• Michaela Newsom

What's your biggest sleep issue?

If you answered A this may be due to one of the following:

· High cortisol levels.

Cortisol is one of our stress hormones and follows a 24 hour circadian pattern. In the mornings cortisol is at its highest and it then falls throughout the day so that by the time it gets to bed time, cortisol levels are low. If this pattern becomes disrupted, cortisol levels may remain high into the evening leaving you feeling tired but wired and unable to fall asleep.

· Too much blue light exposure blocking melatonin.

Most of us have heard of melatonin and its link with sleep. Now whilst melatonin plays no part in actually falling asleep, levels of melatonin rise in the evening and this acts as a trigger for the onset of sleep. However, melatonin production is inhibited by cortisol and also blue light ( as given off by electronic screens).

· Not enough sleep pressure.

Although our sleep cycle is regulated through our circadian rhythm, there is a second, independent mechanism that helps to bring on the onset of sleep. A little known chemical called adenosine is produced by the body and levels continuously rise when you are awake which creates ‘sleep pressure’. The longer you are awake, the higher the levels of adenosine and this triggers the onset of sleep. When you fall asleep, adenosine is broken down and removed so when you wake in the morning your levels of adenosine are low. Coupled with high cortisol levels in the morning makes you feel bright and alert. However, if you nap during the day time or early evening, your adenosine levels will decline and your sleep pressure is reduced, making it harder for you to fall asleep. Caffeine is known to block the action of adenosine, which in part is why it makes you feel more awake and alert.

Try some of the tips below to help you fall asleep more easily:

1. Avoid highly stimulating activities such as playing a competitive games, watching thriller or scary movie or even the news.

2. Make an effort to relax for at least 15 minutes before going to bed - a warm bath, massage, meditation.

3. Keep your feet and hands warm. Wear warm socks and/or mittens or gloves to bed if they get cold at night.

4. Go to bed at the same time every day. Our bodies function best when we work to a regular circadian rhythm.

5. Use your bed only for sleep and sex.

6. Keep the temperature in your bedroom comfortable; or even slightly cool. Ideally your bedroom should be around 18 degC.

7. Use a traditional alarm clock instead of your smartphone so that you can leave your phone outside of the bedroom.

8. Keep the bedroom completely dark or use an eye mask to stop your eyes detecting light (even when they are closed).

9. Reset your circadian rhythm by getting exposure to daylight as soon as possible after waking and avoiding the blue light emitted from screens in the evening.

10. Avoid napping late afternoon or falling asleep on the sofa in the evening before going to bed.

If you answered B this may be due to one of the following:

· A hypoglycaemic response.

During the night your blood sugar may drop very low and trigger the release of stress hormones which act to increase blood sugar levels. The surge in adrenaline and cortisol is what wakes you up.

· Alcohol.

Drinking alcohol in the evening means that the liver has to work hard metabolising the alcohol overnight. According to Chinese medicine, the peak hours for liver function are between 3 and 4am so if you find yourself regularly waking at this time, it could be signs that your liver needs a little support.

· Medications.

There are a number of medications can interfere with sleep so be sure to check with your GP about the best time of day to take certain medications. It may be that simply switching to taking some meds in the morning can have a beneficial impact on your sleep.

· Bladder issues.

As we get older our bladder weakens and you may find you start waking in the night to go to the loo.

Try some of the following tips to help reduce waking during the night.

1. Try to take some gentle exercise every day. Regular exercise improves sleep quality, even a nice, brisk walk.

2. Don’t eat a heavy meal within four hours of going to bed.

3. Avoid caffeine after midday. This is not just coffee but also includes cola, green tea and black tea.

4. Do not use alcohol to help you sleep. Although it may help you fall asleep, alcohol has been shown to reduce the quality of sleep in particular significantly reducing the amount of deep, restorative sleep.

5. Don’t go to bed too hungry. If you are feeling hungry, have a small snack such as some nuts or a piece of cheese.

6. Avoid drinking lots of liquid in the evenings to avoid needing to get up in the night to go to the toilet.

If you answered C, then try to implement as many of these tips as possible for a good night’s sleep!

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