Another restless night in bed? Don't reach for the sleeping pills, says HELEN FOSTER - there are far healthier alternatives out there
You're shattered. For the past week you've been lying in bed night after night with all the day's problems running through your mind. You haven't been sleeping, and so you take the tablets prescribed by your doctor. But what if you were told that you wouldn't sleep much longer as a result of taking them and that, most likely, you'd wake up feeling groggier the next day? Would you still pop those pills?

Twenty-five to 35 per cent of people with insomnia (which affects 80 per cent of the population) find themselves seeking medical help for the condition, and that often means being on the receiving end of a prescription. In the US sleeping pills are the second most prescribed medicine after birth control pills, and while figures in the UK aren't quite so clear- cut, more than 16 million prescriptions for sleeping tablets and tranquillisers were written in England and Wales last year alone.

"There's a vast army of people limping through life supported by a crutch of sleeping pills, tranquillisers and sedatives," says Dr Michael Van Straten, author of The Good Sleep Guide. "And they do limp - sleeping drugs may send you to sleep but it's the wrong type of sleep and you end up more messed up the next day."

The reason is that sleeping pills do not allow you to go into the phase of restorative deep sleep we need to refresh us; you spend the night in a lighter form of sleep instead. And it's not such a long night either - research shows that pills increase sleep length only by 30 minutes a night and, to add insult to injury, they can actually cause sleeplessness. "It's called rebound insomnia and it's like your brain being a stretched rubber band just waiting to be let go," says Dr Chris Idzikowski, director of the Sleep Assessment Advisory Service. According to Dr Idzikowski, when you take a sleeping pill, the area that controls sleep and waking is essentially blocked. When you come off the tablets (even after a short period of usage) two things can happen. The block bursts like a dam and all the "wakefulness" that you've suppressed comes spilling out, or the brain forgets how to sleep on its own. Either way you end up wide awake.

Finally, sleeping pills cause "hangovers". "The day after taking a sleeping pill you can expect impaired judgement, concentration and physical abilities," says Dr Van Straten. In fact, you're no better a performer than someone who missed a night's sleep - and you could even put yourself at risk. Numerous studies have revealed pill users are more likely to be involved in road accidents than non-users. In other words, sleeping pills can be the stuff of nightmares. But what's the alternative?

HERBAL MEDICINES

"Thousands of years of data have proved that herbs can help us sleep," says Dr Van Straten. "The good thing is that they tend to be calming, not soporific, which usually means no hangover the next day."

Valerian: Swiss research on more than 100 people found that valerian improved sleep quality but left no hangover the next day. For best results, take 400-600mg about two hours before bedtime. Try Solgar Valerian, pounds 7.59 for 1,000mg.

Kava Kava: This South American root is one of the most imbibed herbs in Brazil (the country with reportedly the world's highest level of insomnia). While scientific data is scant about its effects, anecdotally it seems to have instant calming effects. Best results occur with 60-120mg taken daily (although it should only be taken for three months). Try Solgar Standardised Extract Kava Kava, pounds 14.65 for 60.

Lavender: "This would be my choice," says Dr Van Straten. "A British study took four patients who had been on sleeping tablets for years and replaced them with a burner filled with lavender oil. Within two to three days all were sleeping better than ever." Try Tisserand Lavender Oil, pounds 4.15 for 9ml.

EXERCISE

Half an hour's exercise four times a week can increase the amount you sleep by an hour or more a day, says US research. "The reason is not because you work yourself to exhaustion, which would be dangerous," says Luke Wilkins, a personal trainer from London gym Real Fitness. "Exercise's insomnia-fighting power occurs because it stimulates the fall in body temperature that triggers sleep." This fall occurs four to five hours after your workout, so for best results you need to work out late afternoon or early evening.

ASPIRIN

In a number of studies, the painkiller aspirin has been shown to increase the amount of time people remain asleep. It's not something you can take if you wake up in the middle of the night (the pill seems to work only on the second half of a night's sleep) but taking two tablets just before bed can help you to get a better night. Take with plenty of water; aspirin taken without water can irritate the stomach lining leading to ulcers and other problems. And never give aspirin to children younger than 12.

DIET

You probably know that caffeine prevents you from sleeping, but did you know that milk or pasta could promote it? "A study in Edinburgh showed that a milky drink before bedtime decreased the time it took people to fall asleep by around six minutes," says Dr David Benton, a specialist in mood and food interaction at the University of Wales. You could get even better results by eating a high-protein dinner followed by a carbohydrate snack. One of the most important chemicals in the body for sleep is serotonin, but for this to work you have to have an amino acid called tryptophan. Tryptophan is found in protein foods so eating a meal high in fish, meat or pulses will increase levels in the body. Combining this with a high- carbohydrate snack a few hours later increases the amount that gets into the brain where it counts. Complicated, yes, but it basically boils down to the fact that a dinner of seared tuna and roasted vegetables followed by a couple of pieces a toast could help you sleep better.

RELAXATION

Fifty per cent of insomnia cases are triggered by stress. "What we need to do is not banish stress, but learn to prevent it where possible and how to deal with it when it does occur, and that's where relaxation methods such as massage, meditation or yoga come in," says Dr Van Straten. To tackle insomnia, just taking 30 minutes a day formally relaxing - or even just sitting on your own doing nothing - can be enough to lower stress levels and help you to sleep.

ENVIRONMENT

Take a look at your bed - pillow position, bed firmness and temperature. Eleven per cent of people suffering insomnia blame heartburn as at least part of the cause, and if your pillows are too high the condition becomes more likely. High pillows can also trigger an unusual sleeplessness reaction. Our body is trained not to let us sleep when we're upright and scientists believe that there's a set point when the body switches this on - it could be triggered by sleeping too high in bed. In terms of bed texture, hard is better than soft. Soft beds restrict normal nightly movement which has a tendency to wake you up. And watch your duvet. The body sleeps best at around 77F; if it's too hot you'll fidget which leads to less restful sleep; if you're too cold you'll wake up.

FALSE FRIENDS

Alcohol: Yes, its makes you sleepy but if you drink more than half a unit, it causes more problems than it solves. Past this point, you'll fall asleep quickly and soundly - for the first half of the night. During the second half you'll be increasingly likely to wake up.

Smoking: Studies at Penn State University in the US found that smokers take twice as long to get to sleep as non-smokers, and that quitting reduced the average time from 52 minutes to 18. Smokers also experience less deep sleep than non-smokers. If you have to have that sacred last cigarette, Dr Van Straten recommends never lighting up less than an hour before bed.

Over-the-counter medications: Many non-addictive sleep preparations are available over the counter in chemists without prescription. They may well send you to sleep, but they can cause problems the next day, since many of these preparations contain antihistamines which have a hangover effect.

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