"Good night, Sleep tight"

In an ideal world, over a third of our lives should be spent sleeping, although most of us have less than this. In recent years, scientists have come to understand why people and animals sleep. It is during sleep that we get the chance to recover and unwind. When we sleep, the following things happen:

• Our breathing gets slower

• Muscle tension decreases

• Blood pressure and heart rate decrease

• Metabolism slows down

• Body temperature gets lower

• Our brains replace the energy and oxygen we use up during the day

• Our brains get rid of the toxins which build up during the day

Sleep is an altered state of consciousness where our bodies and brains are still active, but in a different way than when we are awake. When we fall asleep, we gradually go into a deeper state of relaxation and our bodily responses change in several ways.

The amount we need to sleep seems to be biologically driven and the amount of time we sleep changes with age. We need more sleep as children (16-18 hours as babies) than adults (approximately 7-8 hours) and often even less as we get older. Adults vary in how much they need to sleep from 5-10 hours a night. The best measure of how well we sleep is how rested we feel during the daytime. However, some adults don’t always notice their need for sleep. Some people can, despite too little sleep, function well for a certain period but in the long term may need to make up for lost sleep.

Sleep is affected very easily by physical and emotional changes. Most of us have periods of poor sleep during our lives, for example when we are unwell or stressed or when something bad has happened. Usually, this is temporary. However, some people suffer from chronic sleep problems - which can lead to various problems. It can affect our physical health, for example causing high blood pressure, stomach problems, muscle pain and lowered immune systems. Cognitive functions such as concentration and memory are often affected, and we can have mood swings and feelings of fatigue, making it hard to function in daily life. The increased stress caused by sleep problems can make us feel depressed and anxious.

Some factors that affect sleep are biological, like age and genetics, and we cannot control them. However, there are a variety of important factors that you can influence and control. These are discussed below:

1. Caffeine: Coffee, tea and some soft drinks all contain caffeine. Caffeine stimulates the nervous system, which makes us feel more alert. Caffeine has its strongest effect after about 30 minutes, but can last much longer. Try not to drink anything with caffeine in it later than 4-6 hours before bedtime.

2. Nicotine: Nicotine also affects the nervous system and wakes us up. If you are a smoker, try not to smoke before bedtime, or if you wake up in the night. Otherwise the nicotine may keep you awake, or you might wake up because you are craving a cigarette.

3. Diet: It isn’t a good idea to go to bed hungry, and research shows that a small snack before bed can help sleep. Something easy to digest and not too sugary like a glass of milk or a piece of toast is ideal. A heavy meal should be avoided, and try not to snack in the middle of the night otherwise you may wake up hungry.

4. Alcohol: Many people drink alcohol to try to help them sleep. In the short-term, some people find that alcohol can help them get to sleep, or reduce nightmares. The problem is, later in the night, alcohol increases your metabolism as the body is trying to break it down. This increases our body temperature and interferes with the quality of our sleep. So it is best to avoid alcohol for at least 4 hours before bed.

5. Exercise: Exercise can have a big effect on our sleep. Doing some exercise during the day can help you to sleep better. However, exercising too late in the evening might keep you awake.

6. Fresh air: Fresh air helps with sleep. You may have noticed how well babies seem to sleep outdoors! Try to get outside every day to get some fresh air.

7. Naps: Napping often makes it harder to get to sleep at night. If you take naps, during the day, it may be worth trying to stop and seeing if this improves your sleep at night. The aim is to increase your waking hours and make you more sleepy in the evening. If you absolutely must take a nap, do not sleep longer than 30 minutes, otherwise you will fall into a deep sleep and feel groggy when you wake up.

8. Regular sleep times: It is important to make your sleep hours as regular as possible, by going to bed at the same time every night, and waking up at the same time every morning even at the weekend. Oversleeping will make it harder to fall asleep the next night.

9. Your bedroom: Ideally, your bedroom should be quiet, dark and cool. Make sure you have good curtains or blinds that block out the light completely. You can also try a sleep mask. If your bedroom isn’t quiet, try using earplugs. Bedrooms should not be too warm. Around 13-18 degrees is perfect. This is important as our body temperature gets lower when we sleep deeply. An open window can help, even in winter. If you can, make sure your bed is as comfortable as possible. Bed linen made of cotton or linen is best, as synthetic materials can get too hot. Make sure if you have room to move, without being disturbed by your partner, children or animals.

Sleep is often affected by the thoughts and feelings that we have during the day or before we go to bed. Negative thoughts can make it more difficult to fall asleep. People with sleep problems often feel anxious about how to cope with their poor sleep, and this in turn can contribute to longer-term sleep problems. Trying really hard to fall asleep usually doesn’t work. Sleep is basically a biological process which is not completely under our control. In fact, the more we try to sleep, the more we notice if we are not asleep yet or aren’t sleeping well, which can stress us out and make it even harder to sleep!

