The growing sleep problem that’s keeping your family up all night

From telegraph.co.uk

Bad sleeping habits start earlier than you might think – here’s how to spot them in your children 

Anecdotal evidence suggests an insomnia epidemic among children CREDIT: getty

Yasmin Shaheen-Zaffar woke at 2am to the sound of her 15-year-old daughter, Verona, pacing her bedroom. “She’d get so stressed she couldn’t sleep. In the morning she was snappy and forgetful,” says Yasmin, 51, from Harrogate, North Yorkshire. “Her tiredness led to meltdowns. I was worried about her mental health.”

Verona is far from alone in her struggle with insomnia. Sleeplessness in teens and young people is on the rise: the number of children admitted to hospital with (unspecified) sleep disorders rose by almost 50 per cent between 2012 and 2017.

There are – as yet – no more recent figures, but anecdotal evidence suggests that, since the pandemic, excessive screen time, compounded by a sugary diet and anxiety from the hangovers of lockdown, have created an insomnia epidemic among children.

Clare Cogan is a psychotherapist and clinical hypnotherapist who specialises in treating teenagers. "I’ve noticed a huge rise in insomnia among my young patients,” she says. “It’s incredibly concerning.”

Teens need eight to 10 hours’ sleep a night. However, they are susceptible to insomnia because their bodies start releasing melatonin later than during childhood – a change which disrupts their circadian rhythm (body clock) meaning they fall asleep later, and wake up later.  

Melatonin is a hormone that your brain produces in response to darkness. It helps with the timing of your circadian rhythm and with sleep. Being exposed to light at night can block melatonin production. “This is thought to be for evolutionary purposes, so teenagers can develop independence without threat or interruption,” says Cogan. “But of course, they have to get up for school in the morning.”

Why our children are struggling to sleep 

Experts put the recent rise down to lifestyle and behavioural changes – especially involving screens. Blue lights that devices emit – 95 per cent of teens own a smartphone – block melatonin production. “The majority of teenagers bring some kind of technology into the bedroom, adding to the amount of screen time they get each day and affecting multiple areas of their lives,” says US paediatrician and sleep consultant Nilong Vyas. “Experts are becoming increasingly concerned about the effects of blue light from these electronic devices on the sleep-wake cycle.” 

Verona’s sleep problems started during lockdown in March 2020, when she kept her smartphone in her bedroom to socialise online. “Prior to that I hadn’t allowed electronics in her room, but she told me she felt lonely,” says Yasmin, a parenting coach at Polyvagal Teen.

When she couldn’t sleep, Verona would get into bed with her mother or pass out on the sofa at 4am. “In the morning she was so groggy it was horrendous,” says Yasmin. “She’d started panicking about her A-levels. She was crying a lot. She’d forget to take her folders to school. I worried she’d have an accident crossing the road.”

Dr Vyas says sleep deprivation during adolescence can cause problems with mood, emotions, and academic performance. “Teens experiencing fragmented sleep are more likely to have interpersonal issues with their peers, and chronic sleep loss can lead to a weakened immune system and some mental-health conditions. Some desperate parents are turning to sleeping pills – often inappropriately,” she says.

The rise – and downsides – of sleeping pills 

Recent NHS data analysed by The Pharmaceutical Journal found prescription sleeping drug use among children under 18 has almost tripled in the past seven years – over 60,000 were prescribed synthetic melatonin in March 2022, compared with 20,881 in April 2015.

Melatonin supplements increase the body’s natural supply of that hormone. While available over the counter in countries such as the US, melatonin is prescription-only in the UK – and not licensed for children, unless they are diagnosed with ADHD or are on the autistic spectrum. However, some frazzled parents appear to be buying melatonin online.

Dr Sophie Bostock urges caution around its use. “One review of the effectiveness in adults with chronic insomnia suggested that melatonin added just eight minutes to overall sleep,” she says. “I’m worried young children are learning to rely on an external substance to help them sleep.”

Global clinical guidance recommends CBTi (cognitive behavioural therapy for insomnia) as a first line therapy before drugs. CBTi focuses on re-education to strengthen the patient’s natural sleep processes and address unhelpful thoughts and behaviours that interfere with sleep.

