For many of us seeing that it’s three o’clock in the morning on a bedside clock is a welcome message that we have another three or four hours of sleep to look forward to. But for those with problems sleeping it’s just another reminder of how little they have slept, and how little time they have left.
Insomnia and other problems sleeping affect roughly a third of the population. Certain conditions can disturb sleep – the menopause, prostate issues, arthritis – and certain drugs can cause problems sleeping. For instance beta-blockers can cause insomnia, diuretics can cause broken sleep, and SSRIs can decrease the amount of REM sleep.
The conditions that disturb sleep, and the side effects of medication that cause problems sleeping, are the major reason why insomnia increases to affect nearly 50% of people over sixty. These medical reasons cause shorter periods of sleep, which is mistaken by many people as a sign that we need less sleep as we age. In fact the need for sleep remains fairly constant, and those over seventy-five will often develop an advanced sleep phase. Here tiredness from broken sleep prompts earlier bedtimes, which then result in early morning wakefulness.
The remedy for advanced sleep phase is go to bed later, stay stimulated throughout the day and evening, and to remain socially active and engaged. What remedies are there though for those with insomnia and other problems sleeping?
The first step is to avoid the blue light emitted by smartphones, tablets, TVs and LED lighting before bedtime. The reason for this is that light prompts the regulation of the body-clock and the production of the sleep promoting hormone melatonin. The blue light from devices such as these is at the end of the spectrum that has the highest effect on the body-clock, and so they are the most likely to cause problems sleeping.
There is evidence that mental activity does have an effect on sleep. Experiments with people conducting moderately difficult mental arithmetic as they tried to fall asleep showed that those with insomnia did fall asleep more quickly. Those who didn’t have problems sleeping however saw an increase in the time it took them to fall asleep.
Whilst alcohol can help you get to sleep more quickly it also disrupts REM dream sleep and causes more disturbed nights generally. Instead a better choice is a small amount of food rich in carbohydrates, such as cereal or toast. In addition the milk with the cereal will contain tryptophan which promotes the production of melatonin.
Exercise is another way of promoting sleep. It doesn’t have to be done every day, but it does need at least two and a half hours of moderate aerobic activity per week for exercise to have a positive effect on sleep. When exercise is carried out ideally it should finish six hours before you wish to go to sleep, in order to allow enough time or your body to return to a state of rest.
Temperature is also important and you should aim to be at a neutral temperature – for most people this means a temperature of around 18°C in their bedroom. The aim is to not be so warm as to sweat or so cold as to shiver, and cold feet will always promote insomnia or problems sleeping.
Lavender or neroli oil can also be used, sprinkled on the pillow before sleeping or placed in a diffuser, as tests have shown that both the effect of improving the time taken to get to sleep, and the quality of sleep as well.
Finally, the decision has to be taken as to whether to get up when you simply can’t sleep, or to stay in bed. The answer quite simply depends on how people are able to approach their problems sleeping.
If the bed is becoming a place where you lie awake and are anxious about not sleeping then the answer is to get up, to leave the bedroom, and to engage in some non-stimulating activity for twenty minutes or so. If however you practice mindfulness or meditation then staying in bed, and accepting it as a place of comfort and “quiet wakefulness” will be equally beneficial. Both practices have the same end in mind – to prevent the bed becoming associated with feelings of anxiety about sleep.
Finally if you are having trouble because of the constant reminder of time from the bedside clock then the answer is easy – put the bedside clock where you can’t see it.
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