How much sleep do you really need? Experts say it depends

From timesnews.net 

Chances are, if you’re reading this, you got some sleep last night. But are you feeling rested?

Experts say it’s an important question to consider.

Most of us spend a third of our lives sleeping, but you may need more or less than eight hours a night. The number of hours needed changes throughout your life, with babies and kids needing more sleep and people 65 and older able to function on slightly less than seven to nine hours.

Here’s what sleep scientists and doctors say about how much you really need — and whether your gender plays a role.

Sleep quality over quantity

Sleep is still a mystery, despite how critical it is for our health.

“The reasons aren’t entirely clear, but it’s an essential thing that we all do,” said Dr. Rafael Pelayo, a sleep specialist at Stanford University. “Something remarkable happens when you sleep. It’s the most natural form of self-care that we have.”

Most of the population gets between seven to nine hours — and that particular category has the lowest association with health problems, said Molly Atwood, a behavioural sleep medicine clinician at Johns Hopkins.

Once people either dip into less than six hours of sleep or get more than nine hours on average, the risk of health problems inches up, Atwood said, but everybody is different.

When you’re trying to figure out how much sleep you need, it’s important to think about the quality of it, Pelayo said: “What you really want to do is wake up feeling refreshed — that’s what it’s about.”

“If somebody tells me that they sleep many hours but they wake up tired, something is wrong,” Pelayo said. “You shouldn’t leave your favourite restaurant feeling hungry.”

The number of hours of sleep needed changes throughout your life, with babies and kids needing more sleep and people 65 and older able to function on slightly less than seven to nine hours.       Metro Creative Connection

How much sleep we need changes

The amount of sleep we need changes throughout our lives. Newborns need the most — somewhere between 14 to 17 hours.

“Definitely when we’re babies and children, because we are growing so rapidly, we do need a lot more sleep,” Atwood said.

The National Sleep Foundation recommends most adults between 26 and 64 get between seven to nine hours of sleep. People who are 65 and older can get slightly less, and young adults between ages 16 and 25 can get slightly more.

Humans cycle through sleep stages roughly every 90 minutes. In the first portion of the night, Atwood said that more of the cycle is slow wave sleep, or deep sleep, which is essential to repairing and restoring the body. It’s also when “growth hormone” is released.

In the latter hours of the night, more of the sleep cycle is spent in rapid-eye movement sleep, or dream sleep, which is important for learning and memory consolidation, or the process in which short-term memory gets turned into long-term memory.

Kids get more “deep sleep,” with about 50% of the night in that realm, she said. That drops at adolescence, Atwood said, because our body doesn’t need the same kind of repair and restoration.

Something else interesting happens around puberty: Gender-based differences in sleep start to crop up.

Do women need more sleep?

Though they have the same sleep needs, teenage girls seem to get less sleep than teenage boys, Pelayo said. Additionally, teenage girls tend to complain of insomnia more frequently.

When women become first-time mothers, they often care for newborns throughout the night more frequently, which means less sleep, said Allison Harvey, a clinical psychologist and professor who studies sleep at UC Berkeley.

Hormones may also impact women’s sleep quantity and quality during pregnancy and menopause.

“With menopause in particular, women can develop deterioration in their sleep with an increased number and duration of night-time awakenings,” said Dr. Mithri Junna, a Mayo Clinic neurologist who specializes in sleep.

Atwood said women may also need more sleep right before their menstrual cycle.

“There are definitely times that your body’s telling you that you need more sleep,” she said. “It’s important to listen.”

When to seek help sleeping

You’ll know if you’re not getting enough sleep if you’re feeling grumpy, irritable and inattentive. Long-term, those minor symptoms can become serious problems — even deadly.

“If you’re not getting enough sleep or you have untreated insomnia or sleep apnoea, your risk of depression increases,” Atwood said. “Your risk of cardiovascular issues like high blood pressure, risk of heart attack and stroke increases. Your immune system is compromised. You’re at greater risk for Alzheimer’s.”

If you’re getting the recommended amount of sleep every night but still waking up feeling tired, you might consider going to your primary care physician. They can rule out other health conditions that may affect your sleep, Atwood said. But if problems persist, seeking out a sleep specialist could be helpful.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

https://www.timesnews.net/living/wellness/how-much-sleep-do-you-really-need-experts-say-it-depends/article_4ffd8c81-6eb7-4f90-b6f9-13774e5f250b.html

Say goodbye to insomnia: The exercise retirees over 60 should do for better rest, a new study says

From okdiario.com 

Insomnia can leave you feeling drained and frustrated, and it’s a challenge that only intensifies with age. That’s why, for seniors, it’s more important than ever to find natural ways to improve their sleep.

