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How can I get some sleep? Which treatments actually work?

<a href="https://theconversation.com/profiles/alexander-sweetman-1331085">Alexander Sweetman</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/jen-walsh-1468594">Jen Walsh</a>, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a>, and <a href="https://theconversation.com/profiles/nicole-grivell-1468590">Nicole Grivell</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Do you have difficulty falling asleep? Do you stay awake for a long time at night? Do these sleep problems make you feel fatigued, strung-out, or exhausted during the day? Has this been happening for months? If so, you’re not alone. About <a href="https://www.sleephealthfoundation.org.au/special-sleep-reports/chronic-insomnia-disorder-in-australia">12-15%</a> of Australian adults have chronic insomnia. You might have tried breathing exercises, calming music, white noise, going to bed in a dark and quiet bedroom, eating different foods in the evening, maintaining a regular sleep pattern, or reducing caffeine. But after three to four weeks of what seems like progress, your insomnia returns. What next? <h2>What not to do</h2> These probably won’t help: <ul> <li> spending more time in bed often results in more time spent awake in bed, which can make <a href="https://theconversation.com/how-do-i-stop-my-mind-racing-and-get-some-sleep-207904">insomnia patterns worse</a> </li> <li> drinking coffee and taking naps might help get you through the day. But <a href="https://theconversation.com/nope-coffee-wont-give-you-extra-energy-itll-just-borrow-a-bit-that-youll-pay-for-later-197897">caffeine</a> stays in the system for many hours, and can disrupt our sleep if you drink too much of it, especially after about 2pm. If naps last for more than 30 minutes, or occur after about 4pm, this can reduce your “sleep debt”, and can make it <a href="https://theconversation.com/why-do-i-fall-asleep-on-the-sofa-but-am-wide-awake-when-i-get-to-bed-208371">more difficult</a> to fall asleep in the evening </li> <li> drinking alcohol might help you fall asleep quicker, but <a href="https://journals.sagepub.com/doi/10.1300/J465v26n01_01">can cause</a> more frequent awakenings, change how long you sleep, change the time spent in different “stages” of sleep, and reduce the overall quality of sleep. Therefore, it is not recommended as a sleep aid. </li> </ul> <h2>What to do next?</h2> If your symptoms have lasted more than one or two months, it is likely your insomnia requires targeted treatments that focus on sleep patterns and behaviours. So, the next stage is a type of non-drug therapy known as cognitive behavioural therapy for insomnia (or <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti">CBTi</a> for short). This is a four to eight week treatment that’s been shown to be <a href="https://doi.org/10.1016/j.smrv.2022.101687">more effective</a> than sleeping pills. It involves education about sleep, and offers psychological and behavioural treatments that address the underlying causes of long-term insomnia. You can do this one-on-one, in a small group with health professionals trained in CBTi, or via self-guided <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti/referral-to-digital-cbti-programs">online programs</a>. Some GPs are trained to offer CBTi, but it’s more usual for specialist <a href="https://psychology.org.au/find-a-psychologist">sleep psychologists</a> to offer it. Your GP can refer you to one. There are some Medicare rebates to subsidise the cost of treatment. But many psychologists will also charge a gap fee above the Medicare subsidy, making access to CBTi a challenge for some. <a href="https://doi.org/10.12703%2Fr%2F11-4">About 70-80%</a> of people with insomnia sleep better after CBTi, with improvements lasting <a href="https://doi.org/10.1016/j.smrv.2019.08.002">at least a year</a>. <h2>What if that doesn’t work?</h2> If CBTi doesn’t work for you, your GP might be able to refer you to a specialist sleep doctor to see if other sleep disorders, such as <a href="https://doi.org/10.1016/j.smrv.2016.04.004">obstructive sleep apnoea</a>, are contributing to your insomnia. It can also be important to manage any mental health problems such as <a href="https://doi.org/10.5694/mja2.51200">depression and anxiety</a>, as well as physical symptoms such as pain that can also disrupt sleep. Some lifestyle and work factors, such as shift-work, might also require management by a specialist sleep doctor. <h2>What about sleeping pills?</h2> Sleeping pills are <a href="https://www.sleepprimarycareresources.org.au/insomnia/pharmacological-therapy">not the recommended</a> first-line way to manage insomnia. However, they do have a role in providing short-term, rapid relief from insomnia symptoms or when CBTi is not accessible or successful. Traditionally, medications such as benzodiazepines (for example, temazepam) and benzodiazepine receptor agonists (for example, zolpidem) have been used to help people sleep. However, these can have <a href="https://doi.org/10.1136/bmj.38623.768588.47">side-effects</a> including a risk of falls, being impaired the next day, as well as tolerance and dependence. Melatonin – either prescribed or available from pharmacies for people aged 55 and over – is also often used to manage insomnia. But the <a href="https://doi.org/10.1016/j.smrv.2022.101692">evidence suggests</a> it has limited benefits. <h2>Are there new treatments? How about medicinal cannabis?</h2> Two newer drugs, known as “orexin receptor antagonists”, are available in Australia (suvorexant and lemborexant). These block the wake-promoting pathways in the brain. <a href="https://doi.org/10.4088/PCC.22nr03385">Early data suggests</a> they are effective in improving sleep, and have lower risk of potential side-effects, tolerance and dependence compared with earlier medicines. However, we don’t know if they work or are safe over the long term. <a href="https://doi.org/10.1093/sleep/zsab149">Medicinal cannabis</a> <a href="https://doi.org/10.1111/jsr.13793">has only in recent years</a> <a href="https://doi.org/10.1093/sleepadvances/zpac029.048">been studied</a> as a treatment for <a href="https://doi.org/10.1093/sleepadvances/zpac029.005">insomnia</a>. In an Australian survey, <a href="https://doi.org/10.2147/nss.s390583">more than half</a> of people using medicinal cannabis said they used it to treat insomnia. There are reports of <a href="https://doi.org/10.1371/journal.pone.0272241">significant benefit</a>. But of the four most robust studies so far, <a href="https://doi.org/10.1093/sleep/zsab149">only one</a> (led by one of us, Jen Walsh) has demonstrated an improvement in insomnia after two weeks of treatment. So we need to learn more about which cannabinoids – for example, delta-9-tetrahydrocannabinol, cannabidiol or cannabinol – and which doses may be beneficial. We also need to learn who can benefit most, and whether these are safe and effective over the long term. <h2>What now?</h2> If you’ve had trouble sleeping for a short time (under about a month) and nothing you try is working, there may be underlying reasons for your insomnia, which when treated, can provide some relief. Your GP can help identify and manage these. Your GP can also help you access other treatments if your insomnia is more long term. This may involve non-drug therapies and/or referral to other services or doctors. <hr /> For more information about insomnia and how it’s treated, see the Sleep Health Foundation’s <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/insomnia-2">online resource</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/212964/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/alexander-sweetman-1331085">Alexander Sweetman</a>, Research Fellow, College of Medicine and Public Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/jen-walsh-1468594">Jen Walsh</a>, Director of the Centre for Sleep Science, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a>, and <a href="https://theconversation.com/profiles/nicole-grivell-1468590">Nicole Grivell</a>, Research Coordinator and final year PhD Candidate at FHMRI Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-can-i-get-some-sleep-which-treatments-actually-work-212964">original article</a>.

