Doctor Reza - The Specialist in Treatment of Insomnia

Being a Sleep Specialist, I feel insomnia is one of the most common problems associated with sleep. Many people suffer from insomnia at some time during their lives. It may be short lived and easily explained by current circumstances or events, or it may be a long term problem that has gone on for many years.

The amount of sleep we require varies from person to person. Although the average adult sleeps for 7-8 hours, there are many people who easily get by on much less than this and others who sleep for longer. There are no hard and fast rules. Sleep requirement also changes as we get older, people tend to sleep less and have more awakenings during the night with increasing age. These changes are quite normal. It is certainly true that many of us have more sleep than our bodies actually need, a shorter period of good, deep sleep is more refreshing than a longer time spent in bed if much of it is spent in light, fitful sleep.

Effects of sleep loss

Many people worry about the effects of sleep loss. If you have a bad night:

  • Your concentration is poorer the following day
  • You may feel sleepy and irritable. Whilst this is unsatisfactory, it will not do your health any harm and on subsequent nights your body will make up for it with extra sleep.
Reasons for not sleeping well

Listed below are some general points about things that affect sleep:

  • Bedroom environment - The best sleeping environment is one which is dark, quiet and a comfortable temperature. If there are special steps you can take to minimise outside noise, this may help
  • Food and drink - Hunger disturbs sleep. So a light snack or a warm drink before bed may be a good idea. Caffeine is a stimulant which remains in blood circulation for many hours after it has been taken. Try and avoid tea or coffee after lunch. You can try having decaffeinated versions. Alcohol may help some people fall asleep but it usually causes rebound awakenings later on in the night when the level of alcohol in the blood falls. It is better to avoid or limit alcohol intake to before 6 pm
  • Smoking - Nicotine is a stimulant and has effects similar to caffeine so stopping smoking may help
  • Exercise - Regular light exercise as part of a daytime or early evening routine is recommended. However, avoid exercising 3 hours before sleep, as exercising produces substances in the body (eg. adrenaline) which act as stimulants
  • Sleeping tablets - These are only really useful occasionally, for a short term problem.
How to sleep better, sleep well

Relaxation Ė

  • Make time to relax at the end of the day
  • Donít go to bed ruminating on the days events or planning activities for the next day
  • Before retiring, do things that help you switch off and prepare you for sleep
  • If you know that you have a problem unwinding at the end of the day, relaxation exercises may help
  • There are many good relaxation tapes available which may be useful to try.

Routine Ė

  • It is important to establish a regular sleeping and waking routine
  • If you suffer from insomnia, the normal sleep/wake cycle may be disrupted in a number of ways. For instance, sleeping on in the mornings to compensate for a bad night, going to bed earlier or taking a nap during the day to catch up on lost sleep. Unfortunately, all these strategies only serve to disrupt the sleep cycle and fragment sleep
  • In order to re-establish a routine, use an alarm clock to ensure that you wake up at the same time each morning and keep to this time during the week and at week ends, even if you have a bad night
  • You should get up as soon as the alarm goes off and never be tempted to lie in bed dozing otherwise your body expects to be able to do the same the next night and it just gets harder and harder to get up
  • In addition, avoid daytime naps as these break up your sleep and contribute to the insomnia at night
  • These steps will help your body acquire a consistent sleep rhythm.
Methods to sleep better

Below are two alternative strategies that you can employ when you actually go to bed. A good way to start with either of them is to begin with one night when you do not go to bed at all.

Strategy 1

  • Only go to bed when you feel sleepy, not before. Many people go to bed because there is nothing interesting on television or the evening chores have been finished or at a particular time each night even though they do not feel sleepy. It is also tempting to go to bed early if you had a bad night the night before. Resist the temptation to do this but continue with some relaxing activity until you feel really sleepy
  • Do not use your bed or bedroom for activities such as eating and drinking, reading, watching television, listening to the radio, working on a laptop or smartphone, and so on. These can all help you relax in the evening before going to bed but should be done in another room not the bedroom. This helps your body associate the bed and bedroom with sleeping rather than wakefulness
  • Once you have gone to bed, if you do not fall asleep quickly (within about ten minutes) you should get up again and go into another room. Do something relaxing while there and go back to bed only when you feel sleepy again
  • When you return to bed, if you do not fall asleep quickly repeat the above again.

This is quite a difficult strategy as you have to be prepared to get up many times early on but it does work for many people. It helps to leave the heating on, have a flask with a warm drink in another room and printed books or magazines ready. It is important to persist, even though it may be hard in the early days.

Strategy 2

This is a different approach altogether. It is based around the fact that sleep is a natural process which happens involuntarily. People who fall asleep easily donít do anything in particular to make it happen, it just happens. The harder you try and get to sleep, the worse your sleep problem is likely to get and you just become more aware of not getting to sleep and more frustrated. Instead, the second strategy involves actually trying to stay awake. It may sound ridiculous but it works for many people.

  • When you go to bed, lie in the darkened room and try to keep your eyes open rather than closing them. Keep them open for as long as you can
  • Each time they feel like closing try and keep them open for a bit longer
  • The plan is to actually try and stay awake. Remember that relaxing is good for you, even if youíre asleep
  • Try and stay awake by using this method as long as you can. Do not use active methods, such as reading or physical movement though, the idea is to resist sleep onset gently but persistently.
** This site is for patient information only **