How to sleep – a bedside guide
If you lie awake tossing and turning, you're not alone. Will hot drinks, homoeopathy or yoga help you sleep? Esther Walker consults the experts
Tuesday 01 April 2008
Dr Clare Gerada, GP:
Sometimes people make rather too much of not being able to sleep. Not being able to sleep is very unpleasant but it's not going to kill you – no one ever died from not sleeping. If you can't sleep, you should get up and go into another room and do something else for a bit. Everyone laughs at me when I say this, but knitting is the best thing you can do because it's monotonous and distracting.
Then you should try again later. It can be the case that if there's no obvious reason for the sleeplessness, you could have just got yourself into a pattern of not sleeping and of associating your bed with not being able to sleep. In those circumstances, I would suggest buying an anti-histamine over the counter. Phenergan is a babies' antihistamine and it causes drowsiness; it could be that that's all you need to get over the psychological hump of dropping off.
In this way, you can break that cycle of not sleeping pharmacologically and without taking medicine long-term. Most of the people who come to me saying that they can't sleep get over it fairly quickly.
Jim Horne, professor of psychophysiology and director of the Sleep Research Centre at the University of Loughborough:
We are such creatures of habit, and most people like to do certain things before they go to sleep and have routines, which is why they sometimes find it difficult to sleep if they're away from home or staying in a hotel. Peace of mind at bedtime has an overwhelming importance in terms of how easily you will fall asleep.
The quality of the sleep you have is just as important as how easily you fall asleep. Some people can fall asleep but don't sleep efficiently and are tired during the day. We all have a natural dip in the afternoon, but if that dip becomes pronounced or spills out into the rest of the day then there might be something wrong. It's quite difficult to find out what is disturbing your sleep if you're asleep; sometimes it can be as simple as your bedroom being too hot. A partner might be able to tell you if you snore, which can disrupt your sleep. Your partner being very active during the night can also be disruptive.
True insomnia is really a 24-hour disorder: it's a sort of constant wakefulness. Insomniacs tend to be pretty alert during the day and get better sleep at night than they think. People who can't sleep and are very tired during the day might not be suffering from insomnia but tiredness, boredom or depression; they attribute their tiredness to insomnia, but actually it's the other way around. Hypnotics and bubble baths and things like that won't help; the only cure is to find the psychological source of the unhappiness.
Dr Sara Eames, The Royal London Homoeopathic Hospital:
It's amazing how many people are doing simple things wrong that keep them awake, such as drinking caffeine before bed or keeping their bedroom too warm. The good thing about homoeopathy is that there are different remedies for different sorts of sleeplessness. For recent bereavement, ignatia is good; for ongoing, chronic grief, natrum mur can help. If someone is overworked and unable to wind down, nux vomica can help; it can also help if you've eaten or drunk too much and you can't settle down because of that. If it's physical pain that's stopping you from dropping off, rhus tox is helpful.
For new mothers or carers who have their sleep interrupted a lot and then can't sleep when they get the chance to, cocculus can work. Those are things that people can try initially; they can always get a homoeopathic consultation if they need more specific advice.
Joanne Lunn, The British Nutrition Foundation:
Just before bed, you should always avoid anything with a stimulant in it, such as coffee or tea. Some medicine has caffeine in it, too, so check the label of anything you're taking. It's usually daytime cold and flu remedies that are the most likely to contain caffeine. Everyone is different, though, and you are likely to know how sensitive you are to caffeine and how likely it is to keep you awake.
Alcohol is something else that will disturb your sleep. In some cases, it can make you fall asleep, but once you are asleep, you won't be getting as good a rest as you would be if you hadn't drunk anything. To get a really good sleep, you should stop drinking two or three hours before you go to bed. There is a theory that the reason hot milk helps you sleep is that it contains tryptophan, which produces serotonin and makes you feel relaxed. There's probably something psychological about it: if you think it's going to help you sleep, it probably will.
Eating late at night will disrupt your sleep, because if you go to bed on a full stomach, it can cause indigestion and heartburn. If you find yourself hungry just before bed, then it's best to eat a carbohydrate-rich snack such as cereal or wholemeal toast because carbs are digested fairly quickly; the worst things to eat are anything fatty or high in protein.
Jane Kersel, Triyoga Centre, Primrose Hill, London:
This is a 15-minute programme, suitable to practise before you go to sleep, and which will aid relaxation.
1. Lie on the floor on your back, with your head on a pillow. Bend both knees, feet hip-width apart, a few inches away from your buttocks. Draw your right knee in towards you with both hands cupped around the knee/shin, and as you inhale, press the knee gently away from you – feel the stretch through your shoulders and mid-back. As you exhale, gently draw the leg in towards your chest. Repeat five times, and as you exhale, place the foot back to the floor and repeat on the left side. This will open your spine, connect you to your breath and bring you deeper into your body rather than into your thoughts.
2. Keep both feet to the floor, still hipwidth apart and, as you exhale, slowly take both knees over to the right-hand side so that your hips gently turn – keep your torso flat on the floor. As you inhale, slowly bring the legs back up and exhale to the left. Every time you exhale, your legs go towards the floor, and everytime you inhale, lift your knees back up to the centre. Repeat for 10 breaths. This brings you from your thinking mind into your feeling body while at the same time gently stretching your spine and releasing tension in your shoulders and in your neck.
3. Lying on your back, position yourself near a wall, and stretch one leg so that your heel or back of your leg (if you're more flexible) makes contact with the wall. Stretch both legs up against the wall either together or hip-width apart, and allow the wall to completely take the weight of your legs. Place your palms gently on your lower belly. As you inhale, feel the breath lift the belly a little, and as you exhale, feel your belly gently release down towards the floor. Stay in this pose for three to five minutes. With each breath, feel your legs gently releasing and your spine lengthening. This pose is not only great for bringing you into a peaceful place, it's fantastic for helping tired, stressed backs and tight hamstrings. To come out of the pose, bring your legs down the wall and gently roll to your right hand side. Use your hands to gently bring you back up to a seat-ed position.
4. Finally, lie in bed on your back with your head on a pillow. Place your hands, palms up, by your sides. Feel your shoulders relax and the chest open up and breathe easily and long. As you inhale, consciously make your exhale some two to four seconds longer than your inhale (without straining). This will really help to relax you – it's a basic pranayama (yoga breathing technique) that calms and soothes the nervous system.
Shakila Ahmed, Travelodge:
When people check into a Travelodge, they're usually on the move. What they want from us most is a good night's sleep, so we're always coming up with ways of trying to improve sleep. Many of our guests are businessmen, and a lot of them tell us that they have trouble sleeping because they are worried about work. That problem inspired us to offer guests 15 minutes' goldfish-watching before they went to bed; studies have shown that watching fish swim lowers your stress levels significantly. They were a great success. Then we offered "nodcasts", which are podcasts to aid sleep.
The idea behind them is to take advantage of how open the mind is just before you nod off; we explored all the issues that tend to keep people awake and tackle them in the nodcasts.
We've just finished trialling our new pyjamas, which are made of lightweight cotton and silk. It's amazing how something as simple as what you wear to bed can affect how you sleep, and most people complain that they can't sleep because they are too hot. Some people wear too much to bed or wear a nightie that rides up and you end up having a fight with it in the middle of the night. Our pyjamas are like a second skin and keep your body temperature constant while you sleep – it's like sleeping in the buff.
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