Body

How dangerous is insomnia? How fear of what it’s doing to your body can wreck your sleep

<a href="https://theconversation.com/profiles/leon-lack-1142">Leon Lack</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/nicole-lovato-60684">Nicole Lovato</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> I (Leon) have recently seen several patients who were concerned their insomnia symptoms would increase their risk for dementia. They were in their 70s and were awakening two or three times a night, which they took to be insomnia. But they were not impaired in the daytime in a way typical of insomnia. Their brief awakenings are normal for most people and <a href="https://theconversation.com/broken-sleep-its-a-rollercoaster-ride-1792">completely harmless</a>. Brief awakenings emerge from the periodic phases of light sleep that occur naturally between the four or five 90-minute deep sleep cycles. If you’re unaware of this “rollercoaster” of 90-minute cycles, you might think such awakenings are a sign of disease. In fact, they are perfectly normal and experienced more as people age when sleep naturally becomes lighter and shorter – <a href="https://theconversation.com/mondays-medical-myth-you-need-eight-hours-of-continuous-sleep-each-night-5643">with no ill effect</a>. Therefore, I reassured them their sleep patters were normal and they did not have insomnia. This requires daytime impairments – fatigue, cognitive problems, mild depression, irritability, distress or anxiety – in addition to night time symptoms. I trust they were reassured, and so they avoided the type of fear and worry that would have triggered a cascade of events leading to insomnia. <h2>Is it really insomnia?</h2> So where did my patients get the notion their sleep symptoms could lead to dementia? Let’s pick apart this tsunami of alarming information. It usually starts with very <a href="https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-018-1623-0">large surveys</a> that find a statistically significant relationship between measures of sleep problems and subsequently developing dementia. First, most of these studies ask participants to report how long they typically sleep. Those reporting less than six hours a night show a small but statistically elevated risk of developing dementia. These studies do not say if people have clinical insomnia diagnosed by a health professional. Instead they rely solely on participants guessing how long they’ve slept, which <a href="https://academic.oup.com/sleep/article/25/5/559/2750164?login=false">can be inaccurate</a>. The studies would have also included many people without insomnia who are not allowing themselves adequate opportunity for sleep. Perhaps they’d been in the habit of socialising or playing computer games late at night. In other words, we don’t know what proportion of these short-sleepers are simply over-estimating their sleep problems, or restricting their sleep and experiencing chronic sleep loss rather than insomnia. <h2>What do the numbers really mean?</h2> A second problem is with interpreting the meaning of “statistically significant”. This only means the results were unlikely to be due to pure chance. If a single study shows a 20% increased risk of a physical health problem associated with insomnia, how worried should we be? This single finding does not necessarily mean it’s worth considering in our everyday lives. Studies relating insomnia to health risks are also typically inconsistent. For example, although some studies have found small increases in dementia risk with having insomnia, a very <a href="https://mentalhealth.bmj.com/content/ebmental/26/1/e300719.full.pdf">large UK study</a> did not find any relationship between the amount of sleep or sleeping difficulties and dementia risk. <h2>What’s the context?</h2> A third problem is communicating a balanced perspective to the public about the potential dangers of insomnia. Some in the mainstream media, with the help of the researcher’s institution, will report on studies showing a statistically significant increase in the risk of a frightening disease, such as dementia. But <a href="https://theconversation.com/essays-on-health-reporting-medical-news-is-too-important-to-mess-up-68920">not all media reports</a> ask about how clinically meaningful the risk is, whether there are alternative explanations, or how this result compares with what other researchers have found. So the public is left with no context to temper the scary, “increased risk” narrative. This narrative is then shared on social media, amplifying the scary finding. <h2>Obesity, diabetes, high blood pressure</h2> We’ve used dementia as one example of how fears about potential risks to physical health from insomnia arise and are magnified. But we could have used a potential increased risk of obesity, diabetes or high blood pressure. All have been associated with shorter sleep, but researchers are debating whether these links are real, meaningful or related to insomnia. When we looked at the impact of sleep problems on life expectancy, we found <a href="https://pubmed.ncbi.nlm.nih.gov/30529432/">no evidence</a> sleep symptoms alone shorten your life. Only when daytime symptoms such as fatigue, memory problems and distress are included is there a <a href="https://www.nature.com/articles/s41598-023-36016-4">small increased risk</a> of dying prematurely. However, it’s difficult to know if that excess mortality can be explained by undiagnosed heart, kidney, liver or brain disease causing those daytime symptoms. <h2>We should be talking about mental health</h2> However, there is stronger evidence of increased <a href="https://theconversation.com/explainer-whats-the-link-between-insomnia-and-mental-illness-49597">mental health</a> problems, especially depression, with insomnia. The typical daytime impairments of fatigue, distress, cognitive impairments and irritability certainly lower the quality of life. Life becomes more of a challenge and less enjoyable. Over time, this can trigger <a href="https://theconversation.com/explainer-whats-the-link-between-insomnia-and-mental-illness-49597">hopelessness and depression</a> in some people. This is enough reason to seek help to improve sleep and quality of life. People with these problems should seek help from a health practitioner. The good news is there is an effective, long-term, non-drug treatment with no side effects – cognitive behavioural therapy for insomnia <a href="https://bmcprimcare.biomedcentral.com/articles/10.1186/1471-2296-13-40">or CBTi</a>. Even better, successful CBTi also <a href="https://www.sciencedirect.com/science/article/abs/pii/S1389945720303828">decreases</a> symptoms of depression and other mental distress. What is not helpful is unnecessary fear triggered by reports suggesting serious physical health dangers of insomnia. This fear is only likely to increase insomnia rather than mitigate it. <hr /> If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/212248/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/leon-lack-1142">Leon Lack</a>, Emeritus Professor of Psychology, Adelaide Institute for Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/nicole-lovato-60684">Nicole Lovato</a>, Associate Professor, Adelaide Institute for Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-dangerous-is-insomnia-how-fear-of-what-its-doing-to-your-body-can-wreck-your-sleep-212248">original article</a>.

Body

What’s insomnia like for most people who can’t sleep? You’d never know from the movies

