What can I do to help myself?

The causes of sleep problems often depend on the individual, and will vary according to the individual’s personal circumstances. This means that different techniques for improving or resolving sleep problems work for different people. You may need to try several different techniques in order to find what works for you. Here are some suggestions that might help you improve your sleep yourself.

Establish a routine

Try to establish a regular sleeping pattern by going to bed and waking up at roughly the same time every day. Your body will start to associate the specific times of the day with sleeping and waking. You may need to do this for several weeks in order to establish a regular pattern.

Go to bed only when you feel tired enough to sleep. If you usually take a long time to fall sleep, delay getting into bed until the point in time when you would normally fall asleep. Then get up at your usual time. This may mean you will spend less time physically in bed, but a greater proportion of the time you spend it bed will be when you are asleep. Hopefully your sleep pattern will improve.

If you are in a different time zone after a flight, do what you can to adjust to the new time. However tired you feel, go to bed close to the local bedtime, then get up reasonably early the next morning. Your body should then adjust to the new time quickly.

Make sure where you sleep is comfortable

Before you go to bed, make sure that where you sleep is comfortable, and that the temperature, light, and noise levels are right for you. People have different ideas of what is comfortable, so you may need to experiment to work out what works best for you. Generally, dark, quiet, and cool environments are ideal for sleeping comfortably.

If there is anything in particular that is disturbing your sleep in the night, such as a partner that snores or a loud clock that keeps you awake, try to find a solution. You may want to sleep in a different room from your partner for a few nights, or use earplugs to block out any noise. If light is stopping you from sleeping, using thick, black blinds or curtains may be helpful.

Relax before you go to bed

It is important to relax and switch off from daily worries before you try to go to sleep. Stop any stimulating activities, such as working or doing exercise, and avoid looking at screens, such as phone screens, computer screens, TV screens, or tablet screens, an hour before you go to bed (see ‘Regulate light exposure’).

It may also help to do something calming before you go to bed, such as listening to relaxing music, doing something creative, or having a bath.

If you still struggle to go to sleep, you may find you need a more structured relaxation routine. There are several things you can try:

  • Breathing exercises. For example, in a comfortable position, breathe in deeply, then breathe out slowly, making your out-breath longer than your in-breath
  • Muscle relaxation. For example, consciously tense and then relax your muscles, one after the other, starting with your toes and working up your body until you reach the top of your head
  • Visualisation. For example, picture a scene or landscape that has pleasant memories for you
  • Meditation. You can learn meditation techniques at a class or by using self-help materials

Avoid doing stimulating activities in the bedroom

If you carry out stimulating activities in your bedroom, you may start to associate your bedroom with being active. This could mean you find it hard to relax and go to sleep in your bedroom. Avoid doing stressful activities in your bedroom, such as studying, working or doing exercise. Even doing supposedly relaxing activities like watching TV or using a laptop in bed can stimulate your mind and cause you to associate your bedroom with being active, making it hard to fall asleep.

Don’t force yourself to sleep if you can’t

Do not try to force sleep, as this will only make you feel more anxious. If you are finding it difficult to sleep, get up, go to another room and try to relax there. Do something soothing, such as listening to music, until you are tired enough to go back to bed. If you are awake for long periods, repeat this process as many times as you need to.

If you are lying in bed and are unable to sleep, try keeping your eyes open. As they start to close, tell yourself to resist. Often the more you try to stay awake, the sleepier you become.

If you cannot fall asleep because of unwanted thoughts, you may find it useful to use a distraction technique. For example, you may find that visualising a pleasant place or occasion, or repeatedly saying a few words or a phrase, can help. Doing breathing exercises or focusing on your breathing can also distract you from unwanted thoughts that are keeping you awake.

If you wake up during the night, go through your relaxation routine again before trying to go back to sleep.

Catch up on missed sleep

If you have missed out on a lot of sleep, or you are not sleeping at all, you may find you need to catch up on missed sleep. For example, you may want to sleep an hour or two more at weekends, or have short naps during the day.

However, it is important to try not to sleep too much during the day as this may change your sleep routine and affect how well you sleep at night. Try to nap only when it is essential, for instance when you are very sleep deprived and it would be impossible or dangerous to carry on with your usual daily tasks. Try not to sleep for too long, and nap at a regular time each day. Generally, 30 to 40 minutes in the early afternoon works well for people.