“It has only just started to be used for parents and children with ADHD and Autistic Spectrum Disorder, but pilot results are promising,” says Dr Bostock. “Key ingredients include keeping regular bedtimes and routines, only using the bed for sleep, dimming lights and avoiding screens at least an hour before bed.”

Yasmin Shaheen-Zaffar, meanwhile, found a solution in calm advice and compromise. Verona, now 18, is only allowed her phone in her room three days a week, to give her body a chance to rest. Her mother says: “Verona was dismissive at first and it took a while to implement. But she’s sleeping eight to 10 hours a night now.”

How do I send my sleepless teen to sleep?

Fi Star-Stone is a child development specialist and parenting expert. She offers six tips to help your child fall asleep naturally:

• Talk about the importance of sleep with your child from a young age.
• Try teaching good night time habits in a way children can understand, such as by explaining that shuteye recharges the body.
• Introduce a “switch off point” for phones and devices nightly, ideally an hour before bed.
• If your child resists, consider a “switch off box” where the whole family puts their devices.
• Don’t put pressure on yourself – you don’t need to create a strict routine for every day.
• Aim for a realistic bedtime for school nights, and keep some structure on weekends.
• 
  

https://www.telegraph.co.uk/health-fitness/mind/the-growing-sleep-problem-thats-keeping-you-up-all-night/

Sleepwalking & Insomnia: The Link?

From globalvillagespace.com 

On May 9, 2023, an article was published discussing the potential link between sleepwalking and insomnia. Sleepwalking, also known as somnambulism, is a parasomnia that affects approximately 4% of the United States population. However, many people may not even be aware that they sleepwalk. Sleepwalking occurs when an individual is briefly aroused from non-rapid eye movement sleep, which is a deeply restful stage that helps restore body tissue and repair important body functions. According to Kenneth Lee, MD, an assistant professor of neurology and sleep medicine and clinical medical director at the UChicago Medicine Sleep Centre, sleepwalking typically occurs when an individual is no longer fully asleep but also not fully awake. In addition, individuals who experience sleep apnoea or leg movements are at risk for episodes of sleepwalking.

Sleepwalking usually occurs during the first third of the night, and individuals who sleepwalk are unable to think, plan, or function properly. They are unaware of their surroundings and cannot remember any dreams they may have had while sleepwalking. Many doctors believe that a lack of sleep is a major cause of sleepwalking. If an individual has insomnia, it can be hard for their brain and body to pass between sleep stages. When they do get to sleep, they may not settle into deep enough sleep, and their brain can get “tricked” into thinking their body should be active.

Risk factors for sleepwalking include children, as they have more non-rapid eye movement sleep than adults. However, sleepwalking can sometimes continue into adulthood and is usually associated with certain medications such as benzodiazepines and antidepressants. Psychological trauma could also be a contributing factor to episodes of sleepwalking. Sleepwalking can run in families, especially if one or both parents have experienced it. Other potential risk factors include drinking alcohol, having gastroesophageal reflux disease (GERD), having a fever, being stressed, and having a seizure disorder.

According to Jordan Standlee, MD, a neurologist at the University of Michigan Health and a clinical assistant professor of neurology at the University of Michigan Medical School in Ann Arbor, our mental state has an impact on sleep quality. During periods of high situational stress, our brains have a more active fight-or-flight signal, and this often carries over into the sleep period, where our brains have a harder time achieving deep, relaxed, stable sleep. Many people who sleepwalk will report that it happens more often during periods when they are especially stressed or worried.

Signs of sleepwalking include walking during sleep, having your eyes open with a blank look on your face, talking but not making sense, acting confused or aggressive if someone wakes you up, appearing awake to others, sitting up or engaging in activities as though you were awake, and not remembering anything that happened when you wake up.

While insomnia on its own doesn’t directly cause sleepwalking, there are at least four major ways in which the two conditions interact. These ways are a disruptive sleep environment, periods of “situational stress,” sleep apnoea, and medication effects. Sleepwalking has strong genetic factors, meaning some people are inherently more at risk for this symptom. It tends to arise not from deep, stable sleep but rather from disrupted and twilight sleep. Sleepwalking also occurs more when someone is sleeping in a foreign environment, like in a hotel room, or in the setting of sleep deprivation. 