Here, we introduce an exercise backed by recent research: a simple routine that could be the key to more peaceful nights. We’ll explain its benefits and show retirees over 60 how to safely incorporate it into their daily routine for better rest. Let’s get started.

Avoid insomnia with an effective routine for retirees

Recent research indicates that not every exercise is equally effective against insomnia. A study conducted by the Mahidol University in Bangkok examined more than 2,000 participants aged 60 and above. The results revealed that resistance or muscle-strengthening workouts produced the most significant improvements in sleep quality.

Although aerobic activities such as walking or cycling provided some benefits, resistance training, whether using weights or your own body, yielded the greatest boost in sleep quality. Seniors who participated in these exercises experienced notable enhancements in their sleep patterns; they slept longer and woke up feeling more refreshed.

Moreover, the study noted that combining different kinds of exercises, including balance and flexibility movements, offered additional advantages by alleviating issues such as anxiety and mild depression, which are common during restless nights.

Creating a sustainable routine for better sleep

Transitioning into an exercise habit may seem challenging at first, but a few simple steps can help you build an effective plan:

• Start gradually: Begin with light activities such as bodyweight exercises like modified push-ups or gentle squats. Gradually, you can incorporate resistance training using light dumbbells or resistance bands. It’s crucial to listen to your body and adjust the intensity if anything feels off.
• Mix in different movements: Combine a variety of exercises that enhance strength, balance, and flexibility. Adding short walks or light aerobic sessions will elevate your heart rate, while including stretching or yoga keeps your body agile and limber.
• Set a consistent schedule: Plann exercise sessions that last around 50 minutes, two to three times per week. Scheduling your workout earlier in the day can help you avoid overstimulation near bedtime.
• Safety first: Consult your doctor before beginning any new exercise program, especially if you have pre-existing health conditions. Consider working with a trainer or joining group classes designed for seniors to ensure a secure approach. Always warm up before and cool down after your workout to help prevent injuries.

A regular exercise routine that includes resistance training can transform your nights. It not only reduces restless tossing and turning but also instils a sense of accomplishment. For retirees seeking a natural way to combat insomnia, it promotes more restorative sleep and strengthens the body, making everyday tasks easier and boosting self-confidence.

The study shows that resistance training can be a powerful tool for enhancing sleep quality. By safely integrating these exercises into your daily routine, you can overcome sleepless nights while boosting your overall health and energy. With small, consistent efforts, better rest and a more active lifestyle can become a reality.

https://okdiario.com/metabolic/en/psychology/emotions-and-mental-health/say-goodbye-to-insomnia-the-exercise-retirees-over-60-should-do-for-better-rest-a-new-study-says-9369/

How to fall asleep in five minutes

From telegraph.co.uk

A good night’s sleep will set you up for the day. Here’s how to fall asleep quickly 

Benjamin Franklin once said “Early to bed, and early to rise, makes a man healthy, and wise.” Or to put it another way: “Sleep is the single most powerful performance enhancer and health giver there is,” says Dr Guy Meadows, a clinical director and the co-founder of Sleep School.

Too bad we’re not getting enough of it. A recent YouGov poll found that while 77 per cent of Britons aim to get eight hours of sleep, just 25 per cent of us actually manage it. So is it possible to fall asleep fast – and what really helps?

Can you really fall asleep in five minutes?

Absolutely, says Dr Meadows, “However, while being able to get into bed and fall asleep in under five minutes from time to time may indicate good sleep health and efficiency, consistently taking five minutes or less to fall asleep can also be a sign of excessive sleepiness or sleep deprivation.”

The average healthy sleeper takes 15 to 20 minutes to fall asleep, he says. And are some of us simply better at falling asleep more quickly or easily? “Yes, some people are more predisposed to falling asleep quickly due to factors such as genetics, how good their sleep hygiene is, lower stress levels, regular physical activity, and good mental health.”

The amount of sleep we need differs too – whilst babies need over 14 hours per night, adults can do with around seven.

So, what’s the key to falling asleep quicker and maximising your hours of shuteye?

