The complete guide to insomnia and how you can manage it

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Chapter one

An introduction to insomnia

Tossing and turning. Being unable to switch off. Struggling to get restful sleep. We’ve all been there. Not being able to drift off and stay asleep can be so frustrating. It affects you into the next day too, as most people find it hard to function on limited sleep.

But imagine if this happened night after night. For some people, this is a reality. According to the NHS, insomnia means you regularly have problems sleeping. This could be difficulties falling asleep, staying asleep or a combination of both.

More recently, more than half the UK population has been struggling with sleep during the coronavirus pandemic, according to King’s College London. While for some of those surveyed, the lockdown and change of lifestyle has been a chance to “rediscover the importance of sleep”, nearly two-thirds of the public reported some negative impact on their sleep.

Of course this shows how unsettling the pandemic has been for people. But the researchers also suggested that a lack of sleep may have a knock-on impact on people’s capacity to be resilient during the pandemic.

We all need to sleep. If you regularly have a broken night’s sleep or struggle to rest at all, it’ll affect you day-to-day. Numerous things can keep us up at night. Whether that’s anti-social working hours, work-related stress or money worries, you’ll want to work out what’s happening and how to get some well-deserved rest.

How many people struggle with sleep?

We all know how it feels to be tired. But working out the right sleeping pattern for yourself isn’t easy. The amount of hours of sleep people get often fluctuates throughout the week and it can be hard to pin down when you feel your best – and what sleeping pattern contributed to that.

But there are guidelines for how much sleep you should aim for. The recommended amount of sleep you need depends on your age:

Category Age Amount of sleep
required each day
Newborns 0-3 months 14-17 hours
Infants 4-11 months 12-15 hours
Toddlers 1-2 years 11-14 hours
Preschoolers 3-5 years 10-13 hours
School age children 6-13 years 9-11 hours
Teenagers 14-17 years 8-10 hours
Younger adults 18-25 years 7-9 hours
Adults 26-64 years 7-9 hours
Older adults 65+ 7-8 hours
Source: National Sleep Foundation

But there’s some bad news. According to research, almost half of UK adults don’t get the right amount of sleep. A third have insomnia of some kind.

And it turns out we’re not that good at doing anything about it either, with more than half not taking any measures to help them sleep better. Dr Doug Wright, Medical Director, Aviva UK Health comments:

“The most important thing is to take persistent trouble sleeping seriously and not to suffer in silence.”

Sleep is crucial to the healthy functioning of your body. It makes sure your body and brain can repair, restore, and re-energise. In fact, on average, we spend around a third of our life asleep. Just like eating and drinking, it’s essential to stay alive and well. So if you’re struggling to get enough shut-eye, it’s important to get help.

Woman waking up
According to research, almost half of UK adults don’t get the right amount of sleep.
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Causes of insomnia

Many people start trying to improve the quality of their sleep by themselves. Indeed, understanding what might be causing you to have sleepless nights can start to build a picture of how to improve your routine.

According to the NHS, the most common causes of insomnia are:

  • Stress, anxiety or depression
  • Noise
  • A room that’s too hot or cold
  • Uncomfortable beds
  • Alcohol, caffeine or nicotine
  • Recreational drugs like cocaine or ecstasy
  • Jet lag
  • Shift work

But illnesses and the medicines for these illnesses can also cause insomnia, including:

  • Mental health conditions, such as schizophrenia or bipolar disorder
  • Alzheimer’s disease or Parkinson’s disease
  • Restless legs syndrome
  • Overactive thyroid

Insomnia is a complicated condition and comes in different forms. As a result, not everyone’s experience of insomnia will be the same. It can be nice to speak to other people who struggle with sleep, but it can also be frustrating to receive advice which you know hasn’t worked for you.

That’s why it’s important to understand the different types of insomnia:

Acute insomnia

Typically caused by a life event, such as grief or work-related changes, acute insomnia describes any brief period of difficulty sleeping.

Chronic insomnia

Anyone who has a long-standing history of difficulty sleeping could have chronic insomnia. It’s any long-term pattern of problems falling or staying asleep.

Comorbid insomnia

If your insomnia occurs with another condition, it’s described as comorbid insomnia. For example, depression or anxiety. The term could be used to describe insomnia that’s a symptom or results from another illness, or if insomnia causes or worsens another condition.

Onset insomnia

When you have difficulty falling asleep at night.

Maintenance insomnia

When you have difficulty staying asleep throughout the night.

