Sleeping is an essential part of a healthy routine, “powering the mind, restoring the body, and fortifying virtually every system in the body”, according to the Sleep Foundation.
The amount of sleep needed varies largely depending on age group. NHS guidelines indicate that typically, adults need seven to nine hours, children need nine to 13 hours, whilst toddlers and babies need 12-17 hours – although this can fluctuate depending on the individual.
Many people will experience sleep problems at some point in their life which is often solved when a certain situation or worry has been alleviated, says The Sleep Charity. Sometimes, however, these problems can persist, forcing an individual into a significant sleep deficit often known as insomnia.
Insomnia is a sleep disorder where people have difficulty getting to sleep or staying asleep for long periods of time. It is usually classed in two categories: short-term insomnia (less than three months) or long-term insomnia (over three months).
The most common causes of insomnia are:
- Mental health conditions such as stress, anxiety or depression
- Alcohol, caffeine, nicotine or recreational drug usage
- Jet lag
- An overactive thyroid
There’s a significant relationship between sleep and mental health, where living with a mental health problem can influence how well you sleep and vice versa, according to mental health charity Mind.
Stress and anxiety are the two key influences. “Stress is our body’s reaction to pressures from a situation or life event,” says Samantha Ross, Kalms product manager. “In many everyday situations stress can be seen as a normal reaction that helps keep us awake and alert, but when stress becomes excessive or persists over a period of time the opposite effect happens.”
“When our internal neuro-chemical systems are working normally, they regulate biological processes like sleep, appetite, mood and energy levels,” explains Dr Irshaad Ebrahim, neuropsychiatrist and co-founder of The London Sleep Centre. “If we are stressed, the adreno-cortical system is dysregulated and our energy sources are diverted, resulting in sleep disruption and mood changes.
“Before we sleep it’s important to de-stress, reducing levels of cortisol, and replacing them with increased levels of melatonin, the hormone released in the brain that signals to the body it’s time to sleep.”
As an individual continues to have disturbed sleep, a cycle is created where not getting enough sleep deteriorates mood, productivity and ability to concentrate, which in turn emphasises feelings of stress and anxiety. Physical aspects of stress can also lead to an increased risk of respiratory problems, heart disease, diabetes and obesity.
“Many peoples’ sleep issues are worsened through anticipatory stress, whereby we fear an outcome before the event has taken place,” adds Dr Ebrahim. “The stress-sleep cycle is when feelings of stress stop you from achieving a sufficient night’s sleep, or when the thought of not achieving a good night’s sleep intensifies feelings of stress, thus exacerbating the cycle and making it harder to break.”
Other mental health problems
These can make an individual spend more time in bed and sleep more often
This often causes flashbacks, nightmares or night terrors that have a significant effect on sleep.
For example, an individual may hear voices or hallucinate.
These can cause side effects such as insomnia, disturbed sleep and nightmares.
“Sleep powers the mind, restores the body and fortifies virtually every system in the body”
Sleep on it
Most of the time, insomnia can get better – or completely go away – if an individual adjusts their lifestyle habits. For example, customers should make sure to not:
- Smoke or drink alcohol, tea or coffee at least six hours before going to bed
- Eat a big meal late at night
- Exercise at least four hours before bed
- Watch television or use devices like smartphones right before bed
- Nap during the day
- Sleep in after a bad night’s sleep.
Sleep hygiene routine
This can be set by having a fixed wake-up time; prioritising sleep; making gradual adjustments and not having too many naps.
This could include staying consistent, allowing 30 minutes for winding down, dimming lights, unplugging from electronics and practising mindfulness.
This involves getting daylight exposure and being physically active.
This will vary from person to person but could typically include having a comfortable mattress and pillow and blocking out light and noise.
Supplements and sleep
Whilst there are many over-the-counter (OTC) products to help those struggling to sleep, “natural remedies can provide a safe and non-addictive way of coping with a bad sleep cycle”, says Samantha Ross, Kalms product manager. “Valerian root is a popular choice that has long been used to promote relaxation, reduce stress and improve sleep, depending on quantities consumed.”
Different foods can also help promote good sleep quality. “Raw honey stimulates melatonin and shuts off orexin in the body, the chemical that makes us feel sharp and alert,” adds Cheryl Lythgoe, matron at Benenden Health. “A mug of hot water, lemon and honey is a great evening drink for soothing the body and relaxation before bed.
Cherries are known for their natural melatonin that aids the internal body clock, whilst bananas contain natural muscle relaxants – magnesium and potassium – all of which help to promote sleep. “Additionally, as well as being a great source of protein, turkey is great for encouraging sleepiness. It is high in tryptophan, an amino acid that calms the body and balances your hormones, which help to induce sleep,” Cheryl adds.
Amino acids are also thought to help fight fatigue brought on by insomnia. GP Dr Nisa Aslam explains that although the body prefers to get its energy from carbohydrates, proteins and fats can also be broken down for energy when needed.
“From supporting hormone and brain health to contributing to the health of our immune system, amino acids play a vital role in the body,” she says. “They are also important for energy metabolism, the chemical reactions that take place in the body’s cells to produce energy from the diet.”
Put it to bed
Of course, not everyone who suffers from insomnia will be able to solve their problem via lifestyle changes. Pharmacy teams can help patients trapped in their sleep cycle “by talking to them and finding out more about their cause of sleeplessness,” says Samantha. “Together you can address any unhealthy habits that trigger this. For many, simple lifestyle changes will be sufficient. However, for customers who are looking for more support, there are OTC options available.”
Pharmacies can offer a variety of tablets or liquids often referred to as sleeping aids. Some many contain natural ingredients while others are an antihistamine. These will not cure insomnia but may help customers to sleep better by disrupting their cycle. They should not be taken for any longer than two weeks.
Medications can often provoke feelings of drowsiness. This could make it difficult for a customer to do certain things, like drive a car, so staff must ensure to instruct them to try to take the medication before a planned extended period of sleep.
Patients who have tried to change their sleep habits with no effects, have had trouble sleeping for months or whose insomnia is affecting their daily life in such a way they cannot cope should be referred to the pharmacist.
“Many peoples’ sleep issues are worsened through anticipatory stress.”
Common sleep disorders
Kalms Night One-A-Night is a herbal medicinal product containing valerian root which is used for temporary relief of sleep disturbances, says manufacturer LanesHealth. Further in the range is Kalms Day, which also contains valerian root and can be used for the temporary relief of symptoms associated with stress, such as mild anxiety and irritability, the company adds.
LanesHealth: 01452 524012 / kalmsrange.com