Six tips to fall asleep faster

1. Get light into your eyes first thing

When it comes to being able to fall asleep quickly, what we do in the day is almost as important as what we do when we go to bed, says Russell Foster, a professor of circadian neuroscience at the University of Oxford and author of Life Time: The New Science of the Body Clock, and How It Can Revolutionise Your Sleep and Health.

“Most of us should get as much natural morning light as possible to improve our chances of falling asleep later that day,” he says. “This has been shown to move the circadian clock to an earlier time, which helps you feel sleepier at bedtime.” Our circadian clock, or circadian rhythm, is the 24 hour ‘internal clock’ that regulates our sleep/wake cycles.

Guy Meadows agrees. “Your body is naturally preparing to fall asleep from the moment we wake up, and there are things you can do early in the day to help you fall asleep more quickly. Getting light into your eyes first thing signals to your body that the day, and the countdown to bedtime, has begun.”

Meadows is also a fan of what he calls the “fake commute”: “Now more of us work from home we don’t have to step outside every day. To counter this I take a walk round the block every morning without sunglasses to get light into my eyes to set my circadian rhythm. This creates a wonderful pattern of circadian synchronicity and helps improve the quality of my sleep that night.”

2. Never nap after 4pm

Prof Foster says a short nap or siesta in the early afternoon has been historically common throughout Mediterranean countries, largely due to their warm climate and tendency to have their largest meal in the middle of the day. However, while napping has its health benefits, take caution with a daytime nap to ensure you’re still able to fall asleep at night: “Firstly, if you find yourself regularly wanting a nap in the day, you probably aren’t sleeping enough at night,” says Prof Foster. “However, the occasional nap will improve alertness and performance in the afternoon, providing it’s no longer than 20 minutes and not within six hours of bedtime, otherwise it will delay the time it takes you to fall asleep.”

And once you are finally asleep, your body goes through four different stages which are crucial to a restful night. Stage one begins with light sleep, and the final step is REM sleep which can last for 10 to 60 minutes.

3. Don’t exercise too close to bedtime

Exercise is good for our ability to fall asleep, says Prof Foster but, like napping, we have to do it right. “For most of us, exercise helps the sleep/wake cycle and reduces insomnia. However, exercise within one to two hours of bedtime may be a problem by overriding the circadian rhythm and delaying the onset of sleep.” Vigorous exercise in particular isn’t advised, he says, because it can cause a “runner’s high”, which will also delay sleep.

4. Think about your mattress

Prof Foster thinks our mattresses matter when it comes to getting a good night’s sleep, but says there are few scientific studies to back this up. “Research does suggest, however, that a good mattress and the right bedding can conduct heat away from the body, which lowers core body temperature and this can reduce the time it takes to get to sleep and increase deep slow-wave sleep.”

He says you probably need a new mattress if your current one feels saggy or unsupportive, or if you wake up with aches and pains in your back or limbs. “And has it been more than seven years since you purchased it? Do you become more allergic or develop asthma symptoms in bed? If so, it may be time to think about buying a new one.” If you’re menopausal, he advises getting a cooler, more breathable one, and suggests visiting showrooms or department stores to test some out.

On the topic of temperature, Guy Meadows says we sleep better in a cool room and that the ideal bedroom temperature is around 16C to 17C. “Women tend to want a warmer bedroom though, and I’ve had couples tell me that a Dyson fan has saved their marriage when they couldn’t agree on the right temperature,” says Prof Foster. “Men have more muscle than fat and tend to be bigger so retain heat, but your bedroom should be no warmer than 18C.”

5. Stick to the same bedroom routine

Our circadian rhythm thrives on routine, so aim to wake up and go to bed at the same time each day, which makes waking up – and falling asleep – easier.

“More research is needed, but anecdotally relaxing oils, such as lavender, also improve sleep and can be a helpful part of a bedtime routine,” says Prof Foster. “A warm bath is also another good part of a ‘sleep preparation’ routine, because it warms the skin, which increases blood flow from the core of the body, which some studies show can reduce the time it takes to fall asleep.”

Lastly, he says, make your bedroom a haven for sleep: “Your bedroom should contain minimum distractions and be quiet, dark and calm, so try not to work in it during the day.”

6. Mindfulness to minimise stress

“I used to be terribly rude about mindfulness in the old days when there was little data on it,” says Prof Foster. “Now I know better and that mindfulness techniques can help with daytime stress, which is a powerful sleep disruptor.”

