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 on this page which may be supportive in improving your sleep patterns. If you are really struggling, despite trying some things discussed here, it can be helpful to discuss this with your GP team.
We do know that quality of sleep has a significant impact on our general wellbeing. Sleep deprivation can affect concentration, mood and memory the next day. It can give us cravings for sugary foods. In the long term, these are thought to contribute to the development of different mental and physical health diagnoses e.g. depression, anxiety, dementia, metabolic syndrome.
During sleep the immune cell function is improved, which helps our bodies to fight infection (including COVID-19) 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.
There are some medical conditions that can contribute to altered sleep patterns and behaviour too.
This Sleepstation resource discusses the different states of sleep. Sleepstation is not NHS funded but there are some useful resources on their website.
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. However, we all have good and bad days of sleep and no matter where you sit on that sliding scale, things could perhaps always improve!
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
Top Tips To Improve Sleep
Medications (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. CBTi, on the other hand, is a well validated, effective and safe method of treating insomnia.
CBTi (Cognitive Behavioural Therapy Insomnia)
This 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.
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
Free CBTI (FreeCBTi.com)
Matthew Walker: Why we sleep
Updated by Dr Nichola Osborne April 2023
Revised 1/12/23 by Dr Moody-Jones