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Adult Mental Health Service

Practical steps tobeat InsomniaPharmacy/Psychology department - 2010

If self-help techniques such as these don’t alteryour sleep problem, you may benefit from a shortcourse of cognitive behavioural therapy (alsocalled ‘talking’ therapies). Sessions such as thesewith a trained professional will allow investigationinto emotional issues that may be impacting onyour overall mental health state, and preventingyou from sleeping properly.

You may wish to consider keeping a 'sleep diary'.A sleep diary records events that may impact onyour sleep, such as what time you went to bed,when you woke, and record how much sleep andwhat quality sleep that was. This kind of recordcan help to identify triggers for a bad night'ssleep. An example of such a diary can be foundonlineat http://www.sleepeducation.com/pdf/sleepdiary.pdf or you can ask for one from yourkey worker or GP. Relaxation tapes are alsoavailable from some GPs.

Alternatively there are some forms of medicationthat can only be prescribed by a doctor that canbe used for a short period of time to provide ashort term strategy to sleeping problems. If youare being considered for a medication to help yousleep, or you are interested in knowing moreabout medication that can help with sleepdisorders, refer to our leaflet specifically coveringthis subject through the Trust's public website.

Control your periods of restlessness:Control your periods of restlessness:Control your periods of restlessness:Control your periods of restlessness: If you can'tsleep, get up and do something relaxing. Read,watch television or listen to quiet music. After awhile you should feel tired enough to go to bedagain. If you feel physically exhausted, but yourmind is full of racing, intrusive thoughts, don't tryto force sleep, it will only make you feel moreanxious. Try keeping your eyes open, instead, andas they start to close, tell yourself to resist. Themore you try to stay awake, the sleepier you’llbecome. Interrupt unwanted thoughts byrepeating a soothing word (such as 'peace') overand over to yourself. Try visualising a scene orlandscape that has pleasant memories for you.

Control the time you go to bed:Control the time you go to bed:Control the time you go to bed:Control the time you go to bed: Don't go withoutsleep for a long time - go to bed when you aretired and stick to a routine of getting up at thesame time every day, whether you still feel tired ornot. If you've had a bad night, don't sleep in thenext day - it will make it harder to get off to sleepthe following night. Avoid daytime naps, as thesewill disturb your next night’s sleep.

Control your diet:Control your diet:Control your diet:Control your diet: Caffeine hangs around in yourbody for many hours after your last drink of tea orcoffee. Stop drinking tea or coffee by mid-afternoon. A four hour caffeine-free periodbefore bedtime is idea. If you want a hot drink inthe evening, try something milky or herbal (butcheck there's no caffeine in it). Don't drink a lotof alcohol. It may help you fall asleep, but you willalmost certainly wake up during the night. Don'teat or drink a lot late at night. Try to have yoursupper early in the evening rather than late. Don'tuse slimming tablets - many of these containagents that stimulate and so will tend to keep youawake.

An introduction to insomnia:An introduction to insomnia:An introduction to insomnia:An introduction to insomnia:If you find it difficult to get to sleep or difficult tostay asleep for long enough to feel refreshed thenext morning you may have insomnia. Insomnia isnot uncommon, and can occur at any point insomeone’s life. If you have insomnia you mayexperience problems such as waking up fromsleep easily during the time you might expect tostay asleep (most common in older people). Youmay also not feel refreshed on waking up andfind that carrying out tasks during the day is notas easy. Insomnia can also make you feel irritableand you may find it difficult to concentrate onthings you might otherwise be able to.

Insomnia can last for days, months or evenyears. Although sleeping badly from time to timeisn't harmful, prolonged periods of insomnia canbe bad for your health – since it can make certaintasks difficult the next day (e.g. driving oroperating heavy machinery), and there is asuggestion that it can also be a contributingfactor to high blood pressure, diabetes andweight gain.

What is the right amount of sleep?What is the right amount of sleep?What is the right amount of sleep?What is the right amount of sleep?Every individual is different, so it is hard to put anumber on what is the correct amount of sleepfor someone is. Typically older people canmanage with less sleep than younger people.Older people may also find that they have ‘lighter’sleep. Very young infants on the other hand needa large amount of sleep. People tend to need lesssleep as they age, this may be due to morefrequent day time napping or because of ‘body-clock’ adaption that the body makes duringageing.

There are many everyday reasons for not sleepingThere are many everyday reasons for not sleepingThere are many everyday reasons for not sleepingThere are many everyday reasons for not sleepingwell:well:well:well:Environmental:Environmental:Environmental:Environmental: Your sleeping environment maybe too noisy, too hot or too cold, your bed maynot be comfortable.Lifestyle:Lifestyle:Lifestyle:Lifestyle: You may exercise infrequently, mayconsume stimulating agents in the evening (suchas tea, coffee or alcohol, or may take a meal orsnack late in the evening, or not eat enough earlyin the evening and therefore wake early becauseyou are hungry.Physical:Physical:Physical:Physical: You may have an underlying illness thatmakes it difficult for you to sleep, you may be inpain or discomfort from a physical problem.However, there can be more serious causes ofpoor sleep. These problems can be temporary orpermanent, and include emotional problems,anxiety, or depression.

What strategies can be used to help deal withWhat strategies can be used to help deal withWhat strategies can be used to help deal withWhat strategies can be used to help deal withinsomnia?insomnia?insomnia?insomnia?People often think that the best solution toinsomnia is to turn to medication. There areseveral things you should try before doing that.Here is a list of things to try:

Control the environment you sleep in:Control the environment you sleep in:Control the environment you sleep in:Control the environment you sleep in: Make surethat your bed and bedroom are comfortable - nottoo hot, not too cold, not too noisy. Aim for aroom temperature around 18 degrees Celsius.Consider an eye mask and ear plugs if you cannotcontrol external influence from light and noise.Make sure that your mattress supports youproperly. If it's too firm, your hips and shouldersare under pressure. If it's too soft, your body sags,which is bad for your back. Generally, you shouldreplace your mattress every 10 years to get thebest support and comfort. Hop pillows, or a fewdrops of lavender oil in the bath or on yourpillow, may help you relax before going to sleep.Make sure that the room you sleep in is wellventilated during the day.

Control your general health:Control your general health:Control your general health:Control your general health: Get some exercise.Don't overdo it, but try some regular swimmingor walking. The best time to exercise is in thedaytime - particularly late afternoon or earlyevening. Try not to exercise too late in the day asthis can upset your sleep. Don't use street drugslike ecstasy, cocaine and amphetamines - as theyare stimulants. Caffeine, and nicotine fromsmoking will also tend to keep you awake, and soit is best to avoid these too.

Control your worries and anxiety:Control your worries and anxiety:Control your worries and anxiety:Control your worries and anxiety: Take some timeto relax properly before going to bed. Somepeople find alternative medicine techniques suchas aromatherapy helpful. If something is troublingyou and there is nothing you can do about it rightaway, try writing it down before going to bed andthen tell yourself to deal with it tomorrow.