In 2015, a study published in the journal JAMA Internal Medicine found those who practiced mindfulness before bed slept better, which the researchers believed was due to it calming the nervous system and lessening anxiety, which helped with relaxation before sleep.

“Most people don’t have a sleep problem, they have an anxiety problem, and mindfulness can be whatever behaviour winds you down for bed,” says Prof Foster. “Whether that’s reading, or some breathing exercises. Mindfulness doesn’t have to be a defined practice, nor take a certain amount of time.”

Meadows says mindfulness might include choosing to focus on the feel of your duvet on your feet or on the movement of your breath for a few minutes.

Prof Foster also advises against using electronics before bed but not because of the light: “But rather because of the kind of things you might see that will cause stress,” he says. “For this reason, I’ve stopped catching up on the news on my phone before bed. Even an email from your boss can make one very stressed before bed, so avoid electronics.”

Lastly, leave tricky conversations for daylight: “Many couples only find the time to talk about important stuff when they’re lying in bed at the end of a busy day,” says Prof Foster. “My wife does the family finances, but I won’t let her talk about them in bed because it’s not conducive to falling asleep quickly.”

The importance of sleep

So, now we know how to fall asleep quickly. But just how important are those eight(ish) hours a night?

“Sleep is a really wonderful and powerful way of improving our health,” says Meadows. “It improves everything from our mental focus and emotional regulation, to managing the hormones that control our appetite and lowering our blood pressure.”

A 2022 study published in the journal PLOS Medicine found a “robust association” between getting fewer than five hours of sleep per night and an increased risk of heart disease, cancer, depression and diabetes.

Dr Severine Sabia, from University College London and a lead author on the study, said that multimorbidity [having two or more chronic diseases] is on the rise in high-income countries. “As people get older, their sleep habits change,” she said. “However, it is recommended to sleep for seven to eight hours a night, as sleep durations above or below this have previously been associated with individual chronic diseases.”

Meanwhile, a 2022 study published in the journal JAMA Internal Medicine found that people who sleep less consume more calories and crave higher fat and calorie foods than those who get more sleep. Beth Frates, from Massachusetts General Hospital, who led the research said improving your sleep hygiene, “may help people to extend sleep time to the recommended seven to nine hours per night”, which could in turn lead to them consuming fewer calories and losing weight. “Many people focus on exercise and diet when it comes to weight management and a healthy heart, but few focus on sleep,” she says.

FAQs

What is the 10-3-2-1-0 rule for sleep?

The 10-3-2-1-0 rule offers a consistent pre-bedtime routine which can help improve sleep. Each number references a different step in the routine.

You should stop drinking caffeine 10 hours before bed and limit food and alcohol intake three hours before bed. Whilst caffeine is a stimulant which increases your energy levels (not what you want before trying to sleep), eating before bed can affect your concentration and cause digestive issues.

You should stop working two hours before bed in order to avoid overstimulation and put down the screens one hour before sleep. Then, in the morning, you should hit the snooze button on your alarm zero times as this can disturb your sleep cycle.

Does milk help you sleep?

Milk contains tryptophan, an amino acid that helps the brain to produce melatonin. It is also high in protein and will help you to feel full which may aid in more comfortable sleep.

However, whilst it may help you feel relaxed and comfortable, which can make it easier to fall asleep, there is no scientific evidence that milk directly makes you sleepy.

https://www.telegraph.co.uk/health-fitness/wellbeing/sleep/how-to-fall-asleep-in-five-minutes/

‘Why do I always wake up at 3am?’ Telegraph readers’ sleep issues answered by an insomnia expert

From telegraph.co.uk 

By Dr. Alanna Hare

Dr Alanna Hare is a consultant in sleep and ventilation at Royal Brompton Hospital and president of the British Sleep Society, with more than 20 years’ experience in treating sleep-related issues. We asked her your questions about how to get a better night’s sleep and beat insomnia.

                                                            Dr Alanna Hare is a doctor and insomnia expert Credit: Heathcliff O'Malley

‘Why do I feel anxious and have intrusive thoughts if I wake up in the middle of the night?’

Claire*

Our brains are often racing with anxious thoughts, but it’s common to be so busy in the daytime that we don’t notice it. If you’re the type to crash into bed exhausted at the end of the day and sleep instantly, it’s no wonder that worrying, intrusive thoughts will crop up in the middle of the night when there’s nothing to take up your attention. Your anxious mind thinks that this is its time to shine and combs over those embarrassing moments from years ago that we’d rather forget.

