Those sleepless nights

Article First Published March 2011

Insomnia

The subject of insomnia comes up time and time again in my conversation with friends and relations and while we have covered it before, it is good to revisit it and check the latest information now available for this very common problem.

Many of my friends admit to wandering around in the night, having a cup of tea or even watching late night movies. This isn’t because they are thirsty or suddenly desire fun entertainment, but because they simply can’t sleep. After tossing and turning, turning over again, putting on or removing bed coverings; opening and closing windows, sipping water and counting sheep, many people simply give up in their attempts tosleep and get up.

Sleep goes through different stages in a cycle that lasts around 90 minutes and changes from drowsiness and light sleep to deep sleep and dreaming, when rapid eye movement occurs. A good night’s sleep may include five of these cycles a night.

These cycles are essential to restore the body, and not being able to get a good night’s sleep can be one of the most frustrating things; the more you know you need to sleep the more difficult it can become – worrying about sleeping can be enough to keep you awake!

Some people worry unnecessarily about the amount of sleep they need. If someone isn’t getting the famous “eight hours sleep a night” they may feel they are not sleeping well. In fact, people differ quite substantially in their sleep requirements and the key is sleeping well when you are asleep (ie having an undisturbed sleep) and waking refreshed. If you sleep solidly for six hours and wake up feeling fine, then this may be your natural requirement.

Sadly, for some, even six hours sleep a night is unobtainable. There are many different causes and while waking in the night is far more common as people get older (sleep problems occur more in older women than men), there is often an underlying cause that can be sorted out.

Obviously discomfort can stop you sleeping; being too hot and cold are obvious causes. Some people really find it difficult to sleep if the room isn’t totally dark or quiet and again these are simple measures that can be addressed.

When, however, there is no obvious cause yet you struggle to get a good spell of continuous sleep and wake up feeling tired, then this needs to be looked at.

Stress and worry can trigger insomnia; things going round and round in the head prevent you from relaxing enough to let sleep overcome you. The illness or death of a loved one; concern over money, work or health, relationship problems – so many things in modern life can cause real concern and it can be difficult to let go when you go to bed. Physical problems such a restless legs syndrome, indigestion or irritable bowel syndrome, pain joint and muscle problems such as arthritis may not be obvious in the day, but on the point of falling asleep they can cause enough disturbance to prevent you totally relaxing. Alcohol can cause wakefulness, as can other substances such as caffeine or nicotine.

It is a good idea to try and determine the cause of your insomnia and there are often things you can try yourself that might help. Consider carefully your daytime routine and diet, is there anything there that seems to tie up with times when you find it difficult to sleep? Try more exercise; write down any worries before going to bed and tell yourself that is it until the morning; even invest in a different mattress to ensure you are totally comfortable. Stop watching tv or being on the computer immediately before going to bed; don’t drink coffee or tea as a bedtime drink. Get into a regular bedtime routine doing the same things at the same time to help your body wind down for sleep. Any of these things might help solve the problem.

If however, sleep is still proving elusive, then doctors today are well informed and there are a number of various treatments they can recommend to get you back into a normal good sleeping routine. Sometimes a short course of sleeping tables is all that is needed to get the routine back; short-acting benzodiazepines and Z medicines are now generally the preferred treatments by doctors when medication is called for. There are also cognitive and behavioural treatments that can work. These can include stimulus-control therapy and relaxation training.

People our age are sometimes prescribed medicines containing melatonin, usually under the name of Circadin. This is only a short term treatment and not recommended for people with kidney or liver problems.

There are a number of non-prescription remedies available at supermarkets and pharmacies, everything from herbal treatments to own brand sleeping tables. As always, it is vital you read all the information and seek advice before you embark on self-treatment.

And a final aspect of insomnia – sometimes that late night hot milky drink can be just the thing to help get you off into a good night’s sleep. However, dentists warm that this really is not a great idea unless you make sure you get up and brush your teeth afterwards. There is no point establishing a good sleeping routine by setting up future problems from tooth decay which really can keep you awake at night!