Sleep issues and how we can help
What are sleep issues?
Poor or irregular sleep is something that all of us will experience at some point or other and can often resolve itself. However, if sleep is disrupted on a regular basis or for a prolonged period of time, or both, it may be down to a sleep-related condition. Whilst these can be down to physiological reasons, sleep difficulties can also be a psychological issue.
Insomnia is the most common form of sleep condition - an umbrella term that describes prolonged difficulties in falling asleep (initial insomnia), staying asleep, or frequent waking throughout the night. People suffering from insomnia often report not feeling rested after sleeping and this can have a significant impact on overall well-being.
Other sleep conditions include: Hypersomnia: A condition which of excessive daytime sleeping and sleep attacks, not related to a physiological condition (such as narcolepsy).
Sleepwalking: Rising from bed and moving around whilst asleep. Sleepwalking is far more common in children than in adults and usually resolves itself at a young age.
Sleep/Night Terrors: Episodes of extreme panic and distress whilst asleep, often involving physical movement and screams.
Symptoms
Difficulties falling asleep. You may find yourself tossing and turning in your bed, unable to find a comfortable position and difficulties settling. It is not uncommon to experience worrying thoughts at this time about the day that’s been or that’s up ahead; or worries about not being able to fall asleep and the impact this will have.
Frequent waking during the night. Perhaps you wake up multiple times for brief or extended periods - significantly more than you usually do.
Feeling fatigued during the day. Insomnia can have a significant impact on the quality of your sleep and it is common to not feel refreshed the next day.
Early wakening. Many people with insomnia experience waking up before their alarm is set to go off. Sometimes this can be accompanied by symptoms of anxiety, such as increased heart rate or worry.
Difficulties concentrating during the day, and feeling more irritable than usual.
Actions that can help
- Try to go to bed and wake up at the same time. Our body clock (or circadian rhythm) is an internal clock involved in many of the body’s functions, such as when we sleep, eat and are most active. A regulated body clock tends to mean a regular sleeping pattern, and a less disrupted night’s sleep. By going to bed and waking up at approximately the same time every night and day, we can help regulate our body clocks.
- Limit your caffeine intake. Caffeine can be a way of boosting your energy levels during the day. However, it can stay in our system for a long time (up to 12 hours) and may affect your ability to fall asleep at night. Caffeine can also make you feel more anxious, which can further exacerbate your sleep routine.
- Schedule in some exercise. By exercising during the day you naturally use up energy and alleviate stress. You don’t have to engage in intense and long periods of exercise - a 20 minute brisk walk can also work wonders.
- Limit your use of technology at least an hour before bedtime. Laptops, iPads, smart phones etc. - all of them emit ‘blue light’, which has been shown to suppress the release of melatonin. Melatonin is a hormone which helps our bodies prepare for and initiate sleep. We can struggle to fall asleep without it.
- Avoid napping during the day. Napping for more than 20 minutes during the day can disrupt our body clock, and make it harder for us to fall, or stay, asleep during the night.
Treatment
1. Self-help for insomnia.
There is a wealth of resources, both online and available through (for instance) your GP, which describe how you can manage insomnia and these have proven helpful for many. Included in these are resources on understanding insomnia, helpful sleep hygiene tips, sleep diaries, and information about how diet and exercise can affect your sleeping pattern. There are also free online Cognitive Behavioural Therapy for Insomnia (CBT-I) courses that you can follow. One of them, Sleepio, is accessible through the NHS. There is also lots of useful information on the Sleepstation site.
2. Psychological therapies.
Talking therapies have proven effective in the treatment of insomnia. They can be used in addition to self-help material. Engaging in psychological therapy gives you a space to understand potential triggers, what helps and what makes it harder to manage insomnia, and look at developing helpful ways to cope, amongst other things. There are different therapeutic approaches that have proven effective, for instance Cognitive Behavioural Therapy (CBT).
3. Medication.
Some prescribed medication can help alleviate the symptoms of insomnia and reduce its impact on your day-to-day life. However, sleeping tablets can have a sedative effect and are not recommended for use over a prolonged period of time. You should talk to your GP or psychiatrist about the options available for you, the benefits and the potential side-effects of any medication. Medication can be prescribed as a stand-alone treatment or in combination with, for instance, talking therapies.
Sleep - Five facts
- 1 in 10 people will experience sleep-related difficulties at some point during their life.
- Acute insomnia is different from chronic insomnia: the former refers to difficulties sleeping for a shorter period of time (usually one or a few nights), whereas the latter can last for months or even years.
- As we get older, we are likely to experience more examples of sleep-related difficulties, such as frequent night waking.
- Insomnia is more common in women than in men.
- Shift-work (especially working night-shifts) can contribute to the development of acute and chronic insomnia.