It’s not unusual to then become anxious about being anxious, and to ruminate on being kept up all night when you need your rest. This can be incredibly distressing, and in the worst cases can cause insomnia and deepen anxieties you might already have bubbling under the surface throughout the day.

For my patients who struggle with this regularly, I recommend acceptance and commitment therapy, a practice that helps people to increase their psychological “flexibility” and find it easier to tolerate their thoughts and feelings. It’s a treatment that helps people to stay in the present moment. I’d recommend following this principle and trying to ground yourself in the present in some way.

A great way to do this is through progressive muscle relaxation: start by clenching your toes and releasing, moving slowly through your body, until you reach your head or have fallen asleep. This will take you out of your anxious thoughts for long enough to drift off to sleep.

‘I’m in my 70s and wake up at 3am every night feeling alert. How can I get back to sleep?’

Trevor*

Six in 10 of us in Britain wake up in the night unprompted and find it hard to get off to sleep again. In fact, we all briefly wake throughout the night, though we may not remember it, two or three times on average. Finding that your sleep is interrupted at the same time every night is common too, and often signals the beginnings and ends of your sleep cycles, dictated by your unique circadian rhythm.

Of course, waking up at night is only a big problem if you can’t get back to sleep again. If you find yourself wide awake at three in the morning, you’ll likely want to turn over and try to get right back to sleep, but that feeling of alertness you mention can sometimes mean that drifting off is hard to do.

Instead, get up and move to another part of your house, and do something relaxing for 20 to 30 minutes, until you naturally feel sleepy again. You could read a book, listen to some music, or even watch TV – anything but scrolling social media, more because it’s hard to put down than because of the blue light from your screen, which these days we believe is less disruptive to your sleep than was once thought.

It might sound counter-intuitive, but the longer you lie in bed, the more frustrated you’ll get and the more awake you’ll feel. Make your bed a space where only sleep happens and you’ll find it easier to sleep through the night over time.

‘How safe is it to take prescription sleeping pills from time to time? I usually don’t struggle to sleep, but I often wake up far too early and take about a quarter of a pill at 4am or 5am to get back to sleep again’

Stephen C.

Doctors prescribe sleeping pills for short-lived periods of insomnia, the sort you might have after a bereavement or the breakdown of a relationship, because we know that they’re effective. We call these the “z-drugs”: zolpidem and zopiclone are the ones licenced for use in the UK. More than a million people are prescribed them each year in Britain, and we know that they’re safe and effective when taken in the short term, for four weeks or less.

Regularly taking a full dose of z-drugs in the long term, rather than for an acute period, can increase your risk of falls and accidents. In my opinion, it’s unlikely that taking a quarter of a sleeping pill at four in the morning is doing much to your body (or indeed, sleep) at all, though I’d advise you to make your GP aware of what you’re doing.

You’re likely experiencing the good end of the placebo effect: you’ve conditioned yourself to switch off and relax after taking your quarter-pill, because you believe that it works. But is what you’re doing dangerous? At this dose, that is unlikely, but it would be far preferable to address the underlying issue and help you sleep without needing medication.

These pills aren’t effective for chronic insomnia, the sort that isn’t prompted by a recent event or that has gone on for more than a few weeks. For my patients struggling with this sleep problem, I always recommend a specific form of cognitive behavioural therapy, a talking therapy, that’s been adapted for insomnia, called CBTi. I trained in delivering this more than 10 years ago, and it’s very effective. It works to address the behavioural issues around insomnia and the thoughts that can drive it, by changing people’s beliefs around sleep and helping them sleep again naturally and reliably.

‘Why does alcohol affect my sleep so badly? Just one drink can keep me awake for hours. Is there anything I can do?’

Amber*

Unfortunately, alcohol is the enemy of sleep. Yes, it can help us get off to sleep more easily in the first place, with alcohol being a sedative drug. But your blood sugar drops as your body digests the drink you’ve had, making you wake up in the night, on top of your bladder demanding extra trips to the loo.

Drinking alcohol also makes it harder to get rapid eye movement (REM) sleep, the all-important stage of sleep that allows us to consolidate new memories from the day before and feel rested when we wake up. This can contribute to your hangover as much as your liver’s complaints about what it’s been fed.