<a href="https://theconversation.com/profiles/aaron-schokman-1463327">Aaron Schokman</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/nick-glozier-94435">Nick Glozier</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Hollywood appears fascinated by sleep’s impact on the mind and body. Blockbuster movies featuring someone living with insomnia include <a href="https://www.imdb.com/title/tt0108160/">Sleepless in Seattle</a> (1993), <a href="https://www.imdb.com/title/tt0137523/">Fight Club</a> (1999) and <a href="https://www.imdb.com/title/tt0278504/?ref_=fn_al_tt_1">Insomnia</a> (2002). But how well do these and other portrayals compare with what it’s really like to live with insomnia? As we’ll see, most movies tend to either minimise or exaggerate symptoms. Insomnia is rarely depicted as a treatable illness. And these portrayals have implications for the estimated <a href="https://www.sleep.theclinics.com/article/S1556-407X(22)00022-4/fulltext">one in three</a> of us with at least one insomnia symptom. <h2>Back in the real world</h2> Insomnia is a common <a href="https://doi.org/10.1378/chest.14-0970">sleep disorder</a> where a person struggles to fall asleep, stay asleep, or wakes up too early – despite having adequate opportunity for sleep. <a href="https://doi.org/10.1111/j.1753-6405.2012.00845.x">Around 5%</a> of adults experience significant insomnia to the degree that it causes distress or impairs daily life. It’s a common misconception that insomnia is only a night-time issue. <a href="https://www.healthdirect.gov.au/insomnia">Insomnia</a> can impact your ability to stay awake and alert during the day. It can also affect your <a href="https://theconversation.com/explainer-whats-the-link-between-insomnia-and-mental-illness-49597">mental health</a>. At work, you might be more prone to accidents, more forgetful, or make poorer decisions. At home, you might be irritable or short with your friends and family. So what is it like living with insomnia? Apart from the effects of poor sleep quality, many people experience <a href="https://doi.org/10.1016/j.smrv.2021.101583">anxiety or dread</a> about the night ahead from the moment they wake up. From early in the day, people plan how they can improve their sleep that night. <a href="https://doi.org/10.1016/j.smrv.2016.01.003">A review</a> found people living with insomnia felt their sleep concerns were often trivialised or misunderstood by health-care professionals, and stigmatised by others. <h2>Movies can minimise symptoms …</h2> Nicholas Galitzine’s character in the recent romcom <a href="https://www.imdb.com/title/tt10172266/?ref_=fn_al_tt_1">Red, White and Royal Blue</a> (2023) has insomnia. We’re briefly told he struggles to fall asleep at night. However, we never see any meaningful impact on his life or depiction of the difficulty living with insomnia entails. That said, minimising the impact of insomnia can have benefits. It shows insomnia is an invisible illness, doesn’t have obvious visual symptoms and anyone can have it. But this can perpetuate the expectation someone with insomnia should be able to function unencumbered. Or it can fuel the misconception having insomnia may be beneficial, as in <a href="https://www.imdb.com/title/tt0050543/?ref_=fn_al_tt_1">Insomnia Is Good for You</a> (1957). <h2>… or exaggerate symptoms</h2> But most Hollywood portrayals of insomnia tend to depict the most extreme cases. These usually feature insomnia as a symptom of another condition rather than a disorder itself, as is commonly experienced. These movies tend to be psychological thrillers. Here, insomnia is often used as an enigma to keep the audience guessing about which events are real or figments of a character’s imagination. Take <a href="https://www.imdb.com/title/tt0361862/?ref_=fn_al_tt_1">The Machinist</a> (2004), for example. The main character is emaciated, ostracised and plagued by paranoia, hallucinations and delusions. It’s only towards the end of the movie we learn his insomnia may be the result of a <a href="https://doi.org/10.9740/mhc.n101819">psychiatric disorder</a>, such as post-traumatic stress disorder. <figure><iframe src="https://www.youtube.com/embed/-R4rQMImHwE?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>In The Machinist, the main character has paranoia, hallucinations and delusions.</figcaption></figure> Hollywood’s focus on extreme cases of insomnia is a recurring pattern (for instance, <a href="https://www.imdb.com/title/tt0137523/">Fight Club</a> 1999, <a href="https://www.imdb.com/title/tt0434165/?ref_=fn_al_tt_3">Lucid</a> 2005). It’s understandable why Hollywood latches onto these extreme portrayals – to entertain us. Yet these portrayals of insomnia as something more severe or threatening, like psychosis, can increase anxiety or stigma among people living with insomnia. While it’s true other medical conditions including <a href="https://theconversation.com/explainer-whats-the-link-between-insomnia-and-mental-illness-49597">mental illnesses</a> can lead to insomnia, insomnia often exists on its own. Insomnia is often <a href="https://theconversation.com/explainer-what-is-insomnia-and-what-can-you-do-about-it-36365">caused by</a> more mundane things like too much stress, lifestyle and habits, or longer daylight hours at higher latitudes (such as in <a href="https://www.imdb.com/title/tt0278504/?ref_=fn_al_tt_1">Insomnia</a>, 2002). Something these exaggerated portrayals do well is highlight the impact sleep deprivation can have on safety, albeit extremely dramatised. Regardless of profession, <a href="https://doi.org/10.1037/xge0000717">not getting enough sleep</a> at night can substantially impact cognitive function, increasing the chance of making a mistake. <figure><iframe src="https://www.youtube.com/embed/emIHzg4VH8A?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>In Insomnia, one character has insomnia because of extended daylight hours.</figcaption></figure> <h2>Movies rarely depict treatment</h2> It is rare to see insomnia depicted as a health condition requiring medical care. Very few characters struggling with insomnia seek or receive help for it. An exception is the narrator in <a href="https://www.imdb.com/title/tt0137523/">Fight Club</a> (1999). But he has to pretend to have other illnesses to receive therapy, again suggesting insomnia is not a legitimate condition. <figure><iframe src="https://www.youtube.com/embed/BdJKm16Co6M?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>The narrator in Fight Club pretends to have other illnesses to receive therapy for insomnia.</figcaption></figure> <h2>Why does accurate representation matter?</h2> Many people only learn about the symptoms and impact of sleep disorders through pop culture and film. These portrayals can affect how others think about these disorders and can impact how people living with these disorders think about themselves. Uniform and stereotypical portrayals of insomnia can also impact people’s <a href="https://doi.org/10.1080/15402002.2011.620671">likelihood of seeking help</a>. Most of these films show young or middle-aged men experiencing insomnia. Yet women are <a href="https://doi.org/10.1093/sleep/29.1.85">more likely</a> to have insomnia than men. Insomnia is also <a href="https://doi.org/10.1016/j.jsmc.2022.03.003">more common</a> in older adults, people with a lower socioeconomic background and those living alone. People at higher risk of developing insomnia might not recognise their risk or symptoms if their experience doesn’t match what they’ve seen. <h2>We can do better</h2> While the reality of living with insomnia may not be particularly cinematic, filmmakers can surely do better than using it as a convenient plot point. There are a number of main characters living with different health conditions across pop culture. For instance, the movie <a href="https://www.imdb.com/title/tt4034228/">Manchester by the Sea</a> (2016) features someone with <a href="https://www.rcpsych.ac.uk/news-and-features/blogs/detail/cultural-blog/2017/07/08/manchester-by-the-sea">prolonged grief disorder</a> and the TV series <a href="https://www.imdb.com/title/tt6315640/?ref_=nv_sr_srsg_0_tt_8_nm_0_q_Atypical">Atypical</a> (2017-2021) features someone’s experience living with autism. But if you’re looking for an accurate portrayal of insomnia, Hollywood still has some way to go. It’s about time insomnia is depicted in a way that accurately reflects people’s experiences.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/211823/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/aaron-schokman-1463327">Aaron Schokman</a>, PhD Candidate, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/nick-glozier-94435">Nick Glozier</a>, Professor of Psychological Medicine, BMRI & Disciplne of Psychiatry, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-insomnia-like-for-most-people-who-cant-sleep-youd-never-know-from-the-movies-211823">original article</a>.

Body

6 common factors that are impacting your sleep

While we all do our best to make sure we’re get our eight hours every night, at times it can feel as though we’re our own worst enemies. And while we’re all aware of the importance of sleep, it can sometimes be difficult to figure out what the root of the problem is. Here are six common factors that may be negatively impacting your ability to get shut eye. Correct these and you’ll be on your way to enjoy a good night sleep. 1. Light Studies have shown the exposure to light can wreak havoc in terms of our internal circadian rhythm. Try to avoid having your vision obstructed by any light when you’re about to get to sleep and keep the use of mobile and computer devices to a minimum. 2. Food Asides from the correlation between poor quality sleep and processed foods, it’s generally not recommended you have large, heavy meals just before you’re about to go to bed. Also, try to avoid sugar and caffeine in the few hours leading to bedtime. 3. Noise Noise can also affect the pattern of your sleep as anyone who’s tossed and turned at the sound of a neighbour’s party. Earplugs are one option you can explore. It’s also an idea to perhaps try a light fan to drown the noise out somewhat, or some sort of gentle recording. 4. Temperature Each person has an optimal temperature for falling asleep and it varies between people. If you’re feeling a bit hot under the collar (or too cool to start sleeping) it’s worth experimenting with the temperature in your room until you find one that better suits. 5. Schedule Are bodies are fiends for routines, so try to go to bed and get up at the same time every day, even on weekend. Not only will this help integrate your body into a regular sleep/wake pattern, it will also make the actual process of falling asleep seem much easier. 6. Naps While there’s nothing quite as nice as an afternoon nap during the day, it can actually significantly disrupt out sleep patterns during the night. If you really do have to nap during the day, try to keep it short and avoid napping too much in the later parts of the day. Image credits: Getty Images

Body

Counting the wrong sheep: why trouble sleeping is about more than just individual lifestyles and habits

