Insomnia - hitting the pillow running
It seems so unfair. We all lead busy lives, and just when we're most worn out, a good night's sleep becomes a distant memory. But how do we know what's normal, or when we should worry? And how do we learn to love our beds again?
Insomnia - what is it?
The answer should be obvious - insomnia means inability to sleep. But all of us have problems sleeping from time to time, whether from anxiety or excitement. As a rule of thumb, insomnia is an issue if it's affecting your performance or alertness during the day or having an impact on your mood.
The good news is, you will sleep again! There are lots of tips (see below) which can help. You might think that taking a sleeping tablet won't hurt and may break the vicious cycle of being unable to sleep because you're anxious you won't. However, do beware - sleeping tablets are highly addictive, and can cause more problems than the worst insomnia. Worryingly, a study last year suggested that even taking them as rarely as once a month could be linked to higher death rates. Since this research was released, doctors have been less keen than ever to prescribe sleeping tablets. So if you really feel you have no choice but to take them, keep them strictly for emergencies and never take them for more than a few days at a time at a time.
Some symptoms can point to an underlying medical problem which needs medical help. They include:
If you're a snorer who's feeling exhausted, sleep apnoea could be your problem. When you go to sleep, some of your airways relax and can become completely blocked off. People with sleep apnoea never feel rested when they wake up. You'll need your partner to tell you if this might be your problem - sufferers stop breathing for many seconds at a time, then often 'snort' as if they're disturbed before they start breathing again. Losing weight if you're overweight, and avoiding alcohol (which makes the airways floppy) can solve the problem. If not, talk to your GP as you may need referral to a sleep clinic.
One of the most common symptoms of depression is difficulty sleeping, but you can get into a vicious cycle of finding your mood is affected by poor sleep too. While there are many other causes of insomnia apart from depression, this may be your problem if you also have other symptoms such as:
- Feeling down, depressed or hopeless
- Not enjoying things you usually take pleasure in
- Feeling tired or lacking in energy
- Being off your food or feeling hungry all the time
- Problems concentrating
- Feeling you've let yourself or others down
- Thoughts that you'd be better off dead
Restless legs syndrome
This remarkably common problem results in an overwhelming urge to move your legs and a general feeling of intense discomfort. It usually comes on at night and is worse if you're in a confined space. Try keeping cool - reduce the layers of bedding, invest in a fan for the bedroom and don't exercise in the evenings. If that doesn't help, ask your GP for a blood test - low iron levels or some medications may be to blame.
A surprisingly long list of medications taken for other conditions can interfere with your sleep. These include:
- Water tablets (commonly used for high blood pressure, but also for heart failure)
- Some beta-blockers (used much less often these days for high blood pressure, but sometimes used for abnormal heart rhythms and tremor)
- Some antidepressant tablets (speak to your doctor - some antidepressants help sleep, but some can cause problems sleeping in the short term)
- Steroid tablets
- Some cold remedies (speak to your pharmacist)
If you're in doubt about whether any of these medications could be contributing to your problems, your pharmacist should be able to advise you.
If you think stress is the cause, try the following:
- Don't do anything exciting before you go to bed - including reading a thriller or watching stimulating TV!
- If you've been lying in bed for a while and can't stop your thoughts churning, get up and distract yourself, then go back to bed as soon as you feel tired.
Overall, while insomnia can be distressing, it does usually settle on its own. Just knowing that you'll soon be able to look forward to snuggling down may be all your mind needs to help you drift off. You may also find noting down your sleep patterns, either using a notepad or by downloading patient.info's free Sleep Diary app for iPhones, helpful.
Top tips for a good night's sleep
You probably think you've done everything possible to help you get a good night's sleep. But read on - some of these top tips might surprise you!
- Don't drink alcohol. It may help you get to sleep, but you'll wake early and won't be able to get back to sleep. What's more, there is evidence that the sleep you do get is of poorer quality
- You probably avoid coffee late at night, but what about tea and chocolate? Both contain caffeine, which increases alertness
- Avoid heavy meals late in the evening - including that curry when you come back from the pub!
- Don't catnap, no matter how tempting. This will mean your body needs less sleep when you go to bed
- Don't lie in. Regular waking times help your body clock's rhythms
- Exercise, but not too late. A few hours before bed should tire you out nicely. Too late and your body will still be racing
- Keeping the windows shut may keep noise out, but are you too warm as a result?
- Ban ticking or illuminated clocks
- Keep the bedroom for sleeping - not for reading or watching TV.