Many people choose to take this on the chin, preferring to keep enjoying the social aspects of occasional drinking. While I’m not here to tell you to give it up entirely, as that is a very personal decision, I would advise drinking with as much moderation as you can if you’re concerned for your sleep or broader health. Ninety per cent of people who regularly drink in the evenings report having trouble sleeping.

An occasional glass of wine shouldn’t significantly disrupt your sleep, particularly if you have it well before bedtime. That said, if you do find that you’re kept awake by such a small amount, it might be that you’re more sensitive to alcohol than most, which is all to do with the activity of the enzymes that process alcohol in your body, something that is unique to everyone.

As with many sleep problems, there are powerful psychological factors at play here too. If you expect not to sleep well, because of alcohol or something else, then that’ll become a self-fulfilling prophecy. If you suspect this to be the problem, my advice is the same as for anyone struggling to put their thoughts down: get up and do something else when you wake in the night, or can’t sleep at bedtime, and only get back into bed when you can feel that you’re close to nodding off.

‘I’m 82 years old, and I’ve spent much of my life working on an airline. I lost my husband last June, and now I live alone, going to bed around midnight, falling asleep at 3am and then sleeping until midday, unless I need to get up earlier. Should I start setting an alarm to wake up earlier, or will this odd sleeping pattern pass naturally?’

Sarah*

If you’ve spent your life working in planes, you may be a long-term shift-worker. Sleep problems are common amongst people who work late shifts or night-shifts and we have a specific term for these issues: shift work pattern disorder, a sleep disorder that can cause either insomnia or excessive sleepiness. I have certainly seen people who still have this problem into their retirement.

It’s unlikely that your sleep pattern will move to more usual hours on its own, especially if you’ve only ever been able to sleep at 3am, even prior to your shift work. In this case you might actually have delayed phase sleep disorder, where your body clock is just set differently to most people’s. The treatment for this issue involves careful adjustments to your sleep timings with the help of a sleep specialist. You may be prescribed a dose of the sleep hormone melatonin at night, and bright light therapy in the morning, to set your body clock so that you can sleep earlier in the day.

One question you might like to ask yourself, however: how much of a problem is your current sleep situation posing for you? It sounds to me like you’re getting enough rest, though the three hours you spend in bed prior to falling asleep may be causing you stress. I’m more concerned about how sleeping to midday might affect your social life, given that you’ve suffered a bereavement and you now live alone. Older people report feeling more isolated on average. Getting up earlier may give you more time to touch base with friends and family to make sure that you’re getting enough contact with other people.

If you’d like to get up earlier, while preserving your enviable eight hours of rest, I’d recommend gradually shifting your bedtime backwards, by 15 to 30 minutes a day, and seeing whether you naturally wake earlier too. Get some bright light by going outside if you can in the earlier part of the day, and dim the lights as you prepare for bed. Avoid caffeine after lunchtime to help you drift off more easily at night. If these measures do not help, and this continues to trouble you, it might be time to seek professional help.

‘I have back pain and acid reflux, so I get conflicting advice about the best sleeping positions for my health. What should I do?’

Amina*

As a sleep expert, I’m frequently frustrated by how little doctors are taught about sleep. In my own days as a medical student at Cambridge in the 1990s, I wasn’t taught much about the topic, and little has changed since. This leaves patients with confused advice, and a gulf of information that it’s tempting to fill by seeking help online, where there’s less-than-trustworthy information.

In truth, each case of back pain is different, so I would avoid giving generic advice on the best position to sleep in for this problem. All I can say is that having a good supportive mattress is always important and will help you to sleep more easily.

Acid reflux is a simpler issue when it comes to protecting your sleep. Apart from treatment with medication, it can be helpful to raise the head of your bed, to prevent that acid from coming back up from your stomach. You can either use blocks or raise the front two legs on your bed if they’re adjustable. Then you can sleep in whichever position a professional tells you is best for your back pain. I’d recommend visiting a physiotherapist to find this out.

‘I go to sleep around midnight and set my alarm for 7.30, but wake up around an hour before the alarm goes off. So I lose out on an hour’s sleep which is frustrating. I have blackout blinds so it isn’t the light. What can I do?’