<a href="https://theconversation.com/profiles/mary-breheny-1269716">Mary Breheny</a>, <a href="https://theconversation.com/institutions/te-herenga-waka-victoria-university-of-wellington-1200">Te Herenga Waka — Victoria University of Wellington</a> and <a href="https://theconversation.com/profiles/rosie-gibson-1051224">Rosie Gibson</a>, <a href="https://theconversation.com/institutions/massey-university-806">Massey University</a> Sleep may seem straightforward – everyone does it, after all. But as many of us know, getting enough sleep is not necessarily a simple task, despite what you might read in the media. How to sleep “properly” is a favourite topic of self-help articles, with <a href="https://www.mirror.co.uk/news/health/expert-advice-good-nights-sleep-27900333">headlines</a> such as “Expert advice to get a good night’s sleep whatever your age” promising the answer to your nocturnal awakenings. Older people are commonly the audience of these messages. <a href="https://doi.org/10.1093/geront/gnad058">Our analysis</a> of articles published in the New Zealand media between 2018 and 2021 found sleep is presented as inevitably declining with age. At the same time, sleep is portrayed as a cure for everything: a good night’s sleep is depicted as a way to maintain productivity, ward off illness and dementia, and ultimately live longer. But most of these articles are aimed at the individual and what they can do to improve their sleep. Often missing is any reference to the external factors that can contribute to poor sleep. <h2>Personal choice and sleep</h2> A key message in many of the articles we examined is that sleep is a simple matter of making the right choices. So, if you’re not getting enough sleep it’s probably your own fault. People are lectured about poor “<a href="https://www.cci.health.wa.gov.au/%7E/media/CCI/Mental-Health-Professionals/Sleep/Sleep---Information-Sheets/Sleep-Information-Sheet---04---Sleep-Hygiene.pdf">sleep hygiene</a>” – staying up too late looking at their phone, having too many cups of coffee, or not getting enough exercise during the day. And it’s true, drinking too much caffeine or staring at a screen into the small hours might interfere with sleep. It’s also true that good sleep is important for good health. But things are a bit more complicated than this. As anyone who has struggled to maintain good sleep knows, simple tips don’t always overcome the complex situations that contribute to these struggles. <h2>Awake to other factors</h2> Good sleep is not just a matter of “making the right choices”. Internationally, there’s a growing body of research showing sleep is affected by much more than individual behaviour: it’s often shaped by a person’s <a href="https://www.annualreviews.org/doi/10.1146/annurev-publhealth-040119-094412">social and economic circumstances</a>. New Zealand research is adding to this pool of knowledge. <a href="https://www.sciencedirect.com/science/article/pii/S235272181600019X?via=ihub">One study</a>, based on survey results from just over 4,000 people, found insufficient sleep was more common among Māori than non-Māori, partly due to higher rates of night work. International <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6524484/">research</a> has also found women are more likely to experience insomnia due to their caregiving roles. One US study found unpaid caregivers for children or parents (or both) reported shorter sleep quantity and poorer sleep quality than paid caregivers or people without such roles. A <a href="https://journals.sagepub.com/doi/10.1177/1471301220915071">survey</a> of 526 carers in New Zealand showed two-thirds reported mild or severe sleep disturbance. We also know lack of sleep is <a href="https://www.cdc.gov/sleep/about_sleep/chronic_disease.html">linked to serious disease</a>, including diabetes and heart disease. Sleep duration and quality have been identified as predictors of levels of haemoglobin A1c, an important marker of blood sugar control. And hypertension, stroke, coronary heart disease and irregular heartbeats have been found to be more common among those with disordered sleep than those without sleep abnormalities. Failure to acknowledge the social context of poor sleep means sleep messages in the media ignore the fundamental causes in favour of the illusion of a quick fix. <h2>The commodification of sleep</h2> Sleep is also increasingly characterised as a commodity, with a growing market for products – such as sleep trackers – that claim to help improve sleep quality. Sleep trackers promise to measure and enhance sleep performance. However, their reliability may be limited – <a href="https://mhealth.jmir.org/2021/6/e26462">one study found</a> the tested tracker did not accurately detect sleep, particularly in older adults who had greater levels of nighttime movement. Framing public health problems as matters of personal choice is common. Alcohol and fast-food consumption, for example, are regularly presented as <a href="https://journals.sagepub.com/doi/full/10.1177/1745691619896252">matters of individual responsibility</a> and poor personal choices. The <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/hpja.737">role of marketing</a> and access to healthy food gets a lot less attention. Of course, simple tips for getting good sleep may be useful for some people. But ignoring the underlying social and economic factors that shape the possibilities for good sleep will not address the problem. Health promotion messages that focus on individual behaviour miss <a href="https://onlinelibrary.wiley.com/doi/10.1111/1467-9566.12112">the structural barriers to better health</a>, including poverty, low levels of education, high rates of incarceration, substandard or crowded housing and racism. We need to move beyond messages of individual behaviour change and start talking about inequities that contribute to the problem of who gets a decent night’s sleep and who doesn’t.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/210695/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mary-breheny-1269716">Mary Breheny</a>, Associate Professor of Health Psychology, <a href="https://theconversation.com/institutions/te-herenga-waka-victoria-university-of-wellington-1200">Te Herenga Waka — Victoria University of Wellington</a> and <a href="https://theconversation.com/profiles/rosie-gibson-1051224">Rosie Gibson</a>, Senior lecturer, School of Psychology, Massey University, <a href="https://theconversation.com/institutions/massey-university-806">Massey University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/counting-the-wrong-sheep-why-trouble-sleeping-is-about-more-than-just-individual-lifestyles-and-habits-210695">original article</a>.

Caring

How listening to music could help you beat insomnia

<a href="https://theconversation.com/profiles/victoria-williamson-277929">Victoria Williamson</a>, <a href="https://theconversation.com/institutions/university-of-sheffield-1147">University of Sheffield</a> In our hectic world, a good night’s sleep is worth its weight in gold when it comes to improving <a href="http://www.apa.org/topics/sleep/why.aspx">physical and mental well-being</a>. Much more than a basic method of energy conservation, sleep is a state during which muscle and bone are generated and repaired, and memories and learning systems are updated. Sleep also allows the body and brain to clear out the toxic byproducts of the day’s waking activity that might otherwise build up and cause harm. <a href="http://healthysleep.med.harvard.edu/healthy/matters/benefits-of-sleep/why-do-we-sleep">In short, good sleep is a cornerstone of human health</a>. Sadly, not all of us are blessed with the bounty of a good night’s slumber after a long and often tiring day. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1978319/">Around 30% of adults</a> experience chronic insomnia at some point in their life – where sleep is disrupted for more than a month. Estimates are even higher in older populations and those who experience regular stress. <a href="http://www.webmd.com/sleep-disorders/features/10-results-sleep-loss#1">Insomnia can be devastating</a>, and has been linked to cognitive deficiencies – such as memory lapses, psychological problems including mood and anxiety disorders, and long-term health concerns including obesity and dementia. The most severe cases of chronic insomnia can even increase <a href="http://www.medicalnewstoday.com/articles/290065.php">the risk of mortality</a>. <figure><iframe src="https://www.youtube.com/embed/TTDDK6goHVg?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> The cost of insomnia goes well beyond just health. According to the National Sleep Foundation, insomniacs are two to four times more likely to have an accident – with over <a href="https://www.cdc.gov/features/dsdrowsydriving/">72,000 traffic accidents a year</a> in the US alone linked to sleep deprivation. Insomnia also costs US companies an <a href="http://www.nbcnews.com/id/12152327/ns/health-sleep/t/chronic-sleep-problems-costing-us-billions/">estimated $150 billion</a> in absenteeism and reduced productivity, every year. Given our need for regular and deep sleep, it is no surprise then that people with insomnia often reach for the medicine cabinet. Pharmacies in the UK regularly dispense more than <a href="https://www.theguardian.com/society/2012/may/11/nhs-spending-sleeping-pills-50m">15.3m prescriptions for sleep aids</a>. But this is not the safest route to a good night’s slumber, as the use of over the counter and prescription sleep aids can lead to harmful side effects, dependency and withdrawal. <h2>Music for sleep?</h2> Research has shown that listening to “self-selected” music – music of your choice – can actually shorten stage two sleep cycles. This means people reach restful <a href="https://theconversation.com/can-listening-to-music-help-you-fall-asleep-49864">REM sleep – the restorative part of our sleep – more quickly</a>. In the study, students who listened to 45 minutes of <a href="http://lib.semmelweis.hu/sepub/pdf/2008/a18426457">music before bedtime</a> for three weeks saw a cumulative positive effect on multiple measures of sleep efficiency with similar effects reported in older citizens in Singapore. Following all this evidence, the NHS now recommends “<a href="http://www.nhs.uk/Conditions/Insomnia/Pages/Prevention.aspx">listening to soft music</a>” before bedtime as a method to prevent insomnia. With all this in mind, <a href="http://musicwellbeing.group.shef.ac.uk/">our research unit</a>, along with colleagues from the Sleep and Cognition Laboratory at the University of Lincoln and Goldsmiths, University of London, has embarked on a new music sleep project, to find out what people listen to when they are nodding off – and why people believe music helps their sleep. <a href="https://dl.dropboxusercontent.com/u/16722236/Final%20sleep%20infographic.pdf">The first phase of our music sleep survey </a> has been completed by 651 people, who have told us a great deal about the music that helps them to sleep. We discovered the top rated composer of sleep music in our sample is Johann Sebastian Bach. He was followed by Ed Sheeran, Wolfgang Amadeus Mozart, Brian Eno, and Coldplay. Aside from those few top rated artists, there was an enormous variety of individual choices – with 14 different genres and 545 different artists named. And it is this data which will give us the basis to examine the features of effective sleep music. Using computer programs we will be able to pin down the consistent musical features that support sleep among these many diverse musical sounds. <h2>Face the music</h2> We also found out a lot about the reasons why people are turning to music in the first place. And they are varied. In our <a href="https://dl.dropboxusercontent.com/u/16722236/Final%20sleep%20infographic.pdf">research</a>, people highlighted the importance of music for blocking disruptive external (such as traffic) and internal (like tinnitus) sounds, for filling uncomfortable silences, and providing a sense of companionship and security. This suggests that a one size fits all approach to music for sleep is unlikely to suit all insomniacs, because people are tuning into so many different types of music for so many different reasons. <a href="https://www.youtube.com/watch?v=TTDDK6goHVg&feature=youtu.be">The next step for our research</a> will be to expand <a href="http://musicpsychology.co.uk/sleep/">our survey</a> to cover as many populations and cultures as possible. We will then test the music that people report to be consistently effective at different stages of sleep using advanced sleep recording techniques. Our aim is to develop personalised music selection technology, combined with advice on music sleep strategies, as a complete package for people who need to restore their sleep to normal for the sake of their health, quality of life and well-being. Until then, the best advice we can offer when choosing music to put you to sleep is to trust your own musical choices over generic “sleep” playlists. You know best what you are looking for in a bedtime track – based on what you like and what you need from the music at the time. And in the near future we will be armed with the necessary evidence that will allow us to move from this “instinctive approach” to a more informed and optimised application of music as an effective aid in the battle against insomnia.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/61622/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/victoria-williamson-277929">Victoria Williamson</a>, Lecturer in Music , <a href="https://theconversation.com/institutions/university-of-sheffield-1147">University of Sheffield</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-listening-to-music-could-help-you-beat-insomnia-61622">original article</a>.

