Sleep Disorders

Sleep Hygiene: Tips for Better Sleep

What is sleep hygiene?

Sleep hygiene refers to the habits and practices that help you get a good night's sleep. It includes your daytime routines, bedroom environment, and pre bedtime activities.

Managing Insomnia: Sleep Hygiene Tips and Information on Medications

Insomnia is a common sleep disorder that affects people’s ability to fall asleep, stay asleep, or get enough restful sleep. It can lead to daytime fatigue, poor concentration, and irritability. Thankfully, certain changes in lifestyle and routine, known as sleep hygiene practices, can improve sleep quality. In some cases, medications may be recommended, though they come with potential risks.

Sleep Hygiene Techniques for Better Sleep

Good sleep hygiene involves creating an environment and routine that supports restful sleep.

1. Establish a Consistent Sleep Schedule

• Go to bed and wake up at the same time every day, even on weekends. A consistent schedule helps regulate your body’s internal clock and improves the quality of sleep.
• Avoid napping during the day, especially in the late afternoon, as it can make it harder to fall asleep at night.

2. Create a Relaxing Bedtime Routine

• Wind down before bed with calming activities, such as reading, listening to gentle music, or taking a warm bath. Avoid activities that cause mental stimulation or stress.
• Limit screen time an hour before bed. The blue light from phones, tablets, and TVs can interfere with your body’s melatonin production, making it harder to fall asleep.

3. Make Your Sleep Environment Comfortable

• Keep your bedroom cool, dark, and quiet. Use blackout curtains to block out light, and consider earplugs or a white noise machine to mask any disruptive sounds.
• Invest in a comfortable mattress and pillow that supports good posture and comfort, as these play a major role in sleep quality.
• Use your bed only for sleep and intimacy. Avoid working, eating, or watching TV in bed, as these activities can make your brain associate the bed with wakefulness rather than sleep.

4. Watch What You Eat and Drink

• Avoid caffeine and nicotine in the late afternoon and evening. Both are stimulants that can keep you awake.
• Limit alcohol before bed. While alcohol may make you feel sleepy, it can interrupt your sleep cycle and lead to less restful sleep.
• Avoid heavy meals close to bedtime, as digesting a big meal can interfere with your ability to fall asleep comfortably.

5. Manage Stress and Anxiety

• Practice relaxation techniques, such as deep breathing exercises, progressive muscle relaxation, or mindfulness meditation, to ease stress and anxiety before bed.
• Consider writing down thoughts in a journal if you find your mind racing at bedtime. Writing can help offload worries, allowing for a more peaceful transition to sleep.

6. Get Regular Physical Activity

• Exercise during the day helps regulate your sleep-wake cycle. Even a short walk or moderate physical activity can make a difference.
• Avoid intense exercise within a few hours of bedtime, as it can raise your heart rate and make falling asleep harder.

Medications for Insomnia: Benefits and Risks

While lifestyle changes are the first line of treatment for insomnia, some people may need additional help. In such cases, medications may be prescribed to aid sleep, but these should be used with caution.

Types of Sleep Medications

1. Over-the-Counter Options: Antihistamines, like calms or nytol, are available without a prescription, though they can cause daytime drowsiness and are not generally recommended for long-term use.

2. Prescription Medications: In the UK, doctors may prescribe:

   • Benzodiazepines (e.g., temazepam): These are sedatives that promote sleep but come with a high risk of dependence and tolerance. These are not recommended for use in the NHS and your GP will not issues prescriptions for this drug.
   • Z-drugs (e.g., zolpidem, zopiclone): These work similarly to benzodiazepines but are considered somewhat safer for short-term use.
   • Melatonin: Available on prescription, melatonin supplements can be effective, especially for older adults, as they help regulate the sleep-wake cycle. These are licenced for use in certain groups of patients only.

3. Antidepressants: In cases where insomnia is linked to anxiety or depression, certain antidepressants (e.g., amitriptyline or mirtazepine) may be prescribed for their sedative effects.

Risks and Side Effects of Sleep Medications

• Dependence and Tolerance: Benzodiazepines and Z-drugs can lead to dependency. Over time, your body may require a higher dose to achieve the same effect, increasing the risk of addiction.

• Withdrawal Symptoms: If you stop taking certain sleep medications suddenly, you may experience withdrawal symptoms, which can include rebound insomnia, irritability, and anxiety.

• Daytime Drowsiness and Cognitive Effects: Many sleep medications can cause grogginess the next day, impacting your ability to concentrate and perform daily tasks. In older adults, these medications may also increase the risk of falls or confusion.

• Short-Term Use Only: Most sleep medications are intended for short-term use only, typically a few days to a few weeks. Long-term reliance on these medications can increase risks and may make insomnia worse in the long run.

Alternatives to Sleep Medications

If you’re experiencing chronic insomnia, consider Cognitive Behavioural Therapy for Insomnia (CBT-I). CBT-I is a proven, non-medication treatment that addresses thought patterns and behaviours impacting sleep. This therapy is available through iTalk via the NHS or private providers and has shown long-lasting improvements in sleep quality.

Summary: Improving Sleep with Hygiene Practices and Informed Medication Use

For insomnia sufferers, the following steps can help:

1. Prioritise Sleep Hygiene: Practising good sleep habits and maintaining a regular sleep routine can significantly improve sleep quality.
2. Use Medications Sparingly: While medications can help in the short term, they carry risks and should only be used sparingly
3. Consider CBT-I: This therapy provides long-term skills to manage insomnia without medication.

By making sleep hygiene a priority and being cautious with sleep medications, you can work towards better, more restful sleep and an improved quality of life.