Insomnia
Are you one of the rapidly increasing number of people suffering from sleep disturbance? Apparently ‘how to sleep’ is the 6th most-searched phrase on Google. Whilst we need 7-9 hours of sleep a night, the average we actually get is 6.7. Millions of prescriptions for sleeping pills are written each year and sales of over the counter sleep aids continue to escalate.
As well as making you less productive the following day, a lack of good quality, as well as quantity of, sleep harms your health in many ways. It has been linked with depression and feelings of insecurity, weight gain/obesity, diabetes, heart disease/attacks, high blood pressure, lower immunity, Alzheimer’s disease, a lower IQ and it can even shorten your life expectancy. As insomnia persists, the anxiety surrounding it can exacerbate the problem.
Identifying the cause will obviously help address the issue. Let’s first differentiate between two different types of insomnia: sleep onset ie difficulty falling asleep, and sleep maintenance ie frequent or early waking. Things that can cause difficulty in getting to sleep include of course anxiety - you may be worrying about something that happened that day, an on-going problem or perhaps something important that is happening the following day, an exam, a big event or a job interview. Similarly, fears and phobias, especially for children, will have the same effect. Stimulants like caffeine can prevent us from falling asleep, and it will also be difficult if we are in pain. One often overlooked cause is climate: what temperature is your bedroom, is there fresh air coming in? Mould? Damp?
Many things can wake us up in the night. Excluding external noises (such as a partner snoring, thunderstorms or overhead planes), two of the most common are alcohol and hypoglycaemia. Alcohol may help us to fall asleep initially, but it is not a deep restorative sleep and its dehydrating effects soon wake us up. Our body not only needs glucose to carry out metabolic functions during the night, but this is also the time it restores and repairs. If it lacks sufficient glucose for these functions, it will wake us up. One of the most frequent adjustments I find myself making to client’s diets is to ensure they have a sustained glucose release during the night. This does not mean eating a large dinner late at night, but ensuring that adequate calories have been consumed during the day and that complex carbohydrates have been incorporated appropriately. If you are waking a lot in the night, you should also consider checking with your doctor that it is not being caused by a medical condition, such as sleep apnoea or nocturnal myoclonus, or is a side effect of medications.
Melatonin is a hormone which induces sleep and regulates the sleep cycle. It is made from serotonin. Consequently if you are low in serotonin, for example those suffering from depression, you may have sleep difficulties. Cortisol is another hormone which if dysregulated can have a huge impact on our sleep as part of its role in regulating our circadian rhythm.
Tips for improving sleep
Your nutrition can have a huge impact on your sleep. You should ensure you are consuming a well-balanced, nutritious diet with all the macro- and micronutrients that your body needs. This will support your blood sugar, neurotransmitter and hormone balances, especially of serotonin and melatonin. Chicken, turkey, fish, tofu, eggs, dairy, brown rice, oats, lettuce, nuts and seeds are especially beneficial for sleep. Eat 3 regular meals a day, with a good breakfast and lunch and a lighter supper, which should be consumed at least 2-3 hours before bedtime.
Avoid caffeine after mid-afternoon - it has a half life of approximately 5 hours so it can take up to 10 hours for it to leave your body. Avoid alcohol and other stimulants.
Lap tops, phones, TVs and all other wifi-enabled electrical devices should be kept out of the bedroom, or otherwise put on flight mode. If you really need to have your phone on or a baby monitor close by, ensure it is at least 2 feet away from your head.
Our exposure to artificial light has a direct impact on our body’s ability to regenerate and recuperate during sleep - reduce your exposure as much as possible and especially 2-3 hours before bed. Your bedroom should be as dark as possible to maximise melatonin production - black out blinds or curtain linings help.
Follow a regular bedtime routine - get into the habit of making time to wind down before going to sleep. You are more likely to be able to sleep deeply if you have allowed the mind and body to relax first.
Ensure your bedroom is well-ventilated and the temperature is slightly cool. Use natural bedlinen such as cotton or linen. Change the weight of your duvet according to the season.
If you wake up during the night, ask yourself if you might be dehydrated or slightly hypoglycaemic (your body needs glucose to carry out metabolic, repair and restorative functions during the night and will wake you up if it doesn’t have enough fuel for this). Avoid looking at your clock. Instead, lie on your back and try to relax each part of your body, starting from your toes and working up to your head. Breathe deeply from your diaphragm and tell yourself it doesn't matter if you don’t fall asleep.
Write ‘to-do’ lists - if you make a list of outstanding tasks, you are less likely to wake up during the night thinking about what you have forgotten/haven’t had time to do.
Relax during the day - yoga, meditation, walk in nature, short naps of 5-15 minutes and even a break of 3-5 minutes can enable the body to relax, renew energy and improve sleep quality and cognitive function. Sit or lie in a well-ventilated room, progressively relaxing muscles and breathing deeply from the abdomen. You won’t actually fall asleep but enter a deeply relaxed state.
Regular exercise has been shown to improve both the quality and quantity of sleep. It should be taken during the morning or afternoon, but not in the evening, unless it is a relaxing form such as yin yoga.
…and finally, let go of wanting to sleep: the more pressure we put on ourselves to sleep, the less likely we are to fall asleep. This is especially true at times of stress or before big events. It may help to replace the word ‘sleep’ with ‘rest’.