Sleep is essential to the maintenance of physical and psychological health. We all know how difficult life can be when we’re not sleeping well. Poor sleep can have a negative impact on your energy levels, mood, performance and enjoyment of life. So it’s worth taking a few minutes to think about how you might be able to improve your quality and quantity of sleep.
During sleep our heart rate slows, body temperature falls and the complex changes take place in brain activity. When we first fall asleep we enter the non-rapid eye movement (NREM) stage of sleep. NREM is divided into three stages, with each stage becoming progressively deeper.
NREM1 and NREM2 are light stages of sleep from which we are easily woken. NREM3 is a deeper stage of sleep and some may feel disorientated if woken from this sleep stage. Finally, we move onto stage four which is known as rapid eye movement (REM) sleep. It is during this stage of sleep that people dream. Normal sleep patterns consist of a mix of all the different stages of sleep. According to the Sleep Council, the consumer education arm of the National Bed Federation, a good night’s sleep consists of five or six cycles, whereas disturbed sleep consists of far fewer.
Most adults need between six and nine hours of sleep every night. By working out what time you need to wake up, you can set a regular bedtime schedule to help aid a good night’s sleep. The NHS Choices website recommends that people who are struggling to sleep may find that keeping a sleep diary can help. This may help to uncover lifestyle habits that can contribute to insomnia. A typical sleep diary may include answers to some of the following questions:-
If you do go to your GP or a sleep expert for more help with sleeping they may ask you to keep a sleep diary to aid their diagnosis of your sleep problem. For further information, see the NHS Choices website.
People for whom sleep problems are a regular occurrence and are interfering with their daily life, may be suffering from a sleep disorder. Anybody who is unsure as to whether they have a sleep disorder can take the Epworth sleepiness scale test. For further information about the test, see the Narcolepsy UK website.
Continued poor sleep can affect the brain’s function and lead to problems such as forgetfulness, irritability or lack of concentration. Over a prolonged period the part of the brain that controls language, memory, planning and sense of time is severely affected. So sleep is crucial to feeling good and enjoying life. Given that insomnia is often caused by lifestyle choices, here are some tips that might help to improve your sleep:-
Some prescription and over-the-counter medication can cause insomnia as a side effect. These include:-
People should check with their GP or local pharmacist to see if any medication they are taking could cause insomnia or sleeping difficulties.
Restless legs syndrome, also known as Willis-Ekbom disease, is a medical disorder that causes an urge to move your legs (this can also affect some people’s arms). This urge develops when sufferers are lying down or resting and is usually caused by uncomfortable, tingly or aching sensations. This sensation is often worse in the evenings and during the night, so it is most commonly associated with difficulty in sleeping.
Common signs and symptoms include:-
Sufferers often find that the discomfort eases when they move, stretch or massage their legs. In some instances, restless legs syndrome is linked to an underlying medical condition, for example, iron deficiency or kidney disease. In instances where it is not related to an underlying medical condition, sufferers might find that regular exercise, good sleep habits and quitting smoking may help. For further information and support, see the RLS-UK, the restless legs syndrome charity website.
Obstructive sleep apnoea (OSA) is a condition where the walls of the throat relax and narrow during sleep, interrupting normal breathing. These pauses in breathing interrupt the sufferer’s sleep and whilst people rarely remember the interruptions, they can often feel exhausted, tired and irritable during the day. Symptoms of sleep apnoea include:-
Sleep apnoea is a serious condition and anybody who suspects that they may have sleep apnoea should consult their doctor. Treatment options include:-
For further information about sleep apnoea, including advice about treatment, see the British Snoring and Sleep Aponoea Association website.
Narcolepsy is a sleep disorder that causes people to fall asleep very suddenly at inappropriate times. It is caused by a malfunction of the brain mechanism that controls sleeping and waking. People who have narcolepsy may have sleep attacks at any time, for example, whilst working, talking or driving. Symptoms include:-
For more information, including the diagnosis and treatment of narcolepsy, see the Narcolepsy Association UK (UKAN) website.
Conditions such as depression, anxiety and stress commonly cause insomnia and sleep disturbances. Equally, people who suffer from a severe sleep problem over a long period of time can go on to develop a mental health problem. Often, people with long-term sleep problems can develop unhelpful thoughts and associations with sleep that make the problem worse.
In these instances cognitive behavioural therapy (CBT) can help people to change negative patterns of thinking and behaviour. CBT, also known as a talking therapy, can be offered for a range of sleep problems.
The Mind website has advice about how to deal with sleep problems that are related to mental health conditions, for example, anxiety and depression. For further information, see the Mind website.
The NHS England Improving Access to Psychological Therapies (IAPT) programme is designed to help people to access therapy easily. Anyone who needs therapy, such as counselling, can access it through their GP, workplace, educational establishment or voluntary and charitable organisations. Ordinarily, this service is free to NHS users and GPs should be aware of what is available to patients in their local area and also make the necessary referral.
For people who prefer not to go through their GP, some services have a self-referral option which enables you to go directly to a professional therapist. To search for local psychological therapy services, see the NHS Choices website.
Availability of services can vary and NHS therapy in some parts of England, in particular rural areas or small towns, can be very limited. Equally, people may have to wait a long time or travel some distance to find something suitable.
If you live in Wales or Scotland, please visit Health in Wales or NHS Scotland for information about services.
Pharmacist Support’s Listening Friends telephone helpline is staffed by trained volunteers and provides callers with the opportunity to talk anonymously and in confidence to a pharmacist about any stresses they are facing in their work or home life. You can contact our Listening Friends Helpline on 0808 168 5133, or you could contact our enquiry line on 0808 168 2233.
Sleep centres can help with the diagnosis and management of sleep disorders. People will need a referral from their GP in order to access an NHS sleep clinic. For a full list of sleep clinics/centres in the UK, see the Narcolepsy UK website.
YoungMinds is a charity committed to improving the emotional wellbeing and mental health of children and young people. Parents who are worried about their child’s sleeping habits can call the YoungMinds Parents’ Helpline on 0808 802 5544, or for further information, see the YoungMinds website.
The Sleep Council has a series of nodcasts featuring soothing sounds to help you off to sleep at night. These include birdsong and the sound of the sea. For further information, see the Sleep Council website.
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