Diet and physical activity

What you eat and drink can affect how well you sleep. Be careful about using stimulants like alcohol, caffeine and nicotine, particularly in the evening. Large meals late in the evening should also be avoided. It is also a good idea to avoid drinking too much liquid before you go to bed, so you do not need to get up to use the toilet in the middle of the night.

Doing regular physical activity, especially physical activity outdoors, can also help you sleep, as it makes you more physically tired. This does not have to be strenuous exercise. Any activity, for example housework, going for a walk, or yoga can make you more physically tired and thereby help you fall asleep easier. However, avoid doing exercise late in the evening, as the brain chemicals exercise releases give you energy, which can affect your ability to sleep.

Regulate light exposure

Light has an important impact on how well you sleep. Generally, you will sleep better at night if you have spent time in natural daylight during the day. If you spend most of the day inside, try and incorporate short breaks into your daily routine where you go outside.

If you cannot go outside, you may find it helpful to use a light box to regulate your light exposure during the day. Light boxes are extremely bright lights with at least 10 times the intensity of household lights. They are designed to replicate natural daylight.

At night, avoid bright lights, as they can disturb your sleep. Turn off backlit electronic devices such as smartphones, tablets or laptops, and dim the lights in the room where you are going to sleep. If you wake up in the middle of the night and need to use the toilet, avoid switching on a main light as you may find it harder to fall asleep again afterwards.

Keep a sleep diary

If you have been experiencing sleep problems for a long time, and you are finding it difficult to work out what is affecting your sleep, you may find it useful to keep a sleep diary. A sleep diary involves recording information about your sleep habits. This can help you identify the factors that are affecting your sleep. It may also be helpful for any professionals you are working with.

A sleep diary could include information about:

  • What time you go to bed
  • What time you get up
  • Total hours of sleep
  • Overall quality of sleep; you may express this on a scale
  • How many times you wake up in the middle of the night
  • How long you are awake for when you wake up in the middle of the night
  • What you do when you wake up in the middle of the night
  • Whether you have nightmares, night terrors or sleep paralysis during the night
  • Whether you sleep-walked during the night
  • Whether you sleep during the day and for how long
  • Any medication you are taking, including dose and what time you take it
  • The amount of caffeine, alcohol or nicotine you have
  • The amount of physical activity you do
  • What you eat and drink
  • Your general feelings and moods, including any anxious and repetitive thoughts

You could create your own sleep diary, or you may want to use a template. You may need to try a few before finding one that suits you.

Try to resolve stresses and worries

Try to identify anything in your life that is causing you stress or worry, as stress and worry affects one’s ability to and quality of sleep. For example, you may be worried about relationship problems or your financial situation. Alternatively, you may be sleeping badly because you have a stressful job or are taking on too many responsibilities.

Once you have identified what is causing you stress or worry, there may be practical measures you can take to address the problem, such as visiting a financial advisor or talking to your employer about reducing your workload. This may help to improve or resolve your sleep problems.

Some people also find it useful to write a list of what is worrying them early in the evening, to help get rid of anxieties before sleep.

Try a herbal remedy

You may find that herbal sleep remedies, such as hop or lavender pillows, or a few drops of lavender oil in the bath or on your pillow, help you relax. There is also some evidence to suggest that valerian, passion flower and lemon balm help to promote sleep. Check with your doctor or a pharmacist before taking a herbal remedy to make sure it is safe for you, particularly if you are taking any other medication.

Recognise and challenge unhelpful thought patterns about sleep

If you have long-term sleep problems, it may be because you have developed unhelpful thoughts or associations about sleep which are making the problems worse. If this is the case, you may need to learn to recognise and challenge your thoughts about sleep. Self-help materials may help you do this. Self-help materials based on Cognitive behavioural therapy (CBT) techniques have been shown to be effective in treating sleep problems. CBT is a talking treatment that helps people change negative patterns of thinking or behaviour (see ‘Treatments’). There are many CBT-based self-help materials, for example templates, worksheets and exercises, available in books and online.

However, it may be difficult to change the way you think, and you might find that you need help from a professional, particularly if your sleep problems started a long time ago or in childhood (See ‘Treatments’ below).

 

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