Do you have trouble sleeping ?

Help is at hand

Fixing Broken Sleep

“I’ll sleep when I’m dead”.

This famous quote from “Werewolves of London” singer songwriter Warren Zevon in some ways sums up the ‘she’ll be right’ attitude many Australians have had in the past to getting adequate amounts of good quality sleep.  Unfortunately, Warren passed away in his early fifties (which is curious in itself).

Thankfully Australians are now starting to realise that along with a balanced diet and regular exercise, sleep is vitally important in ensuring holistic good health.  Much of this greater awareness around sleep deprivation has been fed by increased screen time for many people, particularly at night time.  Additionally, older people wanting to stay active and enjoy life to the fullest are now more aware of poor sleep patterns and its impacts on their quality of life.

So, how do you get to sleep and stay there?  Who is the best person to talk to about getting to sleep, and back to sleep?  There is a better alternative to Googling it, and trying to work it out for yourself? Help is at hand.

Doctors know that chronic conditions can be very debilitating, both physically and mentally, and they regularly assist patients to manage their diabetes, hypertension, high cholesterol, asthma etc.  Your doctor is trained to understand and diagnose such conditions, to seek specialist support where appropriate, and to help you treat and manage them.  Obstructive Sleep Apnoea (OSA) and insomnia are chronic conditions which disrupt sleep.  Your doctor is the best person to start you on the journey to better sleep.

  • Waking is part of normal sleep, but an individual should be able to return to sleep easily:
  • adults need a minimum of 6.5 hours of quality sleep.
  • teenagers need a minimum of 9 hours quality sleep.
  • routines are important; establish daytime, evening and night time habits:
  • waking at the same time in the mornings is more important than going to bed at the same time
  • some flexibility allowed at weekends / during holidays.
  • limit screen time & use of electronic devices before bed especially the immediate 3-4 hours prior to bedtime (see below about light exposure)
  • avoid clock watching during sleep, keep it out of reach, preferably outside bedroom.
  • eating & drinking:
  • avoid large meals before bed, especially the immediate 3 hours before sleep
  • small snacks before bed is OK but avoid eating in the middle of the night.
  • avoid stimulants:
    • cigarettes.
    • caffeine:
  • maximum level is circulating in blood at 1 hour after ingestion
  • half-life of about 4 hours
  • caffeine content:
    • coffee ~200mg
    • tea ~50mg
    • caffeinated soft drinks~ 100mg
  • alcohol is a sedative initially but becomes a stimulant later in the night
  • sleep is about confidence – whenever possible do not take your worries with you to bed:
  • journaling – allocate dedicated time for writing diary & task list
  • externalising emotions may help – write down your feelings on a piece of paper and throw it away after finishing.
  • meditation / breathing techniques (abdominal breathing) / nasal breathing / muscle relaxation.
  • mindfulness: visualisation, awareness of the moment.
  • temperature;
    • room temperature ideal for sleep is around 18C
    • core body temp needs to drop 1-1.5C to initiate sleep
    • warm shower approx. 30-60minutes before bedtime can be helpful
    • opening of skin pores facilitates heat loss.
    • cotton socks / gloves (keep peripheries warm), light clothing to allow core temperature heat release.
  • light:
    • light suppresses melatonin and inhibits sleep
    • keep bedroom dark to facilitate sleep
    • block out curtains are ideal to also block out noise, eye shades.
    • a low light environment & low intensity background white-noise can be comforting for children.
    • exposure to morning light is helpful
    • outdoor light is better than indoor light.
  • exercise regularly for the reasons above (light & temperature regulations):
    • morning exercise in the outdoors is preferred.
    • avoid exercising 4 hours prior to bedtime as it raises core body temperature.
  • comfort:
    • 30% of our lives are spent in bed, invest in a good mattress, pillows and sheets / blankets.
  • power napping:
    • during the day can be helpful.10-20 minutes only and do it BEFORE 3PM.

formerly known as bed restriction therapy.

  • make it a habit: heads down + lights off = sleep.
  • bed is strictly for sleep and sex ONLY:
    • do NOT read, listen to music or watch TV in bed.
  • get out of bed if unable to sleep in bed by 15-20 minutes:
    • go outside of the bedroom into a “quiet room” with dim warm light.
    • do low level activity in the “quiet room”:
  • read fashion magazine, recipe cook book etc.
  • repeat journaling (see above).
    • try going back to bed after 15-20 minutes, but if unable to sleep in bed by 15-20 minutes, repeat the process as above.
  • going to bed early doesn’t guarantee more sleep:
    • the more time you spend in bed unable to sleep, subconsciously trains your brain of this “bad” sleep behaviour and encourages anxiety.
    • go to bed later increases sleep debt / drive – counter intuitive but this generates better sleep efficiency.
    • gradually bring forward going to bed time by 15 minutes every couple of days.
    • do not restrict more than 5 hours of sleep per night.
  • catch up sleep:
    • sleep debt does NOT need to be repaid in full.
    • best repaid during dark hours rather than light hours.
    • going to bed earlier when tired is better than sleeping in.