Distractions in your sleeping environment can make things worse. Noise or light in the room can cause both insomnia and sleepwalking, particularly having a television on in the bedroom throughout the night. It is hard for the brain to stay in deep, stable sleep while this kind of light or noise is present, and the result can be either recurrent full awakenings – insomnia – or partial awakenings, which predispose you to sleepwalking. Some of the common medications used to treat insomnia can themselves cause sleepwalking. Sedating medications such as zolpidem, eszopiclone, zaleplon, suvorexant, lemborexant, and daridorexant have all been described to cause complex sleep behaviours, meaning sleepwalking, as well as other sleep activities such as cooking and eating food, making phone calls, and driving while asleep.

If an individual experiences a sleepwalking episode, they should talk to their doctor. A sleep study needs to happen, and safety measures need to be taken. For example, if an individual lives in a two-story home, they want to put up a barrier to their stairs and lock their windows. Problems falling and staying asleep can also be discussed with a psychologist. The best course of treatment is cognitive-behavioural therapy for severe insomnia. This is a way to retrain your brain and body how to sleep again. Making sure that insomnia is addressed and sleep is consolidated will reduce the risk of sleepwalking. Good sleep hygiene should also be a nightly ritual. Individuals should not eat or exercise close to going to sleep and should stop drinking caffeine for six hours beforehand. Yoga, meditation, and deep breathing can also help. Focusing on being kind to your mind and body can help individuals rest a lot easier.

https://www.globalvillagespace.com/GVS-Health/sleepwalking-insomnia-the-link/

Struggling with getting a good night's sleep? You're not alone

From cbc.ca/news/canada

For Calgary-based Terry Golbeck, sleeping through the night can be an unpredictable process. He finds himself occasionally waking up at odd hours, trying to slow down his thoughts through a couple of tried-and-tested strategies like meditation and pressing acupressure points to drift off to sleep.

"I'm in my 70s, so I seem to recall my grandmother saying, you know, I need less [sleep], I can't sleep," he said in a conversation on Alberta at Noon.

Goldbeck has been coping by tweaking his bedtime routine to improve his sleep quality, taking melatonin and magnesium supplements an hour before he goes to bed.

"As we transition into the sixth and seventh decade, our sleep does become more fragmented and it is more difficult to achieve a stable night of sleep. This is completely normal," said Dr. Charles Samuels, medical director of the Centre for Sleep and Human Performance in Calgary.

He added that there's a common misconception that older individuals need "less sleep" than others in their everyday lives.

"Your sleep requirement remains stable over a lifetime," he said before explaining that your sleep patterns may change as you get older and you may find that you don't sleep as much as you used to at night. 

The best way to combat the sleep deficit is to take short, 30-minute afternoon naps every day, according to Samuels. As for melatonin, the sleep expert believes that the supplement may help older individuals sleep better because it regulates circadian rhythms. 

However, Samuels remains a huge believer in the importance of meditation and mindfulness practices for better sleep quality. He also recommends using tactics like regular exercise and limited screen time in the evenings. 

"I would argue that probably, the meditation is doing the biggest thing [in Goldbeck's case] because there is evidence for meditation improving sleep," he said.

Long-term sleep deprivation can lead to 'impaired cognitive functioning.' (Narith Thongphasuk / Shutterstock)

According to Samuels, many people don't realize that bad sleep shouldn't be downplayed or ignored because it can lead to "impaired cognitive functioning" and make it harder to focus on important tasks.

It can also affect memory and interfere with weight regulation because a lack of good-quality sleep can cause us to crave unhealthy foods.

"We need to rest every 24 hours. We need to rest our body and our brain, or there is a downstream consequence," Samuels said.

For Malina Adams, seeing her three-year-old show signs of sleep apnea a few years ago was an alarming experience.

"He stopped breathing when he was sleeping. And it was really scary because I had never experienced anything like that," she said.