Music

8 mistakes insomniacs make when they’re trying to fall asleep

<h2>Going to bed too early</h2> If you slept poorly the night before, you may want to slide into bed ahead of schedule. But this can actually make sleeplessness worse. People with insomnia frequently have irregular sleep-wake cycles. Sticking with a consistent sleep routine – a regular bedtime and a regular wake time – strengthens your body’s circadian rhythms and the biological cues (like melatonin release) that help you fall asleep. Hitting the sack unusually early may garner you some ‘extra’ sleep in the early part of the night, but you’re likely to wake up earlier than normal, throwing your sleep routine even more off-kilter. Aim to have your bedtime deviate by no more than 30 minutes from one night to the next. <h2>Getting in bed before you’re sleepy</h2> I recently had a patient who was often anxious and alert at bedtime – she described the feeling as “wired and tired”. She’d crawl into bed anyway, and lie wide awake late for an hour or more, frustrated and sleepless. I recommended she delay her bedtime until she felt ready to fall asleep. A restless, wired mind is one symptom of sleep deprivation. Learn to recognise the difference between being tired and being sleepy – and hold off going to bed until you feel ready to nod off. Take some extra time with your nightly routine, or find other ways to relax away from bright lights and screens near your face. <div> </div> <h2>Drinking alcohol to help you nod off</h2> Plenty of people are looking for ways to cut back on their drinking. It’s a good idea, according to the US National Sleep Foundation. The relationship between alcohol and sleep is complicated. One drink in the evening may help you fall asleep, but drinking more heavily can be stimulating, not sedating. Even if a nightcap does help you doze off initially, alcohol in your system at night disrupts your rest in other ways, causing lighter, more restless sleep, exacerbating snoring, and making you more likely to have to get up to use the bathroom. If you’re already having trouble sleeping, skip the before-bed glass of wine. <h2>Eating just before bed</h2> People with insomnia may be more prone to late-night snacking. Up later, they’re more likely to get hungry again after dinner. And the presence of stress – whether about daily life or sleep itself – does more than interfere with slumber. It also boosts the inclination for late-night eating, which can disrupt sleep. The evidence is growing about the hazards of late-night eating, and new research suggests that weight gain and rising insulin and cholesterol levels are among the risks. Make your last full meal two to three hours before bedtime, and don’t do a lot of snacking right before bed – or in bed. A light, sleep-friendly snack 90 minutes or an hour before turning in is OK, but eating right before sleep can keep you awake, especially if you have insomnia. <h2>Logging onto social media from bed</h2> Do you do a final check of social media right before lights out? This is a behaviour that often gets pegged to 20- and 30-somethings, but I have patients in their 40s, 50s, and 60s who share this sleep-disrupting habit. Holding your phone close to your face exposes you to bright, blue-wavelength light, which is especially disruptive to sleep. A new study by scientists at the University of Pittsburgh indicates using social media within 30 minutes of bedtime increases disturbances to sleep. Scrolling through Facebook and liking your friends’ Instagram stories will stimulate your mind and keep you alert, just when you need to wind down. Establish a social media cut-off time of at least 60 minutes before bed. <h2>Thinking negatively about sleep</h2> What causes insomnia? Chronic difficulty sleeping can stem from many factors, including health conditions, medications, poor sleep habits and stress. Anxiety about sleep itself often compounds the problem. Negative, distorted thoughts about sleep can trigger the body’s stress response, including raising blood pressure, heart rate and brain activity. This makes it harder to nod off, which further increases anxiety about your inability to sleep. To break this anxious, sleep-depriving cycle, replace negative sleep thoughts with positive ones – a technique known as ‘cognitive restructuring’. For example: “I’ll never be able to fall asleep” becomes, “As I allow myself to relax, sleep will happen.” Use mindfulness practices and relaxation breathing to help you re-focus your thoughts. <h2>Staring at the clock</h2> Sometimes my patients struggling to find a cure for their insomnia go in search of complicated solutions. Clock-watching is a common pitfall for people who struggle with sleep – and the remedy couldn’t be simpler, or more effective. If you’re having trouble falling asleep, stash your bedside clock. Constantly checking the time ratchets up sleep-related stress, and makes it almost impossible to drift off. “The later it gets, the more afraid I feel about the sleep I’m missing, and how tired I’ll be the next day,” a patient told me recently. Place the clock firmly out of your view, so you’re not tempted to check the time again and again. If you struggle to get to sleep, try these <a href="https://www.readersdigest.com.au/healthsmart/conditions/sleep/10-relaxation-techniques-to-help-you-wind-down-for-sleep" target="_blank" rel="noopener">10 relaxation techniques that help you to wind down for sleep.</a> <h2>Trying to get more sleep than you need</h2> The standard recommendation of eight hours of nightly rest is a good one, but it isn’t for everybody, all the time. Individual sleep needs vary. Some people who regularly experience insomnia aren’t built to achieve – or even need – a full eight hours of sleep. For some people struggling with sleeplessness, six or six-and-a-half hours might be a more realistic goal. By focusing too narrowly on hitting the eight-hour mark, you may inadvertently create stress that makes sleep harder to come by. Instead, put your attention on the quality of your rest. Practise good sleep hygiene, create a restful sleep environment, give yourself some relaxing night-time rituals, and pat yourself on the back for making high-quality sleep a priority. This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/conditions/sleep/8-mistakes-insomniacs-make-when-theyre-trying-to-fall-asleep" target="_blank" rel="noopener">Reader's Digest</a>. Images: Getty

