35 What can I do about my insomnia? Can I have some sleeping pills?

EVERYONE has problems falling asleep occasionally, but that doesn’t make them an insomniac, says independent sleep expert Dr Neil Stanley.

‘The medical definition of insomnia comprises taking more than 30 minutes to fall asleep, waking up in the middle of the night and not getting back to sleep, waking up earlier than expected or having unrefreshing sleep,’ he says.

‘The key is this needs to happen for the majority of nights for more than one month and it needs to have a daytime consequence, i.e. people have had so little sleep that they feel they may fall asleep during the day. On that basis, not many people actually suffer from medical insomnia.’

Before you go to the doctor, Dr Stanley advises ensuring you aren’t sabotaging your own attempts at sleeping.

‘You need to find the time to wind down — around an hour is ideal but half an hour is better than nothing.

‘That means no looking at phones for at least half an hour. Some even suggest phones are avoided for two hours before bed as they emit blue light which suppresses the release of melatonin, the hormone that makes you feel sleepy.

‘And no looking at work emails, as this can provoke worry.’

You also need to cool down your body temperature by 1c — counter-intuitively, a hot shower or bath will help as it sends the blood to the periphery of the body, cooling your core.

Keeping your bedroom cool (cooler than a living room) is also advisable to help precipitate this fall in temperature, which should occur as part of the body’s natural daily rhythm.

‘I keep the radiators switched off in the bedroom throughout the year and also keep my window open — just a crack — whatever the weather,’ reveals Dr Stanley.

Alcohol can interfere with quality of sleep for some, so avoid large quantities before bed.

‘However, it’s a bit like caffeine — some people are more sensitive to its effects than others, so if you find that you have disturbed sleep after drinking before bed then don’t do it, but if a little tot of sherry sends you off then fine.’

Another cause of night time sleeplessness can be snoozing for too long during the day. You should restrict daytime naps to 20 minutes at most.

If, despite these good habits, your sleep is still disturbed then ask your doctor for help — but Dr Stanley says that for most people, sleeping tablets are not the answer. ‘Sleeping pills are not going to fix the problem if your habits are keeping you awake — they just fix the symptoms,’ he says.

Indeed, some have been found to add only 12 minutes to time spent asleep each night.

‘Sleeping pills might help get you to sleep but they won’t keep you asleep for a full seven to eight hours,’ he says.

‘The pills available now are designed to clear your system by the morning to prevent that hangover feeling associated with older types and they won’t send you to sleep instantly.

‘Older style pills used to work so quickly that some elderly people who took one couldn’t get upstairs before falling asleep. We still have yet to design the perfect sleeping pill.

‘However, if you can’t sleep through pain or you are a medical insomniac — and physically cannot sleep — then pills might be suitable for you.

‘I think the Z drugs such as zolpidem work best. They help reduce the excitability of brain cells. People talk about the possibility of dependency on these drugs but they are safer than the benzodiazepines in that respect, and if there is a real need then people should take them.

‘ They are only licensed to be used for 14-28 days, but if your clinician thinks you need them for longer then he or she can make that decision. ‘A short course might get you back on track. But in the long run, it’s good sleep habits that are going to help you to sleep better.’

Herbal over- the- counter remedies typically contain ingredients such as valerian and hops, and won’t be as potent as prescription drugs, says Dr Stanley.

‘There’s no reason not to give them a try, but if you expect these pills to knock you out for eight hours then you might be disappointed.

‘However, for some people they may provide the little nudge they need to get some quality sleep.’

How do you feel at 11am? Due to the way our body clock works, this is when most people feel their best, so if you’re tired, you’re probably sleepdeprived