Adams recalled that her son wasn't able to get enough rest and it was "almost like he hadn't slept" which led to moodiness and exhaustion. He was also experiencing behavioural problems.

After consulting doctors, Adams was told her son has attention deficit disorder (ADHD) and would benefit from medication. Unconvinced, she insisted that her son's sleep issues needed to be addressed first.

"I'd like to look at these sleep issues because sleep apnea can kill adults," Adams said. "What's it doing to a three-year-old getting to a baby's brain?"

While the family figured out a solution after working with an ear, nose and throat (ENT) specialist, they've found themselves struggling again four years later. 

Adams noticed that her son's sleep apnea has returned and he's facing learning difficulties in school. She is now trying to determine the cause with the help of doctors, but is worried about an ADHD 'misdiagnosis' due to sleep issues.

According to Samuels, Adams' concerns shouldn't be taken lightly. The sleep expert said that it's crucial to conduct a "clinical evaluation" to determine if a child's sleep patterns are being disrupted.

"Sleep disturbance and sleep disorders can cause the symptoms consistent with ADHD," he said. "The number one sleep disorder that can look like ADHD is, in fact, sleep apnea."

Sleep disturbance and insomnia, in general, can show up in different ways and aren't limited to being unable to fall asleep. A person with insomnia may find themselves waking up in the middle of the night and not able to get the rest they need to function during the day.

Long-term insomnia can also lead to mental illness or show up on account of a mental health issue like anxiety, depression, or post-traumatic stress disorder (PTSD.)

"There's a tight relationship between insomnia, difficulty sleeping and mental health issues," Samuels said. "We would tend to definitely treat with medication if we were reducing the risk of a mental health outcome. That would be number one for sure."

https://www.cbc.ca/news/canada/calgary/insomnia-sleep-rest-charles-samuels-1.6853900

Five steps to help prevent sleepless nights due to money worries before next pay day

From dailyrecord.co.uk

A new study suggests finances are keeping nine in 10 people awake at night 

A new study by Virgin Money suggests more than half of working Brits (54%) suffer from anxiety in the week before payday and of those, a fifth (20%) said this is a regular monthly occurrence.

For a significant number of people, this is causing sleep disruption, with nearly nine in 10 (88%) people saying thoughts about money impact their sleep in some way. The research found more than one in 10 (12%) said money worries are keeping them awake every night, with another 14 per cent experiencing sleep disruption on a weekly basis.

The research also indicates people are equally likely to worry about their current financial situation (16%) as they are their future finances (16%), highlighting this isn’t a short-term problem. When it comes to worrying about money, the survey shows women (91%) are more likely to experience sleep disruption than men (85%).

         Women worrying about money are more likely to experience sleep disruption than men. (Image: Getty)

Financial anxiety was found to be most likely to impact the sleep of 25-34-year-olds (90%), while the over 55s are the least likely to experience sleep disruption (86%).

The research also finds people are struggling with money worries regardless of income. People earning £25,000 - £50,000 are slightly more likely (88%) to be kept awake by financial anxiety than those earning £10,000 - £25,000 (87%), but high earners still struggle with money concerns, with eight in 10 of those earning £75,000 - £100,000 saying that money worries sometimes impact their sleep.

Clinical Psychotherapist, Dr Jo Gee, a specialist in anxiety and stress management, explains the phenomenon of ‘pre-pay day anxiety’ which relates to feelings of stress, nervousness and worry, which are triggered in the run-up to pay day.

She said: “We often notice our clients have increased anxiety in the seven days before pay day, which can range from mild ‘worry thoughts’, to money fear and even paranoia. The anticipation of pay day is enough to pump adrenaline into the bloodstream, which is responsible for many of our anxiety symptoms, such as increased heart rate and insomnia."

Five tips to get a better sleep despite money worries

To help prevent sleepless nights due to money worries, Katy Simpson, personal finance expert at Virgin Money, has partnered with Dr Hana Patel, sleep expert at Time4Sleep, to share five tips for getting a good night’s sleep in the face of stress.

Don’t shy away from your finances

Katy said: “When we’re confronted with something that’s causing us stress, it’s a common reaction for people to bury their worries and avoid interacting with their source of anxiety, in this case, their money. But ignoring your finances could actually create more problems.

