While sleep disturbances are common for people suffering from chronic pain, fatigue or long term illnesses, it is also not unusual for people with no health difficulties to suffer sleep problems because of lifestyle, stress or simply because they struggle to turn their mind off at night.

What happens during sleep?

• Sleep occurs in stages.
• First you close your eyes and spent a period of time in relaxed wakefulness.
• Stage 1 sleep which is a drowsy, relaxed state between waking and sleeping.
• Stage 2 sleep is a light sleep state, still easily awakened from.
• Stage 3 and 4 are slow-wave sleep of deep sleep, difficult to wake from.
• REM (Rapid Eye Movement) sleep, entering the visual, emotional world of dream sleep.
• During a sound sleep we progress from stages 1 to 4 and then to REM sleep in about 90 minute.  A good sleeper will move through four to six of these ninety-minute cycles.

Why Do We Sleep?

• Deep Sleep:  Research has shown this is a state of profound rest in which the brain and body shuts down, also serves to renew our physical energy.  It’s also a chance for our immune system to turn on to combat illnesses; this may explain why we tend to sleep a lot while ill.  Deep sleep is thought to be the most essential stage of sleep.
• Stage 2:  Probably a less potent form of deep sleep and is also involved in restoring physical energy.
• REM sleep:  Has been viewed as “window to the unconscious” however contemporary research suggests that it permits us to process and save novel information in memory.

Two Brain Systems That Govern Sleep:

• Wakefulness system; dominates during the day and keeps us awake for around sixteen hours, after that this system diminished in strength.
• Sleep system; as the wakefulness system grows weaker the sleep system becomes dominant and keeps us asleep for about eight hours.
• Some people suffering from sleep disturbances may possess a sleep system that is too weak or a wakefulness system that is too strong.

Types of Insomnia

There are two broad categories:

• Chronic insomnia - lasting for several weeks, months or even years.
• Transient insomnia - lasting for a few nights or weeks only, usually connected to a stressful event e.g. an exam, a bereavement.

Within these broad categories insomnia usually takes one or more of the following forms:

• Difficulty falling asleep - more common among young people.
• Sleeping lightly and restlessly, waking often, lying awake in the middle of the night - more common in people over 40. In younger people it may be associated with depression.
• Waking early and being unable to get back to sleep - this is more common in older people and anyone worrying about something in particular.

Common Symptoms

If you...

• are tired during the day
• have frequent headaches, are irritable or lack concentration
• are tired and not refreshed on waking
• sleep better away from home
• take longer than 30-40 minutes to fall asleep
• wake repeatedly during the night
• wake far too early and are unable to get back to sleep
• only get to sleep with the aid of sleeping pills or alcohol

...then you are probably suffering from insomnia.

Main Causes

Insomnia is a condition that is caused by something else! Sometimes it won't be immediately obvious what the causes are in your own case, but the following list might give clues:

• states of mind - anxiety, depression, worry, anger, grief, anticipating a difficult event
• change - moving house/city, starting university
• environment - noise, discomfort, time zone change
• pain - one of the commonest causes
• medical conditions - heart, breathing, stomach, digestive, high blood pressure, arthritis, anorexia.
• recreational drugs - including nicotine, caffeine, heroin, cocaine, amphetamines, LSD, cannabis
• sleeping pills and tranquillisers - can actually cause sleep disturbance
• other prescription drugs - including some contraceptives, diuretics, slimming pills, beta-blockers, stimulants.

Some causes of insomnia can't be easily dealt with but most can.

How common is Insomnia?

• It’s the most common health complain following pain and headaches. 
• Studies have suggested that about one-third to one half of adults experience insomnia.

What habits promote a good night's sleep?

Good sleep habits can help you get a good night's sleep. For example:

• Try to go to sleep at the same time each night and get up at the same time each morning. Try not to take naps during the day because naps may make you less sleepy at night.
• Avoid caffeine, nicotine, and alcohol late in the day. Caffeine and nicotine are stimulants and can keep you from falling asleep. Alcohol can cause waking in the night and interferes with sleep quality.
• Get regular exercise. Try not to exercise close to bedtime because it may stimulate you and make it hard to fall asleep. Experts suggest not exercising for 3 hours before the time you go to sleep.
• Don't eat a heavy meal late in the day. A light snack before bedtime, however, may help you sleep.
• Make your sleeping place comfortable. Be sure that it is dark, quiet, and not too warm or too cold. If light is a problem, try a sleeping mask. If noise is a problem, try earplugs, a fan, or a "white noise" machine to cover up the sounds.
• Follow a routine to help relax and wind down before sleep, such as reading a book, listening to music, or taking a bath.
• Avoid using your bed for anything other than sleep or sex.
• If you can't fall asleep and don't feel drowsy, get up and read or do something that is not overly stimulating until you feel sleepy.
• If you have trouble lying awake worrying about things, try making a to-do list before you go to bed. This may help you to "let go" of those worries overnight.

Our clinicians are willing to work alongside anyone suffering from sleep difficulties to help resolve any underlying difficulties, develop a sound pattern of sleep hygiene (good sleep habits) and learn how to reduce mental and other tension or stresses.