Body

5 tips to beat insomnia

At the very least, insomnia (or sleep deprivation) will make you feel tired, grumpy, and lacking that get-up-and-go. Fear not, we have some really simple tips that will help improve your sleep, overnight. The first step to ensuring you sleep well is to understand what a good night’s shuteye means. Generally speaking, if you’ve slept well you should feel refreshed the next morning and ready to face the day. As every person’s sleep needs are different, the amount of time required catching Zs can vary. The Sleep Health Foundation says most adults need between seven and nine hours sleep each day. But this may include naps and time spent dozing in front of the TV. A good rule of thumb is: if you’re getting less sleep than you used too but still feel rested and energetic during the day, you’re onto a winning formula. So why do over one-third of Australians experience trouble getting to sleep or staying asleep from time to time? Well, there's no hard and fast explanation. But the internet and texting have been proven to be major sleep distractions. Stress is another big sleep-stealer. So too is worrying about getting to sleep. Other issues to consider are life changes like moving, physical limitations due to illness, retirement, medication, or the death of a loved one which can cause stress. And then there’s conditions such as arthritis, heart failure, heartburn, sleep apnoea, restless leg syndrome, an enlarged prostate, or Alzheimer’s disease which can all make sleeping and, staying asleep, harder. From expanding your waistline and making you reach for the higher-fat, higher-calorie foods, to reduced hand-eye coordination leading to accidents, experts now know that a lack of sleep can be more dangerous than first thought. Things like your attention span, learning and memory could be affected. A lack of sleep can also speed up the ageing process and take a toll on your skin by affecting collagen production. Top tips for improving your sleep: Stick to sleep schedule Sleep should be up there with food, water and exercise as one of the cornerstones of good health. Thus, you should look at sleep the way you do a healthy eating or exercise plan – and stick to it. With a little trial and error, work out how many hours you need a night. Then, create a sleep schedule by going to bed at the same time each night (preferably before midnight) and waking up at the same time each morning, even on weekends. This will help you develop a natural sleep/wake cycle. Create a sleep sanctuary Winding down after your day is important in ensuring you’re relaxed and in an ideal state for bed. Ban TV, computers and phones from the bedroom and for a little while before you go to bed. Instead, have a warm bath with your favourite essential oils, read under a soft light or do some deep breathing or gentle yoga poses. If you are prone to worrying, write a quick list of your problems and possible solutions that you can address the following day. That way you will be ready to sleep when you hit the pillow. Restrict your sleep Research suggests that one way to encourage a good night’s sleep after 60 might actually be to restrict your sleep. A study conducted at the University of Surrey suggests that a later bedtime could help you drift off sooner. The researchers also found that, of eight hours spent in bed, the over 65s group slept for an average of six hours and 30 minutes. This pattern could tell your body that it’s ok to drift in and out of sleep all night. Spend less time in bed. If you can, get up, don’t spend eight hours in bed when you’re only sleeping for six of them. And if you can’t fall asleep, but have been trying for around 20 minutes, get up and go to another room and try again when you feel sleepy. Don’t drink alcohol close to bedtime Despite popular opinion, alcohol will not help you get a good night’s sleep. Although it may make you feel sleepy and fall asleep, it actually disrupts your sleep. In the second half of the night, sleep after drinking alcohol is associated with more frequent awakenings, night sweats, nightmares, headaches and is much less restful. Thus, avoid alcohol for at least four hours before bedtime. Furthermore, binge drinking will affect your levels of melatonin (which makes you feel sleepy at night and regulates your body rhythm) for up to a week. Try a herbal remedy Mother Nature can provide a number of herbs that have a gentle sedative effect. Things like valerian, ziziphus, chamomile, lemon balm, hops and lactium may help calm your mind so you can get a good night’s sleep. Seal the mattress The sneezing, sniffling, and itching of allergies can cause fragmented sleep - and your mattress may be to blame. Over time, it can fill with mould, dust mite droppings, and other allergy triggers. Avoid these sleep disturbers by sealing your mattress, box springs, and pillow. Visit the doctor! If nothing seems to work well for you, speak to your doctor about your sleep problems. There’s always the chance that a condition you have or medications you’re taking are affecting you’re sleep. The doc can also refer you to a sleep specialist or another professional who might be able to help you get the sleep you deserve. Image credits: Getty Images

Body

The 5 types of insomnia revealed

Having trouble getting some shut-eye at night? You may not be alone – one third of Australians will suffer from insomnia at some point in their lives. Treatments for insomnia vary from relaxation techniques to medication, but no cure has been found to be universally effective. And now a new research has discovered why. A <a href="https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(18)30464-4/fulltext">new study</a> published on the Lancet Psychiatry has found that the sleep disorder could be categorised into five different types. Researchers at the Netherlands Institute for Neuroscience used the data of more than 2,200 volunteers aged 18 and above to create a report on different sleep complaints, brain mechanisms and treatment effects. “While we have always considered insomnia to be one disorder, it actually represents five different disorders,” said Dr Tessa Blanken, one of the researchers. Below is the breakdown for each type: <ul> <li>Type 1: Highly distressed; people who score high on neuroticism and are more prone to feeling down or tense.</li> <li>Type 2: Moderately distressed but reward sensitive (that is, more responsive to positive emotions and events).</li> <li>Type 3: Moderately distressed and reward insensitive.</li> <li>Type 4: Slightly distressed with high reactivity; stressful life events to environment and life events. Stressful life events would induce severe and lasting insomnia in this type.</li> <li>Type 5: Slightly distressed with low reactivity; stressful life events would have no effects on sleep for this type.</li> </ul> While these five type groups share the same sleep complaints – including difficulty falling asleep and early morning awakening – they react differently to treatments. For example, cognitive behavioural therapy was only helpful to group 2, while benzodiazepines benefited groups 2 and 4. The study also found that group 1 was most at risk of developing depression and other sleep disorders. “Subtyping now enables much more efficient research into the prevention of depression, by inviting specifically those with the highest risk,” the study said. Volunteers whose electrical brain activity was measured again after five years were found to retain their types, which suggested that sleep problems are “anchored in the brain”. This finding, the researchers said, “could be a new page in the history of insomnia, promoting discoveries on mechanisms and interventions”. Do you have insomnia or other sleeping problems? Share your story in the comment below.

Body

We’re not sleeping enough and it is killing us

Inadequate sleep has a huge impact on how you function, feel and think, yet recent data has revealed that 50 per cent of people are failing to get enough shut-eye. Despite being exhausted, 75 per cent of people are also having difficulty falling asleep once they lay their head on their pillow. Most people will pin their sleep deprivation on either a busy schedule that physically removes you from your bed, or a busy mind that mentally keeps you alert during the night. It is recommended that adults get 7-9 hours sleep each night and Dr Nick Fuller has shared tips with <a href="https://www.dailytelegraph.com.au/lifestyle/were-not-sleeping-enough-and-its-killing-us/news-story/8dfd04ff4efb4e94d06da2c805ed9c8a" target="_blank">The Daily Telegraph</a> on how to make sure that happens. 1. Boost serotonin levels Not only does serotonin regulate sleep but also your mood and appetite. It is derived from the amino acid, tryptophan, so make sure your evening meal contains naturally high amounts of tryptophan. Some examples of foods containing tryptophan include dairy foods, eggs, tofu, soy beans, salmon, lamb, chicken, turkey, cherries, Kiwi fruit, nuts and seeds. 2. Have a good bed You spend a lot of time in your bed and sleeping is such an important aspect of your health, so it is justifiable to spend good money to make sure you have a quality bed. 3. Avoid caffeine Dr Fuller recommends avoid having coffee six hours before you go to bed. Many people also forget about caffeine in tea, so if you are having a tea before bed, opt for herbal tea. 4. Remove screens from bedroom Not only should you not go on your computer or phone right before bed, but Dr Fuller also suggests removing the technology entirely from your room. This will give your body a chance to produce melatonin, the hormone that regulates sleep. 5. Regular exercise Consistency is key when it comes to exercise and we all know that it improves our quality of life throughout the day, but it also improves our quality of sleep. 6. Limit fluids before bed To avoid waking up in the middle of the night to go to the bathroom, moderate your fluids after 4pm. 7. Avoid smoking before bed Dr Fuller explains that nicotine is a stimulant and can prevent a good sleep and cause insomnia. Call the Quitline 137 848 to discuss free available support to stop smoking. What are your tips for getting a good night’s sleep? Do you have trouble sleeping? Let us know in the comments below.