“Avoiding checking your online bank account regularly for example, might mean that you don’t spot fraudulent activity. Or that you’re unaware of a bounced payment, meaning that you miss an instalment which could incur a charge from the supplier and negatively impact your credit score, or that you’re in your overdraft. Keeping on top of your online banking means that you’ll be aware of any potential issues, and you’ll be able to plan ahead.”

Schedule daily ‘worry time’

Dr Patel explained: “Scheduling dedicated ‘worry time’ will allow your mind to process anxious thoughts, including money worries. Reflect on these thoughts by writing them down, as seeing them in front of you can allow you to address your concerns, recognise how unrealistic some of these scenarios are and reduce any feelings of anxiety. Writing your worries down can also help you to focus on developing a solution and see clearly what actions you need to take to better manage your finances and ease your concerns, which can help you to feel more relaxed as the evening approaches.

“Take 10 minutes every day for ‘worry time’, you can even block this in your calendar so it becomes a daily practice. With repetition of ‘worry time’ you should begin to notice that you have a somewhat quieter mind, which is particularly important as you approach bedtime.”

Get the hang of budgeting

Katy said: “Taking some time at the start of every month to create a budget will help you to spend and save effectively, as well as allow you to spot and address any money issues in advance.

“You may find that the coming month has several important birthdays, or that a large annual payment is due. Budgeting means that you’ll have factored these expenses into your spending at the beginning of the month and will allow you to plan accordingly around your financial commitments.”

Get used to talking about your money

Katy explained: “Many people don’t feel able to talk openly about money with friends and family. As a result, some can feel forced into social activities or purchases that they can’t afford, and this can cause financial anxiety.

“By practising talking about your money with those close to you, you can get into the habit of saying ‘no’ to unnecessary expenses. It’s not a bad thing to tell a friend that you can’t afford to go out this weekend, or to explain to a family member that things are a bit tight around their birthday, but you’ll treat them after you’ve been paid.”

Routine, routine, routine

Dr Patel said: “The repetition of a bedtime routine can work wonders for reducing pre-sleep anxiety. Instead of allowing your mind to wander, you can focus on what’s next as part of your routine, whether that’s reading, running a bath or going to sleep.

“This routine will also help to trigger feelings of tiredness while allowing you to properly wind down, and this works particularly well when the routine is repeated. Aim to keep a regular bedtime too, as this will help to solidify the routine.”

https://www.dailyrecord.co.uk/lifestyle/money/payday-money-worries-disrupt-sleep-30066290

Why Women Get Insomnia And How To Get Better Sleep

From positivelyosceola.com

By Maria Bello

Insomnia is a common condition, but women have more trouble sleeping than men. It’s estimated that one in every four women get insomnia, compared with one in every five men. A combination of physical and mental factors account for the difference, from menopause to pregnancy to depression. That’s why it’s especially important for women to practice good “sleep hygiene” to help ensure they get a good night of rest to prepare for the day ahead.

What Interferes with Women’s Sleep?

Multiple health factors in both men and women can lead to insomnia, including pulmonary and cardiac disorders, hypertension and chronic pain. Medications for those conditions may contribute to sleep disorders.

Sleep problems also are more common for both men and women as we age. But for older women, menopause makes insomnia even more likely. Hot flashes and night sweats can wake women up and then make it difficult to go back to sleep. These symptoms can last months or years.

For younger women, pregnancy is a major factor interfering with sleep, notably in the third trimester, when a woman’s abdomen increases in size and pressure on the bladder makes trips to the bathroom more frequent during the night. About 75% of pregnant women report sleep disturbances, which continue after a child’s birth because of night-time feedings or comforting a crying baby.

Women also are far more likely than men to get urinary tract infections, which can lead to sleeplessness.

Another reason for women’s sleep issues? Their male partners. Men are more likely to be habitual snorers, and the racket can make it tough for women to sleep.

Finally, depression and anxiety are two major contributors of chronic insomnia, and women are more likely to experience both of those disorders. One pre-pandemic survey found a significantly larger percentage of women than men experienced varying levels of anxiety.

