- Mindfulness meditation
Mindfulness is a great way to bring your focus to the present moment, says Dr Wild. ‘First, focus on slowly inhaling and exhaling,’ she says. ‘Notice any sensations you’re feeling – for example, in your hands, feet and legs. Observing your body in a calm and mindful way can leave your body and mind feeling very relaxed.’
If you find yourself rushing through the body scan, following a guided meditation on an audiobook or dedicated sleep app might help you make the most of the exercise (just be sure to set your screen to night mode first).
- Progressive muscle relaxation
Similar to a body scan, this approach focuses on gradually releasing tension from muscles throughout the body. ‘Lie on your back and try to consciously relax each part of your body, starting from your toes and working up to your head and face,’ says Dr Ramlakhan.
If you find your mind wandering at any point, relax – it’s totally normal. Simply pause for a moment before returning to the technique without internal judgement or frustration.
How to get a good night’s sleep
Don’t wait until you’re tossing and turning to take action. Follow our tips and develop a bedtime schedule to cultivate a quality night’s kip ahead of time:
✔️ Make your bed(time) and lie in it
A regular routine can really help you to get a good night’s sleep, and can even help you drift off quicker, says Dr Wild. ‘Set up a regular sleep schedule – head to bed at the same time each night and add in relaxing activities, like reading a book or having a hot bath before bed.’
A healthy bedtime routine could include simply slowing down and taking your time as you shower or clean your teeth, adds Dr Ramlakhan. ‘You also might like to do things like light a candle or use an oil burner with a relaxing scent, write a gratitude journal, meditate, or do some gentle yoga,’ she says.
✔️ Avoid the news
Switch off screens an hour or two before bed, says Dr Ramlakhan. ‘Particularly checking your inbox, social media and watching the news, as these things are likely to make you feel wired, anxious and even fearful – not conducive to a good night’s rest,’ she says. ‘We sleep well when we feel an inner sense of safety and our nervous system is settled.’
✔️ Keep a bedside diary
If you want to drift off quicker, try writing down anything that’s on your mind, suggests Dr Wild. ‘Not only can this help you to organise your thoughts and leave you feeling calmer, but it can stop any worries or stresses building up inside your head,’ she says.
You don’t have to meticulously record the day’s events – simply scrawling your thoughts offers relief, even if you never plan on reading them over again. Bullet pointed lists can be useful, too.
✔️ Eat well for optimum sleep
Eating regular, healthy meals throughout the day will stabilise your blood sugar levels, says Dr Ramlakhan. ‘To sleep well, we need a balance of serotonin and melatonin in our system,’ she says.
‘Adequate amounts of vitamin B6 and tryptophan are needed to boost these hormone levels and they are found in chicken, cheese, tofu, tuna, eggs, nuts, seeds and milk, so include these on the menu as part of a healthy, balanced diet,’ she adds. However, avoid eating large meals late at night, as these can cause indigestion and affect your sleep, adds Dr Wild. ‘Try and have a light dinner in the evening,’ she says.
✔️ Stay hydrated (with water, mainly)
Drink plenty of water, says Dr Ramlakhan. ‘Like every other system in the body, our bodies need to be well hydrated for our sleep biochemistry to function well,’ she says. Steer clear of tea, coffee and energy drinks from midday onwards as caffeine can affect your body for up to 12 hours, says Dr Wild.
‘While alcohol may help you drift off quicker, it can affect the quantity and quality of your sleep, and you may find yourself waking up frequently in the night,’ she adds. ‘Instead, have a milky or caffeine-free herbal tea or stick to water.’
✔️ Make a point of moving your body
Regular exercise is one of the best ways of reducing stress levels and improving sleep, says Dr Ramlakhan. ‘Exercise helps produce the chemical adenosine, which promotes sleepiness and enables melatonin to work more effectively,’ she says. ‘But overtraining can produce too many stimulating hormones which can make it harder to get to sleep quickly, especially if you exercise in the evenings.’
If you can, take your workout outside – or simply go for a wander around the block. ‘There’s lots of health and wellbeing benefits to heading outdoors for a walk,’ says Dr Wild. ‘Not only can it boost your mood, reduce stress and improves your self-esteem, but it also helps your body to produce melatonin.’
✔️ Try a herbal remedy
Aromatherapy oils have long been used to calm the mind. Lavender, valerian and vetiver essential oils are believed to aid relaxation and restful sleep, and are available in pillow sprays and room sprays. Herbal remedies containing valerian, lavender and passiflora have also been shown to help with sleep issues by reducing anxiety and aiding natural sleep. Your pharmacist will be able help you choose the right one for you.
Avoid over-the-counter medications containing sedating antihistamines, such as promethazine or diphenydramine. They may help treat short-term sleeplessness but are unsuitable for long-term use, and often cause side effects like daytime drowsiness, dry mouth and dizziness.
What to do if you still can’t sleep
If you’re still unable to sleep, don’t panic. The worst thing you can do is allow yourself to become frustrated and stressed. ‘If it’s been longer than 20 minutes, you should get up and find a relaxing activity to help put your mind at ease, such as reading or listening to quiet music,’ says Dr Wild. ‘Avoid looking at your digital devices if you can, as this can leave you feeling even more awake.’
If you’re still unable to sleep, don’t panic. The worst thing you can do is allow yourself to become stressed.
If sleep continues to elude you, focus on other ways you can take care of yourself throughout the day. ‘Sleep, although vital, is only one way in which we get energy,’ says Dr Ramlakhan. ‘Our energy levels are also supported by the way we eat, drink, move, breathe, and even think. Other forms of rest and relaxation, like meditation, yoga, and self-care, are also highly restorative.’ Don’t beat yourself up – after all, there’s always tomorrow night.
When to see a doctor about insomnia
Most people can overcome insomnia by changing their sleeping habits. If your sleep issues are severe, long-term, or worsening, make an appointment with your GP.
Your doctor will try to find out what is causing the insomnia and make sure you receive the right treatment. They may refer you to a therapist for Cognitive Behavioural Therapy (CBT) to improve the thoughts and behaviours preventing you from sleeping.