Insomnia or some form of sleep disturbance is one of the most common complaints that I receive from patients. Some struggle to fall asleep, others fall asleep easily but find themselves wide awake 2 hours later, others consistently wake up far too early in the morning and are unable to fall asleep again. Either way, a lack of sleep wreaks havoc on the body – mentally, emotionally and physically. Most adults need between 7-9 hours of sleep per day to function optimally and when that fails to happen, people find themselves unable to concentrate properly, being very unproductive, very emotional (some cry for no reason while others become extremely irritable), appetite is increased often leading to cravings for sugary fatty foods which leads to binge eating and general health starts to suffer. The immune system weakens and it becomes so much easier to pick up colds and flu….
There is hope for those struggling with insomnia though – with a little effort and lifestyle adjustment, most people are able to develop a good sleeping routine for life. It just requires some time and patience.
What to do
- The bedroom needs to be made conducive to sleep. This means decorating it with calming, relaxing colours which are easy on the eye. Harsh colours like black and red can be very stimulating and should therefore be avoided, as should bright neon colours. Creams, browns, deeper reds/maroon/purple, soft sorbet colours and white are better options. The bedroom should be completely dark at night so invest in either blinds or curtains. If this is not possible, get a comfortable pair of eyepads. Keep the bedroom free of technology. You need to train your brain to associate your bedroom and bed with sleep. In order to do this, only use your bed for sex and sleep. This means that even during the day, you should never read/study stimulating material, watch TV, work on a laptop/tablet/Ipad or eat meals in bed. With time, your brain will start to realise that nothing else is going to happen in bed and you are more likely to successfully switch your brain off at bedtime. Ideally, do these other activities in an entirely different room. If, however, you live in a studio where you only have one room, at least put a desk and chair/ couch in your room so that you can read/study/eat at the desk and watch TV from the couch.
- Choose a bedtime. The body likes consistency – it assists it in getting into a good rhythm. You need between 7-9 hours of sleep per night – preferably 8-9 hours. Choose a bedtime and stick to it as much as possible. Bear in mind that the sleep you get before 12pm is more potent than the sleep you get after 12. This means that you will feel more refreshed sleeping from 10pm-6am than from 12pm-8am. So try to choose a bedtime around 10-11pm and set your alarm for 8 hours later. Regardless of whether you slept well or not, get up when your alarm goes off – do not sleep in. If you did not sleep well the previous night, this will result in you being exhausted, but this will increase the likelihood of you falling asleep at your chosen bedtime the following night. Once you are in a good sleeping pattern where sleep comes easily, you can then take some liberties here and there by staying up a bit later at times and sleeping in some mornings, but until your insomnia has been resolved, stick to your set bedtimes.
- Ban afternoon naps. Afternoon naps are fabulous, but they spoil our evening sleep. It is particularly tempting to nap after having a bad night but it will simply perpetuate the cycle because it will likely prevent you from falling asleep at your chosen bedtime later that evening.
- Get a pre-sleep routine. For 30 minutes before your bedtime, avoid any stimulating activities – no cellphones, TV, academic books, work-related activites etc. Avoid thinking about or discussing problems and emotional issues. You want your mind and body to unwind and prepare for sleep. Make yourself a caffiene-free warm drink – milk, camomile tea, rooibos tea, lemon water, boiling water with honey…Sit in bed with a relaxing novel/storybook/spiritual book and dim the lights. After 30 minutes you should feel relaxed and ready to doze off. Some people like to have a hot bath/shower just prior to this 30 minute period as they find it puts them in a good, warm and happy place:)
- Avoid caffiene and alcohol. Caffeine should be avoided after 2pm in those with insomnia. Although alcohol does tend to help induce sleep, it tends to cause disrupted sleep and you therefore wake up feeling tired.
- Eat dinner before 7pm. Try to eat dinner before or as close to 7pm as possible. Going to bed with a full tummy can result in reflux and discomfort which can impair sleep. On the other hand, if you are used to an early dinner (perhaps at 6pm) you may need a pre-bed snack. That is absolutely fine as long as you keep the portion sizes in check. Carbohydrates eaten just before bed also aid in inducing sleep so opt for something like a banana or a slice or bread.
- Don’t stare at the clock. If you find yourself in bed tossing and turning for more than 20 minutes, leave the bedroom and sit in another room for a few minutes. Dim the lights and read a storybook until you feel sleepy – then go back to bed. Lying in bed for hours while feeling frustrated that you can’t sleep makes your brain associate bedtime with stress. By going to lie down when naturally tired, you will learn to love bedtime as you know you will fall asleep easily. By sticking to your bedtime and waking up time and by eliminating afternoon naps, your body will eventually naturally feel sleepy at your chosen bedtime so that you do not toss and turn.
- Soak up the sun. A dark bedroom aids in inducing sleep, but similarly, exposure to sunlight during the day assists the body in developing a sleep-wake pattern. So take a walk in the sun during lunch time or go for a jog outside after work.
- Exercise. Regular exercise promotes a good sleeping pattern – just be sure not to exercise after 7pm at night as that can be too stimulating and delay sleep.
- Balance Fluid intake. Keep your pre-bed drink small in size. Drink enough fluid to avoid waking up in the middle of the night from thirst, but not so much so that you wake up every 5 minutes to pee!
By applying the above principles, you WILL develop a good sleeping pattern, but it does take time and patience. The body and brain need time to be conditioned to this new way of living. If you are finding it very difficult initially, there are some natural remedies that you can buy over the counter to assist in inducing sleep. These include camomile tea and drops, valerian drops and melatonin tablets/capsules. Phenergan, an antihistamine, is also often prescribed by doctors for mild insomnia as it causes drowsiness as a side-effect and is not addictive. Some patients are so sleep deprived that they simply can’t fall asleep and find these gentler/alternative sleeping aids ineffective. In this case, your doctor can likely prescribe a prescription sleeping tablet for a few days to help you get into this new routine. I do recommend that you always consult with your doctor before taking any medication for insomnia – whether it be natural or not. This is always the safest route as even natural/alternative medications have contraindications and your doctor can advise you on this. In addition, a sleeping disorder can also be a symptom of an underlying psychiatric condition such as depression, PTSD or bipolar mood disorder and your doctor will be able to screen you for these.
I hope you find this advice helpful. Please feel free to ask any questions or make any suggestions by posting a comment.