Women also are twice as likely to experience depression during their lifetime than men. Cultural factors might partially contribute to that disparity — men find it harder to open up about anxiety or depression.

The Consequences of Insomnia

Acute insomnia can be brief — lasting a few days or weeks — and usually is linked to a stressful event in your life.

Chronic insomnia is more serious because it lasts longer. It can cause severe fatigue. Attention, concentration and memory may suffer. You may become less sociable,  and your performance at school and work may suffer. You may lack energy and become irritable.

Fighting Back with Good Sleep Hygiene

Just like washing your hands and brushing your teeth are important to personal hygiene, good habits at night contribute to your sleep hygiene.

Here are some steps to increase the chances of uninterrupted sleep:

• Go to sleep and get up at the same time. Keeping a schedule is important.
• If you can’t get to sleep, get out of bed and try again later.
• Drink coffee, tea and other caffeinated drinks in the morning only.
• Avoid alcohol and smoking in the evening. (You really would be better off not smoking at all.)
• Keep your bedroom dark, cool, quiet and free of reminders of work or other things that might cause you stress.
• Get plenty of exercise but avoid strenuous workouts too close to bedtime.
• While in bed, avoid looking at phones, computer screens or ebooks that give off light.

You should consult with your doctor before trying over-the-counter medications to help you sleep.

Therapy also is an effective way to get to the root causes of what might be depriving you of sleep.

https://www.positivelyosceola.com/orlando-health-why-women-get-insomnia-and-how-to-get-better-sleep/ 

The nine things that could finally get you a good night’s sleep

From telegraph.co.uk

By Miranda Levy

Whether it’s the odd restless night or chronic insomnia, sleep problems are on the rise – but there are solutions

The world tends to fall into two camps. There are those people whose heads hit the pillow and – snap! – eight hours later, it’s the morning. Then there are 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 of 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). One in 10 of us suffer from chronic insomnia, defined as having trouble sleeping for three days a week for more than three months. Even for those spared the long-term 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. “Insomnia can affect all the above: it’s an awful, lonely condition. But the good news is that there are effective treatments, and however bad things may seem at the time, there is hope.”

However much you’re dreading another tussle with the duvet, here’s the experts’ guide to understanding sleep – and the knowledge that will ease you into better nights.

How much sleep do I need?

There’s a received wisdom about how many hours a person “should” sleep. The oft-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 makeup, 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 Dr 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.”

Why do I find it hard to get to sleep?

First, the basics: make sure your “sleep hygiene” is up to scratch. So, check that your bedroom is dark, quiet and at optimum temperature – between 18C-21C. Your bedding should be comfortable and, ideally, made of natural fibres. Ensure you’ve had enough natural light and exercise during the day (more of which below).

Dr Guy Meadows is clinical director of the Sleep School and author of The Sleep Book: How to Sleep Well Every Night. “Unfortunately, for many of us, good sleep involves managing your caffeine intake,” he says. “Try not to drink caffeine after the early afternoon, because it can have an impact on your sleep, even many hours later,” he says. Coca-Cola and tea (even green tea) also contain caffeine.

Spending too much time on your devices can also delay the dropping-off process. “Smartphones and technology can have a negative impact on our quality of sleep and mental health,” says Dr Meadows. “Phones trigger brain stimulation, making it much harder to get to sleep and stay asleep.” The “blue light” emitted by devices has also been shown to delay the production of melatonin, the hormone that sends us to sleep.

For many, stress and anxiety – whether about a specific meeting the next day, or an ongoing life situation – can play havoc with our ability to fall asleep. “Stress comes in all different forms,” says Dr Bostock. “Another way of describing it is hyperarousal, or an inability to switch off. You might not recognise yourself as stressed, but you are always ‘on’ ”. For ways to combat this, see below.

Reasons you might wake up in the middle of the night

Most people wake up once or twice a night. “Waking up at night is a perfectly normal part of the sleep cycle, and usually nothing to worry about,” says Dr 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 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 sleep,” (see below) says Dr Bostock. “So even when you have slept for the same number of hours, you haven’t had as restorative a rest as you would have had if it had been true sleep.”