Body

Insomnia has been linked to Alzheimer’s

Bad news for insomniacs – <a href="http://www.neurology.org/content/early/2017/07/05/WNL.0000000000004171" target="_blank">a new study</a> has found a worrying link between poor quality sleep and a heightened risk of Alzheimer’s disease. Research examined the relationship between sleep quality and Alzheimer’s biomarkers in a group of 101 subjects with an average age of 63. They concluded that poor sleep quality, sleeping problems and grogginess during the day were linked to increased indicators of the disease. It’s not known for certain why this may be, but studies in animals have found that the brain’s ability to clear toxins like beta amyloid (the plaque-forming protein found in Alzheimer’s sufferers) improves. All participants had known risk factors for the disease, including family history or presence of the APOE gene, believed to be associated with a higher risk. They each rated the amount of sleep they got, the quality of that sleep, any troubles they had staying asleep and any sleepiness they may have experienced during the daytime. “Not everyone with sleep problems is destined to develop Alzheimer’s disease,” Barbara Bendlin of the Wisconsin Alzheimer’s Disease Research Centre and senior author of the paper told the <a href="https://www.nytimes.com/2017/07/05/well/mind/poor-sleep-tied-to-increased-alzheimers-risk.html?mcubz=1&_r=0" target="_blank">New York Times</a>. “We’re looking at groups of people, and over the whole group we find the association of poor sleep with the markers of Alzheimer’s. But when you look at individuals, not everyone shows that pattern.” However, if you’re tempted to turn to sleeping pills, Bendlin warns against it. “We don’t yet know if sleep medication has an effect on amyloid,” she told the <a href="http://www.huffingtonpost.com.au/entry/insomnia-alzheimers-study_us_595e52cee4b0d5b458e8b7c9" target="_blank">Huffington Post</a>. “The next step will be to further query these relationships using objective sleep measures.”

Mind

Beautiful photo series reveals the loneliness of insomnia

If you’ve ever experienced insomnia before, you’ll know just how lonely it can be, especially when it seems the rest of the world is sleeping happily while you endure a constant struggle. Now, 39-year-old photographer Michael Massaia from New Jersey has captured how lonely insomnia really is, with a haunting series of photos depicting an eerily empty Central Park. “It was a bit maddening trying to fill up all the hours,” Massaia, who has suffered insomnia since the age of 13, told the <a href="http://www.huffingtonpost.com.au/2017/05/31/these-stunning-photos-capture-the-loneliness-of-insomnia_a_22119315/?utm_hp_ref=au-entertainment" target="_blank">Huffington Post</a>. “My desire to sleep wasn't to try and get rest, it was to simply help pass the time.” That’s what led the photographer to start a little night-time project, as a way of capturing the contrast between the dark, empty night and the bustling, bright daytime. “I hope people take away from the project a kind of compelling isolation, or perhaps something as simple as being able to turn a defect into something useful.” Take a look at the fascinating photos above and tell us in the comments below, have you ever experienced insomnia? How did you overcome it? Image credit: Michael Massaia.

Art

5 common reasons you can’t sleep

According to the <a href="http://sleephealthfoundation.org.au/pdfs/Insomnia.pdf" target="_blank">Sleep Health Foundation</a>, around one in three people have at least mild insomnia. The causes can vary from medical conditions such as anxiety through to bad sleeping habits. If you’re finding it hard to get shut-eye most nights, try pin pointing the problem and remedying it with the solutions below. 1. You’re still digesting food Acid reflux and general indigestion problems are enough to keep the sleepiest head turning on the pillow. Try settling your stomach before bed with a ginger tea and always sleep on your left side. Lying on your right side causes your lower oesophageal sphincter to relax and food to pass upwards. 2. Your brain won’t stop racing It’s a dreaded cycle to be in. You can’t sleep because your mind won’t quiet down, and as the hours tick by, you become more and more agitated. This is where relaxation techniques really come in handy. Slow your breathing, visualise a place or scene that is calming to you, and imagine it in is much detail as you can. For example, if you are in a garden, what colour are the flowers? Is the grass wet? If all else fails, try taking all-natural vitamins for anxiety before bed. 3. You overslept the previous day Did you treat yourself to a big sleep in, or an afternoon nap? Unfortunately, the first thing you have to do is get out of bed to tire yourself out. Read a book, tidy the living room or even do some light yoga. 4. There’s noise nearby Are you suffering from noisy neighbours or a snoring spouse? If ear plugs are not working, then the best thing to do is embrace the sounds. Visualise yourself to be in a setting where you can transform these sounds into soothing ones, like rolling waves or a vibrant rainforest. Focus on all five of your senses to transport yourself here. 5. No reason, you just can’t sleep Sometimes, our bodies have no good reason for not wanting any shut-eye. The key here is to trick it into sleeping. Choose a point on the ceiling and continue to stare at it, refusing to close your eyes. This is employing the use of “paradoxical intention”, a cognitive technique that involves engaging in your most feared behaviour. In the case of insomnia, it relieves performance anxiety that hinders falling asleep. Do you have any handy tips for relaxation or visualisation exercises? Let us know in the comments below. Related links: <a href="/entertainment/music/2016/08/can-music-help-us-fall-asleep/">Can music help us fall asleep?</a> <a href="/health/mind/2016/08/stop-your-mind-racing-at-night/">How to stop your mind from racing in the middle of the night</a> <a href="/news/news/2016/08/shocking-effect-of-a-bad-nights-sleep/">The shocking effect a bad night’s sleep can have</a>

Body

Can music help us fall asleep?

According to a <a href="http://www.ncbi.nlm.nih.gov/pubmed/15782867" target="_blank">2005 study</a>, up to a quarter of Kiwis suffer from chronic sleep problems. Most people who have had to deal with the condition know just how frustrating it can be as well as the negative impact it can have on many aspects of life. However, many people have found treatment from a somewhat unusual source – music. Psychologist Laszlo Harmat studied 94 students who suffered from sleep disorders. He gave one group classical music to listen to for 45 minutes before bed, another group an audiobook, and the third group nothing. After only three weeks, 85 per cent of the music group found themselves sleeping well. Of the audiobook group, only nine out of 30 became good sleepers. But how does this affect those over 60? Another study conducted in 2003 by Hui-Ling Lai and Marion Good involved a similar experiment on people with sleeping difficulties between the ages of 60 and 83. Just like with the student subjects, the music quickly began to work its magic, with half of the group prescribed music before bed becoming good sleepers. So, how can you try it at home? Researchers recommend slow, relaxing music like classical, jazz and blues. It’s also important to keep the music at a volume that isn’t so low that you can barely hear it and not so loud that it prevents you falling asleep. They also making sure the last song on your playlist is one that gently fades out. This way, you won’t be suddenly woken up by the silence. Do you listen to music when you’re trying to sleep? What other secrets do you have to getting the perfect night’s sleep? Share your tips with the Over 60 community in the comment section below. Related links: <a href="/entertainment/music/2016/06/original-names-of-famous-bands/">The surprising original names of famous bands</a> <a href="/entertainment/music/2016/06/unforgettable-songs-of-the-60s/">Unforgettable songs of the '60s</a> <a href="/entertainment/music/2016/04/the-surprising-real-names-of-singers/">The surprising real names of famous singers</a>

Music

The shocking effect a bad night’s sleep can have

We’re always hearing about why a good sleep is so important to health, but this might just be the most convincing reason yet. A report looking at the relationship between sleep and stroke risk found that people with sleep disorders (e.g. sleep apnea, insomnia and restless leg syndrome) were much more likely to suffer a stroke. In addition, those who had already suffered a stroke were found to be less likely to recover and had a higher chance of repeated strokes. “We have been aware in neurology for a couple of years already that breathing disturbances are a risk factor for stroke,” the report’s co-author Dr Dirk M. Hermann told <a href="http://www.reuters.com/article/us-health-stroke-sleep-disorders-idUSKCN10L1VF" target="_blank">Reuters</a>. “Sleep has restorative functions for the brain and is important for storing information we collect during the night, which explains why stroke recovery is so much affected by sleep disturbances.” Sleep deprivation (i.e. regularly sleeping less than six hours a night) has also been linked to a heightened risk of heart disease, inflammation, diabetes and even dementia. “Sleep is necessary for the 'cleaning' of toxins at the neuronal level in the brain,” said sleep specialist Dr Alice Doe. “By not sleeping enough, the brain does not have the time to allow the brain to be 'cleaned' of the toxins that have been accumulated during the day.” For people over 60, seven to eight hours of sleep is recommended by experts, but any less than five and more than nine may negatively impact health. Tell us in the comments below, how many hours of sleep to you aim for each night? Related links: <a href="/finance/insurance/2016/08/10-health-problems-you-must-not-ignore/">10 health problems you must not ignore</a> <a href="/health/mind/2016/07/how-genetics-determine-our-sleeping-patterns/">How genetics determine our sleeping patterns</a> <a href="/health/body/2016/07/10-science-backed-ways-to-help-you-sleep/">10 science-backed ways to help you sleep</a>

