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Friday 25 November 2011

Tackling insomnia: how to get a good night's sleep

 More than a third of Britons suffer a cycle of insomnia, low energy and heightened stress levels. Victoria Lambert reveals how to get more out of a night's sleep


Sleep drawing
Aiming for a good night's sleep Photo: KarIn Åkesson
Could the secret to a long life be as simple as getting the right amount of sleep? Doctors have long known that there is a link between insomnia and poor health. It can be a symptom of heart, respiratory or neurological disease, as well as hormone imbalances and chronic pain. Psychological problems such as depression and stress can also trigger bouts of sleeplessness, and these issues can all feed each other, creating a vicious circle of sleep deprivation, low moods and an inability to cope with stress.

A study published at the beginning of October revealed a simpler truth: of 459 women monitored by the University of California, those who slept between 6.5 and 7.5 hours per night had longer lifespans. Those who averaged less - or more - sleep had shorter lifespans.

Yet sleep can prove elusive even for the healthy, with more than a third of us reporting sleep problems at some stage. Stress at work or at home, such as when we are organising events such as Christmas celebrations; too much caffeine, or even too little exercise, can all interfere with our ability to switch off at night.

But what's the major cause? "Poor sleep hygiene, if I'm honest," says Dr Simon Wharton, consultant in sleep medicine at Nottingham University Hospital and BMI Park Hospital. "Most people who come to see me think there is a complex reason for lack of sleep but it unravels the same way: they develop poor habits. They try to catch up but the body is not built to store sleep and compensate for late bedtimes, so they fail." He explains that we all go through several stages of sleep: first, we fall into a short period of light sleep where we may dream, which is called Rapid Eye Movement or REM sleep.

Unfortunately, if you wake during a deep sleep, you are more likely to feel tired and "hung-over", and struggle harder to get back into consciousness. "Many people think that they can experience all the stages of sleep but just later, if they move their bedtimes back by a few hours, say to midnight and then rise at 8am," says Dr Wharton. "But we now know that our body clocks are more firmly set than that. They like us to go to bed at about 10pm - and if we do, we will experience the normal pattern of sleep until we wake.

"But if we go to bed two hours later, the clock is already ticking and we miss out on those stages, losing vital deep sleep. Then we wake up feeling unrefreshed."

He confirms that some are natural owls and their sleep clocks don't begin ticking until midnight, because, he says, time keeping is part of the unconscious mind, but adds: "Sleeping in at the weekend is no help at all - you don't catch up on the deep sleep you missed, you just gain a bit more light sleep. And you move yourself further out of synch."


He adds that other lifestyle factors may count such as drinking coffee after midday or alcohol at night. "Caffeine has stimulating properties, and although people think alcohol has a hypnotic (sleep-inducing) effect, it interferes with your natural sleep routine, leaving you less refreshed in the morning."

Other conditions can affect sleep quality: snoring (a partner's or your own) may be disturbing, but sufferers of sleep apnoea fare even worse. "These people suck their own airways shut for a moment stopping breath. Then they wake themselves with a start, sometimes not to full consciousness, but enough to disturb sleep over and over again all night. They feel sleepy all day. "It is partly caused by obesity but also by sheer physiology," says Dr Wharton, "those with short jaws are susceptible."

Age is relevant. A US study reported in 2008 that older people really do seem to need less sleep - subjects of the Harvard trial found that when told to sleep for 16 hours a day for several days, those aged between 60 and 72 years managed an average of 7.5 hours sleep compared to nine hours among the 18-32 year-olds.

Dr Wharton agrees: "You do need most sleep when you are a teenager and the body is growing; but that ends in your twenties. By your seventies, you'll naturally nap during the day and wake up more at night."

So how do you treat sleeplessness if it is not a symptom of a wider condition? Start with the basics, says Dr Wharton. "Don't go to bed too early or too late. No coffee after lunch. No alcohol in the evening and no television, radio, laptop or mobile phone in bed as they overstimulate your brain. Keep the bedroom cool and quiet, and use that room only for sleeping and sex. Take sleeping tablets only for the odd day as when you stop it can cause worse insomnia, and as a last resort, you could try cognitive behavioural therapy (CBT).

Essentially, it comes down to sense, he says. "And the old saying that an hour in bed before midnight is worth two hours after is true. Modern habits of living tempt us to do all the wrong things when it comes to sleep, but we can't get over our basic biological design."


http://www.telegraph.co.uk/health/wellbeing/8128840/Tackling-insomnia-how-to-get-a-good-nights-sleep.html