Why cant I sleep?

Insomnia is a common problem that affects more than half of the UK population.

Normal Sleep..

First of all, what is normal sleep?  The definition of normal sleep varies. However it is known that normal sleep should

  • result in a feeling of having rested once you wake up in the morning
  • the body having 7 to 8 hours of sleep opportunity time

It is normal for sleep to be disturbed as one grows older. This is due to more periods of shallow sleep, irritable bladder and temperature dysregulation ( menopause/andropause)

Abnormal sleep

One may wake up

  • feeling unrefreshed
  • may have intense sleep pressure particularly after breakfast and lunch. (slump)
  • may find oneself to be more irritable/ snappy
  • Not as mentally sharp, taking time to absorb information and cannot come up with new ideas (Brain fog)

General Facts about understanding sleep

  1. The more you look for sleep, the less you get it
  2. Insomnia is a form of anxiety
    1. This may be internal anxiety (“oh I just cant get to sleep”) or external (That meeting the next day.. have I prepared for it?)
  3. Depth of sleep in hormone levels affect sleep
    1. There is a drop in all hormones with age. This means the depth and cycling of sleep changes. The shallow bits of sleep become closer to wakefulness and more frequent
    2. You are there fore more susceptible to noises, lights and temperature settings
  4. The more sleep aids you have the less you sleep. Your sleep aids are a guide, sometimes they lie. Not all the information presented is 100 percent accurate. Trends seen are more accurate.
  5. Preparation for sleep starts during sundowning ( around  5 – 6 PM). If you do not start at this time, your sleep may not set in
  6. Your brain is a creature of habit. Unlearning a habit can be really challenging.
  7. One poor night of sleep does not have to affect the next. In fact you may sleep better the next night.

It is important to exclude medical causes for insomnia including obstructive sleep apnoea

Dealing with anxiety of sleep

  1. Accept it. Do not allow the negative emotions around lost sleep to affect you.
  2. Park it. Keep a note pad by your bedside and write down any ideas or thoughts that come to you.
  3. Diarize it – before getting into bed, put next days events into a diary.

Dealing with depth of sleep

  1. Keep all electronic devices away from easy reach. This avoids temptation of reaching for it it you wake up
  2. Reduce fluids after 6 PM and avoid fluids after 8 PM. The bladder takes 6 – 8 hours to get rid of fluids
  3. Empty your bladder before sleep

Dealing with exercise

  1. Intense exercise (HIIT) which raises your heart rate above 85% of expected after 6 PM can in some people cause difficulty with starting sleep. Swap this for low to moderate intensity exercises in the evening ( walking, stretching)

Dealing with habits and routines

  1. Old habits die hard.. but they can be killed. If your sleep times are variable (eg weekdays and weekends.) then try and ensure this is minimised. (late parties are more the exception rather than the rule (- no more than once a fortnight.)
  2. Alcohol before bedtime increases anxiety at 3 PM
  3. Alcohol before bedtime will ensure you wake up at 3 – 4AM when your body has finally got rid of alcohol . (alcohol is not a sleep aid and does not improve sleep quality or time)
  4. Caffeine – Caffeine is a competitive antagonist of Adenosine ( This is the natural sleep chemical). If you take caffeine after 3 PM, then you will still be battling with caffeine this at 3 AM. You dont need a mid afternoon coffee. Your body does get a natural second wind after 3 PM.
  5. Smoking has a similar effect. Smoking and coffee might have helped you doze off in the past ( Caffeine crash!), but this is not effective as we grow older