News

10 science-backed ways to help you sleep

If you’re one of the millions who struggle to fall asleep or can’t enjoy a quality night of shut-eye, here are some science-backed tips that may change your life. <ol start="1"> <li>Dim the lights – keeping the light on until right before you go to sleep can interfere with your internal clock, as the light tricks your body into thinking it’s daytime and fails to release the sleep-inducing hormone melatonin.</li> <li>Avoid screens – like to check Facebook before bed? Studies have shown that using mobile devices will seriously cripple your quality of sleep.</li> <li>Ditch coffee – okay, this one’s a bit tough. We all need a bit of java to help get the day going, but if you’re one of the many who enjoy a cuppa after dinner, you may want to reconsider. Coffee works the same way as light, in that it suppresses the sleepy hormone melatonin, making it difficult to fall asleep.</li> <li>Ditch alcohol – remember having those big nights in your heyday and finding you woke up at crazy hours of the night? It turns out even small amounts of alcohol can seriously damage your ability to fall and stay asleep.</li> <li>Keep your hands and feet warm – researchers have found that jumping into bed with warm hands and feet drastically decreases the time it takes for fall asleep.</li> <li>Have a bath – ever get that sleepy feeling when you’re having a bath? Take advantage of it! Increasing your body temperature is believed to help you fall asleep faster and enjoy a deeper night’s rest.</li> <li>Be happy – having a positive attitude won’t just improve your mood, it’ll lower your risk of insomnia drastically as you won’t be kept up by negative thoughts.</li> <li>Tune in – listening to classical music (or any genre that you find relaxing) can help lower your blood pressure and improve your sleep quality.</li> <li>Get into a routine – by doing the same things every night before bed, your body will begin to realise those actions mean it’s nearly time to sleep.</li> <li>Use lavender – studies have shown that people who fall asleep with the smell of lavender filling the room had a better night’s sleep and woke up feeling more refreshed than those who didn’t.</li> </ol> Do you have any secrets to getting the perfect night’s sleep? We’d love to hear them! Share your ideas in the comments below. Related links: <a href="/finance/insurance/2016/06/10-unhealthy-habits-you-need-to-stop-now/">10 unhealthy habits you need to stop now</a> <a href="/health/mind/2016/06/the-health-benefits-of-a-positive-attitude/">The health benefits of a positive attitude</a> <a href="/health/mind/2016/06/trick-to-make-you-a-morning-person/">The 4 tricks guaranteed to make you a morning person</a>

Body

3 herbal remedies to beat insomnia

When you’re all tucked into bed and insomnia strikes, many people reach for that bottle of sleeping pills. However, there are many natural remedies that could help you drift off without those nasty side effects. 1. Hop pillow Most of us know that hops are a key component of beer - but in herbal medicine they're favoured for their calming effect on the nervous system. That's good for those who suffer from insomnia, and it's especially good for those who cannot take valerian (which has the opposite effect on some people) though frequently, you see the two herbs combined. Hop pillows were first made popular by King George III, who supposedly used one to relieve his insomnia. You can make your own hop pillow easily enough – just fill a small bag with fresh hops and sew it closed, then sleep with the bag in such a way that you can smell it. Replace it every few months as the therapeutic properties will diminish over time. 2. Valerian tincture The active constituents in valerian depress the central nervous system in a similar way to GABA, a relaxing neurotransmitter in the brain. Clinical studies have shown that valerian is effective in the treatment of insomnia, mostly by reducing the time it takes to go from fully awake to asleep and improving sleep quality. Valerian is easy to grow in rich, heavy loam with good moisture. It's a hardy perennial, with summer flowers reaching up to 1.5m high, but as it's the root that is used, you may want to snip off the flowers so that the plant puts more energy into the rhizomes. You can make a tincture by soaking the chopped roots in three times their volume of vodka. Place both in a jar, screw the lid on tightly and store in a cool, dark room. Shake daily for 4-6 weeks, then strain. Alternatively, you can steep slices of fresh or dried root in freshly boiled water to make a tea. 3. Scullap tea Scullcap is a relaxing nervine used to relieve stress and anxiety, and it can also be taken at night to quieten a busy mind. It is often used with passionflower (Passiflora incarnata) as an overall herbal mind-body sedative. Skullcap leaves can be used either fresh or recently dried, as they lose their potency as they age. For a good night's sleep, make a strong tea with a couple of tablespoons of leaves, taken perhaps an hour before retiring. How do you overcome sleeping problems? Let us know in the comments below. Written by Jane Wrigglesworth. First appeared on <a href="http://Stuff.co.nz" target="_blank">Stuff.co.nz.</a> Related links: <a href="/news/news/2016/05/how-to-tell-if-youre-getting-enough-sleep-each-night/">How to tell if you’re getting enough sleep each night</a> <a href="/news/news/2016/05/reasons-why-we-talk-in-our-sleep/">The reason why some of talk in our sleep</a> <a href="/health/mind/2016/05/yawning-reveals-a-lot-about-your-level-of-empathy/">Yawning reveals a lot about your empathy</a>

Body

Why do women have a harder time sleeping than men?

According to US Department of Health and Human Services, insomnia is more common in women than men, and there’s a few reasons why. For all the ladies out there, here’s what you can blame for your restless nights. 1. Hormones As you know, women have different levels of oestrogen and progesterone than men – and those levels fluctuate throughout the menstrual cycle, which doctors believe can affect your ability to fall and stay asleep. “Oestrogen works on several different neurotransmitter pathways that may have an impact on the regulation of sleep, and progesterone can have a hypnotic property,” says Dr Dianne Augelli, a sleep expert at the Weill Cornell Center for Sleep Medicine at NewYork-Presbyterian. “Fluctuations in these hormones may have an effect on the circadian rhythm.” 2. Menopause The night sweats and hot flashes do make for uncomfortable sleeping, as well as the prevalence of obstructive sleep apnoea that significantly increases as women go through menopause. “Just like how women present with different heart-attack symptoms than men, women present with different symptoms of OSA than men. And insomnia can be one of those symptoms,” says Dr Augelli. 3. Stress Stressing about not sleeping can make the problem worse. Dr Augelli says, “It’s true there’s sort of a snowball effect — there’s an initial insult and then there’s sort of a stress phenomenon that follows that. Concern and worry and hyper vigilance about not sleeping can perpetuate it.” Instead of stressing about how you’re going to function tomorrow, try different relaxation strategies that distract you from the fact you’re not sleeping. Get out of bed and do something relaxing that doesn’t involve a screen, like reading a book or listening to music. 4. Your partner Michelle Drerup, a sleep psychologist and behavioural sleep medicine specialist at the Cleveland Clinic Sleep Disorders Centre, says that in most cases when one person has insomnia, their partner rarely does as well. It means one person is blissfully asleep while the other is lying awake, frustrated that they can’t get to sleep. If you have a partner that disrupts your sleep – like snoring, twitching, or sleepwalking – Drerup suggests sleeping in a different room for a week as a test. If you find yourself falling asleep, talk to your partner about getting treatment or consider making the room change permanent. 5. Bad sleep hygiene The standard sleep-hygiene recommendations include sleeping at the same time every night, keeping the room dark and cool, not using devices before bed, and exercising, but not too close to bedtime. Source: New York Magazine Related links: <a href="http://www.oversixty.co.nz/health/wellbeing/2015/08/cures-from-the-kitchen-cupboard/">8 kitchen cupboard cures for common ailments</a> <a href="http://www.oversixty.co.nz/health/wellbeing/2015/09/old-wives-tale-medical-advice/">Odd medical advice your mother probably told you</a> <a href="http://www.oversixty.co.nz/health/wellbeing/2015/09/monday-music-playlist/">Catchy songs to beat the Monday blues</a>

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10 science-backed ways to help you sleep

3 herbal remedies to beat insomnia

Why do women have a harder time sleeping than men?