The Sunday Telegraph - Sunday
From sleep playlists to the quarter-ho Our rule – here’s what the experts say
Whether it’s the odd restless night or chronic insomnia, sleep problems are on the rise – but there are solutions to make bedtime less of a nightmare, says
When it comes to sleep, the world falls into two camps: those people whose heads hit the pillow and *snap* – eight hours later, it’s the morning; and the rest of us, who suffer from sleeplessness – ranging from the odd stress-induced broken night, to the seemingly endless hell of chronic insomnia.
If you’re a member of the second group, you’ll know the frustration, fury and despair caused by a night without sleep. The tossing and turning, the staring at the numbers on the clock as they relentlessly count down towards dawn and the first snatch of birdsong, which heralds the start of another day you are simply too exhausted to navigate.
Our sleep is bad – and getting worse. Thirty per cent of adults experience sleep problems (up from 23 per cent in 2012). And one in 10 of us suffers from chronic insomnia – defined as having trouble sleeping for three days a week for more than three months. Even for those spared the longterm form of the condition, a recent YouGov poll revealed that 21 per cent of Britons have problems falling asleep a few nights a week.
Women tend to sleep less well than men, and older people less well than younger ones.
“Sleep makes us feel good, helps us learn, improves our concentration, helps us manage our weight, gives us greater self control, reduces our risk of ill health – and is completely free of charge,” says sleep scientist Dr Sophie Bostock (thesleepscientist.com). “Insomnia can affect all of the above – it’s an awful, lonely condition.”
There’s a received wisdom about how many hours a person “should” sleep. The often-quoted magic number is eight hours, sometimes seven – and this has been backed up by several scientific studies over the years.
A 2022 paper from Cambridge University agreed that a minimum of seven hours is recommended for good health. The research was based on hundreds of studies that followed people’s long-term experience of heart disease, diabetes and mental health difficulties. Those who slept between seven and nine hours were typically at lower risk of future ill health, hence the recommendation.
But depending on certain variables, including your genetic make-up, age and lifestyle, your “perfect” amount might fall outside this range.
“Just like your shoe size or height, ‘optimum sleep’ varies from person to person,” says Bostock. “For example, some people have a ‘short sleep’ gene, which means they feel alert and refreshed after just five or six hours’ rest. If you wake up naturally without an alarm, feel refreshed and don’t need caffeine, sugar or a nap to get through the day, then you’re probably getting enough sleep.”
Dr Guy Meadows is clinical director of the Sleep School and author of The Sleep Book: How to Sleep Well Every Night. He says that, for many people, getting a good sleep involves managing caffeine intake: “Try not to drink caffeine after the early afternoon, because it can impact your sleep even many hours later.” Cola and tea (even green tea) also contain caffeine.
For many, stress and anxiety – whether about a meeting the next day, or an ongoing life situation – can play havoc with our ability to fall asleep.
“Stress comes in all sorts of different forms,” says Bostock. “Another way of describing it is hyper-arousal, or an inability to switch off. You might not recognise yourself as stressed, but you are always ‘on’.”
Most people wake up once or twice in the night. “Waking up at night is a perfectly normal part of the sleep cycle, and usually nothing to worry about,” says Bostock. But there can be factors that make the 3am wake-up call more likely.
While alcohol can initially send us into a deep sleep, it can also adversely affect the second half of the night. “As you metabolise the alcohol in the liver, it actually behaves as a stimulant, making you more likely to wake up and meaning you spend less time in REM [rapid eye movement] sleep,” says Bostock. Physical causes, such as pain, prostate problems (meaning you need to get up to use the loo) and the hormonal changes around the menopause, can make matters worse, as can certain medications, including beta blockers and steroids.
There are two basic types of sleep: REM sleep and non-REM sleep (which has three different stages). A cycle of sleep lasts approximately 90 minutes. During a typical night, a person cycles through all the stages of non-REM and REM sleep several times, with increasingly longer, deeper REM periods occurring towards morning. Each cycle of deep sleep lasts from 20 to 40 minutes. The average person cycles through this about four times a night, though not everyone needs this amount to feel fresh and rested the next day.