Rochelle Poznanski, 51, accounts manager for a law firm

It sounds to me like you’re a lark – one of those people who naturally rises early in the morning. This can be inconvenient if you don’t have a reason to be up, but your current sleep schedule means that you’re only attaining six and a half hours of sleep per night, short of the seven we all need as a minimum to be healthy.

To sleep more, I’d recommend that you go to bed earlier. It won’t work if you suddenly try to hit the pillow at 10pm, however. Shift your bedtime forward by half an hour each week, until you hit a time that gives you enough sleep each night (for most adults, this is between seven to nine hours per night). Pairing this with some wind-down time half an hour before bed, with a book or some deep-breathing exercises, will make the process easier.

‘I have a good bedtime routine, a safe and comfortable place to sleep, I don’t drink alcohol or caffeinated drinks and I watch my weight. I have a demanding job and spend all day solving complex issues. I go to sleep around 10pm and always wake up between midnight and 1am. I’m then awake for around two to three hours before falling asleep again until I wake at 6am. Why does this happen?’

Carolyn Moss

From what you’ve described, it sounds like you have sleep maintenance insomnia, a kind of insomnia where getting to sleep isn’t a problem, but staying asleep is a struggle. This is a very common problem. Poor sleep hygiene is a major factor in why people develop this kind of insomnia, but it sounds to me like you’ve done everything you can to limit the issue by changing your lifestyle. If this has gone on for more than three nights a week for three months, then you would be diagnosed with chronic insomnia. The best treatment for this, again, is CBTi.

I’d recommend keeping a sleep diary, noting down when you’re awake so that you can see how much sleep you’re actually getting each night. Avoid spending time in the bed awake and don’t go to bed at night until you are feeling sleepy. Try to stick to getting up at the same time each day. Digital CBTi programmes can provide personalised advice which will help your sleep to repair itself.

‘I listen to a podcast every night to go to sleep and have done for over a decade. It’s the only thing I seem to be able to do to stop my busy mind and wind-down. I am aware however that it could be disturbing my sleep. How can I wean myself off the habit?’

Alana Grayson

According to one survey, from 2022, nearly half of us listen to podcasts, music or the radio to help us sleep. Having background noise can help to distract us from thoughts that might keep us awake, and over time this becomes an association, something that we need to get into “sleep mode”, like wearing pyjamas or having a duvet on the bed.

Unless you’re being interrupted in the night by unexpected sounds in the podcast of your choice, however, then I don’t think this habit should actually disrupt your sleep, or affect your sleep quality in any way. So feel free to keep lulling yourself to sleep with podcasts, unless your partner finds it difficult to deal with, or it’s restrictive when you’re away from home.

If this is the case, try using a technique called cognitive distraction, to keep difficult thoughts away without using a podcast. One method is to count back from 1000 in sevens, starting again when you lose track (this is like counting sheep for adults). You might find that this can replace your podcast as a way of lulling you to sleep.

‘What can I do about menopausal insomnia? I seem to have lost the knack of sleeping through the night and now wake up between 4 and 5 every morning, often dropping off just before my alarm goes off, then spend the day feeling so tired. The only reason I decided to try HRT was to see if it helped this but it hasn’t. The GP suggested melatonin but said I can only buy this abroad! What can I do?’

Louise*

Insomnia is a huge issue for women in menopause or perimenopause. It’s often a very pronounced symptom, and it’s poorly addressed. It’s right that HRT can help with menopausal insomnia if the issue is hot flushes, but if that isn’t the case, or if your form of HRT hasn’t helped with these, I would again recommend CBTi, which has been shown to be just as effective for menopausal insomnia as for any other kind of insomnia. Some forms of HRT are also more beneficial for menopausal insomnia than others. I’d advise that you ask your doctor or a menopause specialist about this.

Melatonin may help, though I wouldn’t recommend it as a first course of action. Melatonin is in fact licenced for over-55s in Britain, where a formal course of CBTi hasn’t been helpful. Otherwise, keeping your bedroom cool and having bedsheets and pyjamas made of natural fibres such as cotton or bamboo can be helpful, as can having a good bedtime routine with half an hour of wind-down time before you hit the pillow. Exercising regularly can also help to manage menopausal insomnia, especially weight-based strength training exercises, though you should avoid doing exercise just before bed as it can make hot flushes worse.

*Names have been changed

As told to Lauren Shirreff

https://www.telegraph.co.uk/health-fitness/wellbeing/sleep/sleep-issues-answered-by-an-insomnia-expert/