Instead of trying too hard to fall asleep or trying to work out exactly what time you have fallen asleep, take a look at the sleep strategies below. Al of these have been shown in scientific studies to be effective at improving sleep, so we suggest you try as many of these strategies as possible.

The first strategy for better sleep is to get up at the same time every morning, including weekends, even if you feel very tired and like you don’t want to get out of bed. This helps to set your biological clock to a regular rhythm. Even though it can seem like a good idea to sleep in when you have not had much sleep the night before, this will make the problem worse.

The second strategy for better sleep is to limit your time spent in bed to the time you are actually sleeping. To help you do this, initially you can try restricting the amount of time you spend in bed so that it is as close to the actual amount of sleep you get as possible. For example, if on a normal night you lie in bed for 9 hours but only sleep for 6 of them, try spending only 6 hours in bed. This helps build up a mild sleep deprivation, which will mean you fall asleep quicker and more deeply. Once this happens, you can gradually start increasing the amount of time you spend in bed.

The third strategy for better sleep is to avoid taking naps during the day. Some people find it easier to relax during the day, and take naps to make up for missing sleep the night before. However, this can sometimes create a vicious circle, making sleep problems worse. If possible, try to avoid naps completely. If you feel you have to take a nap, do not sleep for more than 30 minutes and nap in the morning if possible.

The fourth strategy for better sleep is to only go to bed when you are sleepy. If you get to your planned bedtime and aren’t feeling sleepy, do not go to bed. Sleepiness is different from tiredness, when we are sleepy we often start yawning and feel that our eyes are heavy. Many people with sleeping problems spend lots of time preparing for sleep, lying in bed and reading, listening to music or watching TV. Unfortunately, this often does not work as the bed becomes associated with these other activities, not with sleeping. If you go to bed before you are sleepy, you may also have more time to dwell on things that are bothering or worrying you, which can make it harder to get to sleep.

The fifth strategy for better sleep is to only use your bed for sleeping and sex. The goal of this is to create a strong link between your bed and sleep. People often do other things in their bedroom such as watching TV or talking on the phone. For some people, this can make the bedroom get associated with activities and being awake. So if you are having trouble sleeping, try taking all other activities out of the bedroom. This includes mental activities such as problem solving, planning and discussing important issues with your partner.

The sixth strategy for better sleep is to not lie in bed if you cannot fall asleep. This is a very difficult strategy, but a very important one! If you are trying to get to sleep and cannot within 15-30 minutes, you should get up and leave the bedroom. Once you are up, you can do other activities such as reading a book or listening to music until you are feeling sleepy again. This strategy is helpful because it reinforces the association of the bed with sleep and not with anything else such as lying awake and thinking. This can be used if you struggle to fall asleep when you first lie down, or if you wake up in the night and can’t get back to sleep again.

The seventh and final strategy for better sleep is to take at least an hour to unwind before going to bed. To help you fall asleep, it is important to treat yourself to at least an hour of relaxation before bedtime. You could read, take a bath, listen to music or socialise to help you unwind. Try to avoid activities that are very exciting or interesting as they may wake you up.

These seven strategies are based on two main ideas, the need to associate our bed with sleeping, and the need to find the amount of sleep that suits us best. Starting these strategies can be tough, and you may feel more tired than normal for a while. But gradually, these strategies will help you to sleep better.

Hopefully, your sleep problems will improve, however, you will still occasionally have nights where you have not slept well and feel tired the next day.

If you have had a bad night’s sleep, here are some top tips to cope as best you can:

• Carry on as usual: Try to continue with your routine and planned activities even if you had a bad night. This won’t be easy, but it is important to take your mind off your sleep problems, and you may also find that you can cope better than you would think even when you are tired.

• Do something pleasant: Don’t let poor sleep stop you from doing what you want, and pay attention to your enjoyment of the activity. Pleasant activities often have the effect of cheering you up and giving you energy. Also, doing some physical activity should help you sleep better the next night.

• Manage your activities: On days when you are feeling tired, don’t try to solve difficult problems, as they will seem more complicated after a sleepless night. Try to use your time for routine, pleasant and physical activities, rather than things which need a lot of mental effort – you can save these for a time when you feel more alert. If you do have a problem that needs solving, try to break it down into small, easy tasks and try just doing the first one or two.

• Remember what works: If your sleep is improving with some of your new strategies, take a note of what has helped. That way, if you have a bad night’s sleep again in the future, you can return to your notes to help you out.

• Relaxation: Try relaxation strategies if you can’t sleep. Relaxation helps to make both your body and your brain calm, and this will increase your chances of getting to sleep.

• Spend less time in bed: It might sound strange, but the best way to improve sleep is to spend less time sleeping! You should ideally only be in bed for the hours that you are sleeping, so spending less time in bed is important when you are trying to improve your sleep. When your sleep improves, you can start increasing it again.