Sleep
The Importance of Sleep
You may have been directed to this page because you, or someone you know, has difficulty sleeping, or you are looking to improve your general wellbeing. Matthew Walker tells us "Sleep is not an optional luxury - it is mother nature's life support system!" While this can help us to prioritise sleep as part of a healthy life, it isn't necessarily helpful when you are struggling to sleep (insomnia). We hope this page highlights that you are not alone. Hopefully there are some ideas here which may be supportive in improving your sleep patterns. Just start where you are and see if some small changes can help with your longer term sleep pattern. If you are really struggling, despite trying some of these things discussed, it can be helpful to discuss this with your primary care team.
We do know that quality of sleep has a significant impact on our general wellbeing and health. Sleep deprivation can affect the next day in areas including concentration, mood, empathy, emotional control, decision making and memory. It can give also give us cravings for sugary foods. We can all reflect on days like this after a tough night of unrest, jet lag or working shift patterns!
During sleep the immune cell function is improved, which helps our bodies to fight infection and kill possible cancer cells. Sleep can upregulate genes to promote the immune system, where as limited sleep is associated with upregulation of genes that are associated with promotion of tumours, inflammation and cardiovascular disease.
In the long term, chronic sleep deprivation is thought to contribute to the development of different mental and physical health diagnoses e.g. depression, anxiety, dementia, metabolic syndrome (inc Type 2 Diabetes).
There are some medical conditions (not covered here) that can contribute to altered sleep patterns and behaviour too.
Generally adults should have 7-9 hours sleep. Children need more (a toddler 10-14 hours, a teenager 8-10). Culturally there has been a huge shift in the way we lead modern lives and you won't be surprised to learn we are all getting much less sleep than 100 years ago. The bottom line is, most of us are not getting enough sleep for basic optimal health. But, there is no need to panic! We all have good and bad days of sleep and no matter where you sit on that sliding scale, just think about what one thing might help...
The Science: Stages of Sleep
There are different stages of sleep, shown in the infographic from the British society of Lifestyle Medicine. This Sleepstation resource also discusses the different stages of sleep in more detail.
This image of The Sleep Cycle below shows how the stages cycle throughout the night but also that we are in deeper sleep earlier in the sleeping period, with more REM sleep later in the night. REM is important for memory formation and it is when we make sense of emotions occurring through the day. So if sleep length is shortened this REM sleep might be cut down.
Top Tips To Improve Sleep
- Reset your body's natural clock - are you a lark or a night owl? Sort your sleep rhythm with regular timings - go to bed and wake up at the same time, regardless of weekday or weekend. Weekend lie ins might be a bad idea.
- Routine: Establish a regular wind down, e.g. warm bath, lavender oils on pillow, dimming the lights
- Bedroom: Make it a haven away from computers, TV, phones, blue light - keep it for sleep. Social media late at night can disturb our sleep.
- Mindfulness: Try Mindfulness activities, meditation or Breathing exercises before bed (see the mental wellbeing resources)
- Room Temp: Keep it cool - our bodies needs a cool room to fall asleep or stay asleep - aim about 16-18 degrees celsius. Optimise your sleep environment.
- Nutrition: Eat ‘real food’, avoid processed foods, lower sugary foods and starchy carbohydrates. Include essential 'healthy' natural fats. Our real food/lower carbohydrate page gives some helpful information on different aspects of healthy eating and drinking. There are links to some alternative switches too.
- Limit alcohol - it acts as a stimulant and then a depressant - it disturbs your normal sleep architecture so the stages are disrupted (sleeping tablets also disturb normal sleep)
- Exercise during the day (morning is best, avoid late night high intensity)
- Avoid late night snacks (they can cause a drop in your glucose levels later on and affect your sleep)
- Avoid caffeine if possible after midday (found in coffee, tea, coke, chocolate and some pain killers) - half life is 6-8 hours so 1/4 may still be in your body 12 hours later.
- Try writing down a list of your worries and any ideas on how you might solve them before you go to bed e.g. journalling
Check out the mental wellbeing pages for additional resources and the Sleepstation articles for more information on how sleep works.
The Super Sleep Mission - For Children & Adults Alike!
Sleep is Your SuperPower
What Is Insomnia?
Insomnia is difficulty falling asleep, staying asleep, waking up too early or needing a medication to sleep. Insomnia tends to be given as a diagnosis when it is interfering with your ability to function and when you struggle to sleep, despite the opportunity to do so,
Dr Spielman talks about factors as:
Predisposing: Genetics or life experiences affecting circadian rhythm or hormones
Precipitating: A positive or negative event that triggers difficulty sleeping
Perpetuating: Examples include napping in the day to catch up, staying time in bed awake, irregular sleep patterns/shift work, using substances or sleeping tablets
Treating Insomnia For Adults:
CBTi (Cognitive Behavioural Therapy Insomnia)
CBTi is a well validated, effective and safe method of treating insomnia. It is a powerful tool designed to be used by anyone needing help with poor sleep. You are likely to have had difficulties sleeping for some time and this isn't a quick fix. It may take some time and effort to re-train your brain. CBTi is designed to take at least 6-8 weeks.
CBTi includes:
- Stimulus control
- Sleep restriction
Stimulus control rules (Dr Bootzin) for Insomnia:
1. Lie down intending to go to sleep ONLY when you are sleepy.
2. Do NOT read or watch television in the bedroom.
3. If you find yourself unable to fall asleep GET UP and go into another room. Stay up as long as you wish and then return to the bedroom to sleep.
4. If you still cannot fall asleep, repeat Step 3. Do this as often as is necessary throughout the night.
Resources: Apps and Books
Apps:
Podcasts:
Live Better Feel More: with Matthew Walker
Live Better Feel More BITESIZE: How to master our sleep with Prof Foster
ZOE podcast: with Dr Sophie Bostock
Websites:
Free CBTI (FreeCBTi.com)
Books:
Matthew Walker: Why we sleep
Mindfulness: a practical guide to finding peace in a frantic world. Mark Williams and Danny Penman.
Audio: Max Richter 8 hour Sleep Album
Meditation via Soundcloud website
Resources: Snoring
A Note on Medications:
If you are really struggling with sleep please consult your doctor.
Medications for sleep (hypnotics) are sometimes prescribed for just 2-4 weeks if insomnia is severe, disabling or causing extreme distress. There is limited evidence for the effectiveness of long term medications in the treatment of insomnia and there are concerns about their safety including drowsiness. They can lead to tolerence, dependence, rebound insomnia and increased risks in older people such as cognitive impairment and falls.
Updated by Dr Nichola Osborne April 2023
Revised 21/1/26 Dr by Nichola Osborne
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Deer photography by Matt Roseveare
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