“Some believe that REM sleep is the brain essentially doing therapy on itself, processing our feelings,” says Bostock.
So what can you do to get a better night’s sleep? Here, our experts offer their top tips…
Embrace the light
“From the minute you wake up, you’re effectively winding down for sleep,” says Meadows. Our sleep cycle (or circadian rhythm) is governed by our sense of light and dark. Studies show that exposure to natural light helps the body to produce vitamin D (important for bone, tooth and muscle health) and sharpens your focus. “As soon as you wake up, aim to get lots of light into your eyes,” says Meadows. “This tells the brain that the day has begun, banishing the sleep hormone melatonin, and activating the CAR, the cortisol awakening response.”
The earlier in the day you exercise, the more likely it is you’ll fall asleep at a reasonable hour. “Being active, getting a few extra steps – that’s going to help to increase your sleep drive, and
help to increase the speed at which you fall asleep, too,” says Meadows. However, it’s best to avoid any vigorous exercise at least three hours before bed, as the adrenaline may make it hard to drop off.
Build a routine – and stick to it
“Waking up at the same time every day – including at weekends – sets you up for a successful night’s sleep later,” says Bostock. “Your body clock will recognise the pattern and you’ll start to wake up more alert every morning and then feel sleepy at the same time every night. We can adjust our body clocks by an hour from day to day, but lengthy lie-ins can interfere with your internal rhythms.”
Turn on the lights, eat and shower at the same time every day to train your body to associate those actions with morning.
This, and the following tips, are part of a school of therapy called CBTi (cognitive behavioural therapy for insomnia), which has shown in studies to be far more effective than sleeping pills, which also carry a risk of dependency.
Limit the time you spend in bed
This means spending less quantity of time in bed for better quality sleep. So only go to bed when you are tired and get out when you’re not. “Going to bed later increases your natural drive for sleep,” says Bostock.
In the short term, you may feel really tired, but this often means a less broken night. “The idea is to strengthen the link between your bed and sleep in your mind. So, if possible, use your bed only for sleeping, sex and nothing else.
Watch what you eat
According to Meadows, you should also aim to eat at least three hours before bed, avoiding spicy food or anything that might cause indigestion. “Make your evening meals lighter and healthier, and try adopting a Mediterranean-style diet – plenty of olive oil, healthy fats like oily fish and nuts, and vegetables,” he says.
A 2020 study by Columbia University agreed that the Mediterranean diet “appears to provide the best sleep outcome”.
Don’t turn your bedroom into a battleground
After a run of a few bad nights, it’s easy to start to dread going to bed. But, says Bostock, this is counter-productive. “Instead of telling yourself: ‘That’s it, I’m never going to get back to sleep again,’ reassure yourself: ‘I’m a good sleeper, I’m just having a bad night.’”
Follow the quarterhour rule
“If you are in bed for 15 minutes and still wide awake, rather than getting frustrated, you should get up – stop stewing and go and read a book,” says Bostock. TV is not recommended, because it might stop you feeling sleepy, while the blue light from a phone or tablet can interfere with the maintenance of melatonin production.
Try relaxation and mindfulness techniques
“We also teach clients various tricks and tools to help the brain to switch off its ‘fight or flight’ response to stress,” says Bostock. “Since the mind and body are interconnected, relaxing the muscles can be a shortcut to easing a racing mind. For example, progressive muscle relaxation involves deliberately tensing and then releasing the major muscle groups in turn.”
Meanwhile, the web is full of meditation apps, breathing exercises – there are even sleep playlists on Spotify and ‘sleep stories’ on YouTube.
‘Try not to drink caffeine after the early afternoon because it can affect your sleep even many hours later’
If all else fails, accept your temporary sleeplessness
Dr Meadows is an advocate of acceptance and commitment therapy (ACT) where those who find themselves up at night are taught to accept the discomfort of a racing mind.
“The point is to actually be OK with being awake,” he says. “Because the more willing you are to be awake, the fewer obstacles there are in the way of sleep.” If you give up “trying” to sleep at 4am, you may well find yourself waking up with the alarm at seven.