Poor sleep regularly affects a third of people in Britain but when sleep affects quality of life and ability to function normally it is classed as a more serious health issue: insomnia. “It’s the most commonly reported mental health complaint in the UK. People with insomnia will complain about poor quality sleep, with symptoms that include not being able to get to sleep, waking up in the middle of the night and not being able to get back to sleep and/or waking too early,” explains clinical psychologist and member of the British Sleep Society Dr Gabriella Romano, who runs training and workshops on sleep for health professionals.
In fact, the Government is so concerned about the impact of insomnia on people’s health and wellbeing that it is drawing up guidelines on how much sleep everyone needs and explaining sleep hygiene steps to help achieve it. “Sleep is as important as diet and exercise when it comes to the nation’s health. But we place no importance on it. People go to huge amounts of time and expense to eat well and exercise regularly, but without a good night’s sleep all that effort will be in vain,” says Lisa Artis, chief adviser at the Sleep Council. “Research shows we aren’t getting enough sleep and it’s slipping down people’s lists of priorities.”
Sleep expert Neil Stanley agrees, commenting: “While insomnia itself isn’t increasing, getting a good night’s sleep is no longer as high in importance in today’s modern lifestyles – becoming a luxury for many. Technology and our 24-hour society definitely play a role in this.”
Sleep is essential for good health and wellbeing, as well as enabling people to get through daily tasks safely and effectively.
Being tired significantly affects judgement and one in five crashes on major roads are related to lack of sleep, according to the Royal Society of Public Health. Other sleep-related accidents are a major cause of injury and death, but insomnia is linked to many more health conditions too such as high blood pressure, diabetes, depression, heart disease, cancer and stroke.
Sleep is important for conserving energy for cell renewal and growth, restoring the brain and body and organising networks in the brain. A recent study published in the Journal of Experimental Medicine discovered that sleep improves the ability of immune cells to fight infection so even just a short period of poor sleep, people become more vulnerable to infection.
Poor sleep also affects appetite-regulating hormones, making cravings for junk food more likely and reducing the inclination to exercise regularly, which links insomnia to obesity.
And it’s not just physical health, almost four in five people with chronic insomnia have low mood and research suggests that insomnia may also be a factor in Alzheimer’s disease. It increases the risk of developing severe depression, suicidal behaviour and suicide. And it’s now thought that insomnia is not just a symptom of mental health conditions but may be involved in the cause and maintenance of these conditions too.
Sleep patterns are controlled by two systems in the body:
A normal night’s sleep is divided into four main parts. Each cycle lasts around 1.5 hours and all four stages need to be experienced in order to wake up rested:
Most people need six to nine hours sleep a night. However, younger people tend to sleep for longer and older people for less than this. “There are no hard and fast rules about the amount of sleep each of us needs. It’s more about getting the right amount for the individual that allows them to feel awake and refreshed the next day,” says Neil.
A recent survey has revealed that more than two-thirds of people (67 per cent) think more education and public health initiatives from the Government are needed to promote good sleep health.
As a result, the Sleep Council is calling on the Government to make a good night’s sleep a public health priority and place greater emphasis on sleep in terms of advice, education and sleep support services.
“We do understand there’s complexity around sleep. You can’t just tell people to get eight hours of sleep a night. Some people would clearly love to but don’t know how to go about doing that or there may be external factors stopping them,” says Lisa Artis, chief adviser at the Sleep Council. “What we want is for the Government to take action and provide better sleep support services so there is somewhere for people to be signposted to and make sure these services are offered by accredited sleep practitioners.”
Insomnia can generally be divided into two types:
There are many causes of secondary insomnia and it’s important to ask the right questions to find out the cause, which can include the following:
Sleep is as important as diet and exercise when it comes to the nation’s health
“Pharmacy staff can support customers with self care tips to help prevent sleep problems by recommending a good bedtime routine and addressing unhealthy sleeping habits,” says Neil.
Part of this may include reassurance about the fact that there is not a set number of hours of sleep someone needs. Some people may need more and some need less than the average six to nine hours a night – it all depends on how they feel during the day. It can also help to explain that it’s normal to wake for short periods during the night and that being anxious about being awake and worrying about poor sleep will only make them less likely to sleep.
“Sleep is as critical to a healthy lifestyle as diet and exercise and customers should be advised on what the effects are from lack of sleep,” says Lisa. “It’s important that pharmacies encourage customers to look at their sleeping patterns and their habits in the run up to bedtime. To ensure they experience healthy sleep it’s essential to follow good lifestyle habits and eliminate the factor or factors that are causing disturbed sleep.”
One in five crashes on major roads are related to lack of sleep
The Sleep Council has produced the 10 Commandments of Good Sleep, in conjunction with Professor Jason Ellis, a sleep expert from Northumbria University, as part of its annual sleep awareness campaign Sleeptember.
“With the wealth of studies, surveys and expert opinions, it has led to a lot of conflicting messages. By looking at the different advice and scientific evidence, it’s been possible to create a simple, best practice guide for achieving a healthy night’s sleep,” says Jason. The 10 Commandments of Good
If customers have recently started suffering with sleep issues, Lisa says that sleep hygiene measures may help to solve the problem. “The key is completing a diary for two weeks to see what you are doing, what you are eating etc, on the days when you do and don’t sleep well. From that you can start to identify what sleep hygiene principles to put into place. However, if sleep problems have been going on longer than three months, for at least three nights a week, customers may need some further intervention from their GP.”
Adopting good sleep hygiene habits should be the first way of managing insomnia and for many people this will be enough. However, for customers who need more help, there are several options available:
In conjunction with the Sleep Council, Penguin Random House has developed a series of audiobook stories aimed at people with chronic insomnia, which are designed to help send listeners off to sleep.
The Penguin Sleep Tales series of short stories, each 15 minutes long, is designed to calm the mind and relax the listener, encouraging them to visualise calming settings and landscapes to provide the right frame of mind for sleep.