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Dr Sarah Jarvis

Health Question & Answer


Sleep Routines

I cannot get to sleep and automatically wake up at between 5 & 5.30.a.m, no matter what I do, even if I go to bed at 3.a.m. Any advice you can give?

- Valerie, UK


You’re in good company. It’s thought that about one in five people suffer from insomnia – any kind of sleep problem enough to stop you functioning on top form during the day. It’s a myth that everyone needs eight hours of sleep a night – while most need six to eight hours, some people can cope perfectly on five.

Most people are naturally more alert either late at night or early in the morning – the ‘owl’ and the ‘lark’ – and if you’re getting enough sleep to avoid feeling drowsy in the day, waking every day at 5.30am isn’t abnormal. In fact, one of the most common expert tips for people suffering from insomnia is to set your alarm at the same time every day, including weekends, to reset your body clock into a regular rhythm. However, if you’ve always been able to sleep through until later, you should be looking for another cause.

Some experts believe that the most common problem is the occasional poor night’s sleep, which makes people anxious the next night that they won’t sleep. This in turn raises adrenaline levels when you get to the bedroom, and this in turn leads to more wakefulness and a vicious cycle of anxiety over sleeping.

But there are lots of other factors which can contribute. Some people are very sensitive to the effects of caffeine on levels of alertness, so it may be worth avoiding caffeine (coffee, tea, chocolate, some painkillers and caffeinated soft drinks) after 4pm or even completely for a couple of weeks. Alcohol may help you get to sleep but it interferes with the quality of sleep and tends to lead to early morning wakening. Several medications can also interfere with your sleep pattern – ask your pharmacist. Depression is also a common cause of poor sleep – the ‘classic’ sleep disturbance associated with depression is early morning waking, although it can cause problems getting to sleep, disturbed sleep or even sleeping too much.

It may be worth starting off by calculating how much time you’re actually spending sleeping – from the time you get off to sleep (don’t clock-watch as this can increase anxiety) until the time you wake up – every night for a week. If you’re tired in the day, add an hour to this and use this as your baseline sleep level to aim for by adjusting your bedtime. Then try to get your sleep rhythm back:

  • Keep your bedroom for sleeping only, apart from reading or watching TV for 15-30 minutes before you turn the light out
  • Don’t turn the lights out until you’re sleepy
  • If you spend more than half an hour wide awake, get up and do something else, only going back to bed when you’re tired again
  • Don’t take naps during the day if possible – if you do, not for more than half an hour and not after about 3pm
  • If you’re waking every morning at 5 or 5.30, get up at this time every day to begin with.

Once you’ve got your sleep pattern back in synch by getting into this sort of pattern, you can start trying to get up a bit later.

Dr. Sarah Jarvis
Healthcare Professional

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