Written by Philippa Walsh

How common are sleep problems?

Sleep problems are common. It is believed that 30% of adults struggle to get a good night's sleep. There is nothing more frustrating. 

We can experience problems in a number of ways. How many times have you lay in bed desperate for sleep, only for it to elude you until your morning alarm sounds? Or perhaps you have no trouble getting to sleep, it's staying asleep that's the problem. 

How much sleep do we really need?

It is widely believed that we need between 7 to 8 hours sleep to maintain our wellbeing. This is a misnomer. People have different needs. Many studies have shown that these can vary from needing only 4 to 6 hours sleep a night, to needing 10 hours or more.

Our needs do not remain fixed and vary over the course of our lifetime. A newborn baby may sleep for up to 17 hours a day. By the age of 5, this will reduce to 11 hours a day and by adolescence only 8 or 9 hours may be needed. By our thirties, we will usually be sleeping for less than 8 hours a night and this will reduce further with age. Many people by the age of 70 will only require between 4 to 6 hours sleep, still feeling refreshed the next day. 

Sleep needs are also dependent upon the level of activity we engage in during the day. Someone who does a more labour intensive job, works longer hours or is on the go all day will usually require more sleep than those who lead a more sedentary lifestyle.

Sleep problems explained

As we get older, our sleep patterns can change. It's not uncommon for older adults to drop off to sleep during the day, especially if their sleep was disturbed during the night. This in itself can be somewhat problematic, as daytime napping can make us less inclined to sleep well at night. 

Often when we're feeling depressed it can be tempting to retreat to our beds during the day; again this can maintain sleep difficulties. Not sleeping properly can lead to anxiety and frustration. The worry of not sleeping then becomes the problem. Anticipating a bad night's sleep tends to be a self-fulfilling prophecy. If we lie in bed looking at the clock and worrying about it, we're not going to be relaxed enough to sleep.

There are a number of physical and psychological factors that can determine how well we'll sleep.  These are:

Physical :

• Bodily discomfort including pain or having to get up and use the toilet during the night.

• Noise

• Light levels and temperature

Psychological:

We've all heard of the term 'racing thoughts' and these are often cited as a reason for not getting a good night's sleep. Common worries that we can't seem to be able to switch off at night are:

• Events that have happened that day and what's on the agenda the next day.

• How long you've been lying awake for.

• How long it is before you have to get up.

• What the future holds.

• Upsetting past events.

In a nutshell, sleep problems can result as a side-effect of medication, a physical health complaint, the emotional distress of a bereavement, depression, stress and anxiety. 

Solutions for common sleep problems

Problem: Frequent visits to the loo at night,.

Solution: If you find that you're having to get up in the night to use the loo, try and reduce your intake of fluids before bedtime. If this doesn't help, speak to your GP to rule out any medical reasons. As we get older, it is not uncommon for us to need the loo more at night. If there is no medical reason for this, worrying about it will only disturb your sleep further. Getting into the practice of using a good relaxation technique at night, can help alleviate anxiety.

Problem: Pain or environmental discomfort

Solution: Speak to your GP about different pain relief strategies that may improve how you feel. If what you're using to manage pain is ineffective, find out if you are able to change to an alternative medication. Try to find out if what you've been prescribed affects sleep.You may also benefit from discussing the psychological impact of pain with a professional psychotherapist.  

Rule out an underlying medical condition that is affecting your sleep. If you know that you have such a condition, discuss your options with your GP.

If your discomfort is non-specific, perhaps it's time to invest in a more comfortable bed or pillows. Something as simple as the addition of a memory foam mattress topper can significantly improve your comfort and help you achieve a better night's sleep.

If the room is too light, try black out blinds/curtains. If there is noise coming from somewhere you can't control, ear plugs can help. If the room is too hot or cold, try a different duvet tog or change the temperature of your room. If safe to do so, open your window a little to let in some fresh air. Being in a stuffy room can interfere with sleep.

Problem:  Worrying about not getting enough sleep

Solution:  Try to remember that not sleeping enough may cause you to feel tired and unfocused the next day, but that a lack of sleep won't kill you!  We never feel at our best the day after a bad night's sleep, but lying in bed worrying will only keep your mind active, increase your anxiety and keep you awake for even longer.

Stop checking the time! This will only make you feel under pressure to sleep. Try and shift the focus of your worries and think about something relaxing. Imagine yourself lying somewhere like on a warm beach or in a beautiful park. Imagine the sun on your body and listening to the sea or a gentle breeze.

There are now many relaxation and mindfulness apps to try. YouTube is a great resource for learning visualisation techniques. You may also choose to use the colour breathing technique explained in another one of articles.

Problem: Bereavement 

Solution: It is natural to experience disturbed sleep after a loss or other significant event. Try to remember that your sleep pattern will usually return to normal after a while. If this continues for longer than you feel able to cope with, talking to your GP or a Counsellor may help.

Problem: Stress, anxiety or depression 

Solution: Try to identify what the cause of your problem is.  If you are in a fragile emotional state, it can help to write down what is upsetting you so that you can see if your issues can be resolved on a practical level.

If you are stressed at work, can you put into place some changes to reduce your stress? If you find that you are worrying about lots of different things at night, writing them down as they pop into your mind can help. Keep a notepad by your bed to do this.

Are these real worries that need to be resolved? If so write down ways that you could do this and then let them go until you have time to action these the next day. If you find that your worries concern hypothetical events that haven't happened, commit to letting them go right then and there. If there is no practical resolution to be found, why hold onto them?

Spend a little time winding down afterwards, listen to some relaxing music, perhaps read a favourite book for 10 minutes or so. If you don't drop off to sleep after 30 minutes. DON'T stay in bed.

This may sound odd, but if you're only going to lie in bed worrying you might as well do something to make you feel sleepy. Go into another room and watch something boring on TV. Make a hot milky drink, but try to make this non-sugary and caffeine free.

Essential sleep hygiene tips

It's part of out normal routine to maintain our personal or dental hygiene, but often our sleep hygiene is neglected. It's vital to get into good sleep habits if we want to get a good night's sleep. Here are some key things you can do:

• Avoid using phones/laptops in bed. Bed is for sleeping - using phones and other devices stimulate our brain and make us less able to wind down for a good night's sleep.  The same goes for watching TV. Try and do this in another room and not while you're in bed.

• It goes without saying, but avoid stimulants if you are struggling to sleep.  Caffeine and sugar based drinks or foods should be avoided at least 4 hours before bed.

• Nicotine is also a stimulant and smoking before bed can impair your sleep. Try not to smoke or use nicotine products, such as gum or patches  at least 4 hours before bed.

• Avoid alcohol before bed. Many people will drink before bed to 'feel' sleepy, but this can impair the quality of sleep and result in restlessness and waking to use the loo.

• Stay consistent, try and go to bed and get up at the same time each day. Only go to bed when you're tired and avoid napping in the day if you can.

• Maintain a good pre-sleep routine to wind you down properly. Try to avoid watching TV in bed, maybe have a relaxing bath/shower before bed or read to help you feel relaxed. If you haven''t already, try to get into the practice of using a relaxation technique once you find one that you like and can stick to. 

If you still feel that you are struggling with insomnia - reach out for professional counselling and psychotherapy in Manchester today.