Struggling to sleep? Here's how to fix it

WE all recognise the importance of sleep for our functioning, and how challenging it can be to get through the day on too little of it. This is because sleep is essential for our body and brain to repair, restore and function.

How much sleep we require varies from person to person, with older people typically requiring less sleep than those who are younger than them.

The clichéd eight hours is what’s generally required for adults aged 20-45. Infants can require up to 17 hours sleep per day as newborns, while those over 70 can often function on less than six hours sleep per day.

Good quality sleep consists of a number of sleep cycles (typically 4-6 cycles per night), and each sleep cycle is made up of four stages. Stages 1 and 2 are relatively short and involve the body and brain slowing down. Stage 3 is deep restorative sleep, and Stage 4 is REM or Rapid Eye Movement sleep, during which the brain processes memories and files away the things it’s learned or encountered during the day for future reference.

All these stages have a role to play in good sleep, and if you’re not going through them enough times, or are waking up after stage 2 for example, then the benefits of the sleep won’t be sufficient for your optimal functioning.

Insomnia is something that we can all suffer from at some point in our lives. It’s a sleep disorder that persists for a considerable period of time, and leads to impaired daily functioning. We can feel a lack of refreshment, feel irritable or sleepy during the day, have difficulty concentrating, or trouble regulating our emotions.

This can be experienced due to ongoing difficulties falling asleep, staying asleep or early wakening. Insomnia is something that affects 20-40% of people occasionally, and is twice as common in women. This is probably due to the hormonal and maternal causes of insomnia that women experience, such as menstrual symptoms, pregnancy and menopause.

Other causes of insomnia can be categorised into the following:

Physical - e.g. cardiovascular or respiratory issues are examples of physical issues that impede upon our body’s sleep processes. Restless leg syndrome is another cause of interrupted sleep

Physiological - this could be shift work causing an issue with melatonin release. Melatonin is the hormone that is required for optimal sleep, and it’s released in response to lack of light. In shift work, this doesn’t occur properly at the time required to sleep.

Pharmacological – the effect of drugs or other substances such as alcohol or caffeine can stimulate the body and brain, and make sleep more challenging to achieve. Sleep after alcohol can occur quite easily, but it’s not of sufficient quality, hence why we end up feeling tired afterwards.

Psychological – experiencing a stressful event can cause the mind to race and the body to tense up, affecting sleep as a result.

Psychiatric – the diagnosis of a mental health condition such as depression, anxiety or dementia is very often linked to poor sleep.

When looking to treat insomnia, it’s always best to treat the underlying cause. So if you know one of the above things are leading to your lack of sleep, that’s where you treatment journey should start. HRT, for example, can combat the drop in hormones that affect sleep during the menopause, and prevent the disruptive symptoms such as hot flashes. Otherwise, good sleep hygiene has been shown to be effective in 30% of insomnia cases on its own, with no other approaches necessary. This involves going back to the basics of having a cool room to sleep in, pitch black with no light or devices, breathable bedclothes, a quiet room or earplugs, and no stimulants or large meals in advance of bedtime. Keeping a strict wake/sleep routine is also important.

Cognitive Behavioural Therapy for Insomina (CBTi) is a non-pharmacological approach to treat insomnia which is considered to be first-line, before any drugs are tried. It involves a course of four to six sessions, which educates participants on sleep quality and quantity, on recognising their personal triggers for insomnia, and on developing coping strategies when dealing with lack of sleep. It provides an individualised sleep-wake schedule to adhere to, and can be completed in conjunction with a short term sleeping tablet in some cases.

Failing the above, asking your doctor or pharmacist what medications are available to help with sleep is worth considering, bearing in mind that many of the traditional ‘sleeping tablets’ have a long list of side effects, and are therefore only suitable for very short term use.

That said, there may be something to suit your situation, so do have the conversation. Herbal products have a role to play for some, for example the FabU R&R product developed by pharmacist Laura Dowling has extensive anecdotal evidence, and combines multiple ingredients to support good quality sleep.

We all know the benefits of a good night’s sleep, so if it’s eluding you recently, now is the time to investigate and take action. You’ll be sleeping like a baby before you know it!