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. People who snore or who have sleep apnoea – a condition where the walls of the throat relax and narrow during the night – also have restless nights.

What are the different stages of sleep?

There are two basic types of sleep: rapid-eye movement (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 stages of non-REM (NREM) and REM sleep several times, with increasingly longer, deeper REM periods occurring towards morning.

Stage 1 non-REM sleep is the switch from wakefulness to sleep. During this short period (lasting several minutes) of relatively light sleep, your heartbeat, breathing and eye movements slow down and your muscles relax, with occasional twitches. Your brain waves begin to slow from their daytime wakefulness patterns.

Stage 2 non-REM sleep is a period of light sleep. Your heartbeat and breathing slow down and your muscles relax even more. Your body temperature drops and eye movements stop. Brainwave activity slows, but is marked by brief bursts of electrical activity. You spend more of your repeated sleep cycles in stage 2 sleep than in other sleep stages.

Stage 3 non-REM sleep is the period of deep sleep you need to feel refreshed in the morning. It occurs for longer periods during the first half of the night. Your heartbeat and breathing slow to their lowest levels and your muscles are relaxed. It may be difficult to wake you up. Your brain waves become even slower.

How long should I spend in deep sleep?

Each cycle of deep sleep lasts from 20 to 40 minutes. The average person cycles through this about four times a night, but not everyone needs this amount to feel fresh and rested the next day.

What is REM sleep?

REM sleep first occurs about 90 minutes after falling asleep. Your eyes move rapidly from side to side behind closed eyelids, your breathing becomes faster and irregular, and your heart rate and blood pressure increase to close to waking levels. Most of your dreaming occurs during REM sleep, although some can also occur in non-REM sleep. “Some believe REM sleep is the brain essentially doing therapy on itself, processing feelings,” says Dr Bostock.

Your arm and leg muscles become temporarily paralysed, which prevents you from “acting out” your dreams. As you age, you spend less time in REM sleep.

9 expert tips to help you sleep through the night

1) Embrace the light

“From the minute you wake up, you’re effectively winding down for sleep,” says Dr 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 sharpen your focus. “As soon as you wake up, aim to get lots of light into your eyes,” says Dr Meadows. “This tells the brain that the day has begun, banishing the sleep hormone, melatonin, and activating the CAR – the cortisol awakening response.”

2) Keep moving

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 that sleep drive, and help to increase the speed at which you fall asleep,” says Dr 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.

3) Watch what you eat

According to Dr 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, such as oily fish and nuts, and vegetables,” he says.

A 2020 study from Columbia University agreed that the Mediterranean diet “appears to provide the best sleep outcome”.

4) Build a routine – and stick to it

“Waking up at the same time every day – including weekends – sets you up for a successful night’s sleep,” says Dr Bostock. “Your body clock will recognise the pattern and you’ll start to wake up more alert every morning and 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 the body to associate those actions with morning.

This, and the following tips, are part of a school of therapy called CBT-I (Cognitive Behavioural Therapy for Insomnia), which has been shown in studies to be far more effective than sleeping pills, which also carry a risk of dependency.

5) Restrict the time you spend in bed

This means spending less “quantity” 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 Dr 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, or sex, and nothing else.

Naps can be helpful, but do restrict their duration, and closeness to bedtime.

6) 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 Dr Bostock, this is counterproductive. “Instead of telling yourself ‘that’s it, I’m never going to sleep again’, reassure yourself ‘I’m a good sleeper, I’m just having a bad night’.”

7) Follow the “quarter-hour 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 Dr Bostock. Television is not recommended because it might stop you feeling sleepy, and the blue light from a phone or a tablet can interfere with the maintenance of melatonin production.

8) 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 Dr Bostock. “Since the mind and body are interconnected, relaxing the muscles can be a shortcut to easing the 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 and breathing exercises – there are even sleep playlists on Spotify and “sleep stories” on YouTube.

9) 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 less 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.

Miranda Levy is the author of The Insomnia Diaries: How I Learned to Sleep Again (Octopus Books)

https://www.telegraph.co.uk/health-fitness/body/how-to-finally-get-a-good-sleep/