Tired man
Insomnia is a complicated condition and comes in different forms. As a result, not everyone’s experience of insomnia will be the same.
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The effects and health risks associated with sleep deprivation

We all know sleep is important and have felt how awful it can be the next day (or days) if you’ve had limited or no sleep. But what does it do to your body?

Why we sleep

Well, we need sleep. And it’s widely accepted that there are numerous theories why. While scientists don’t agree on the definite answer of why we need sleep, by better understanding the many theories, we can learn more about the function of sleep and how it helps us.

According to the Division of Sleep Medicine at Harvard Medical School, the main theories include:

Inactive theory

This is one of the earliest theories of why we sleep. You may have also heard it called the adaptive or evolutionary theory. It suggests that being inactive at night was a survival function. In other words, it kept us out of harm’s way. Animals with this behavioural strategy were at an advantage to those who stayed active at night and therefore it evolved to what we now know as sleep through natural selection.

Energy conservation theory

This theory is also based in natural selection, as one of the strongest factors for survival is the utilisation of energy resources. Therefore, it suggests that the function of sleep is to reduce the body’s need for energy at the most effective time of day – night. That’s because it’s the least efficient time to search for more food and more energy. There’s also research to back this up, as energy metabolism reduces during sleep by as much as 10% in humans and even more in other species.

Restorative theories

There’s been a long-held belief that one of the purposes of sleep is to restore the body. It’s the chance to repair and rejuvenate. And over the years evidence has built from both human and animal studies that this is true. In animal studies, scientists have shown that if animals are deprived of all sleep, they die in just a matter of weeks. In humans, many major restorative functions occur mostly, or only, during sleep. These include:

  • Muscle growth
  • Tissue repair
  • Protein synthesis
  • Growth hormone

Brain plasticity theory

Brain plasticity refers to changes in the structure of our brains and how they’re organised. It’s been found that this phenomenon correlates with sleep. We know that sleep is crucial for the brain development of babies and children, who spend more time sleeping than adults. But it’s also clear that there’s a link in sleep and brain plasticity in adults too, especially in the effect that sleep deprivation has on our ability to perform even basic tasks.

There has been a lot written about why we sleep. We recommend Matthew Walker’s Why We Sleep: The New Science of Sleep and Dreams. It’s a fascinating subject, and one which we continue to learn about.

Person trying to sleep
We need sleep, and it’s widely accepted that there are numerous theories why.

Signs of sleep deprivation

The importance of sleep is apparent in what happens to our bodies when we don’t get enough of it. We can feel it. It’s harder to focus or communicate as well. It’s been proven that a lack of sleep has a profound impact on our brain’s ability to function. It’s essential for key cognitive skills, such as remembering important information and being creative and flexible in thought.

You’ll notice the effects of a lack of sleep across all areas of your life, including work. In fact, according to Business in the Community, the annual cost of lost sleep to the UK is around £30 billion with 200,000 working days lost every year due to insufficient sleep. The signs of sleep deprivation include:

  • Decreased communication
  • Performance deterioration
  • Poor concentration/easily distracted
  • Poor cognitive assimilation and memory
  • Poor mood/inappropriate behaviour
  • Greater risk-taking behaviour
  • Inability to make necessary adjustments
  • Increased intake of caffeine/energy drinks
  • Increased sickness

Of course, some of these signs might be noticeable to you, some might be noticed by your family or friends, or even your employer. But all signs should be taken seriously. In fact, the earlier you can take action, the better. Lisa Artis from The Sleep Council says:

“Poor sleep and fatigue are common problems, affecting millions of people world-wide. Chronic sleep debt can have a seriously damaging effect on our mental and physical health and research shows that lack of sleep erodes concentration and problem-solving ability. Each hour of sleep lost per night is associated with a temporary loss of one IQ point.

Early detection is key if someone is suffering with lack of sleep. It is much easier to help and solve the problem if it’s addressed quickly. Once a sleep issue becomes a sleep disorder, such as insomnia, it becomes much harder to change the learned behaviour and habits.”

Person sleeping at their desk
You’ll notice the effects of a lack of sleep across all areas of your life, including work.

Effects of sleep deprivation

Ignoring the signs of sleep deprivation is dangerous. While the occasional sleepless night may make you irritable and tired, the effects of several sleepless nights get worse and threaten your health. According to the NHS, you’ll start to feel your brain getting foggy, it’ll become difficult to concentrate or make decisions. As a result, your risk of injury and accidents increases.

Further down the line and with more limited sleep, your overall health can be affected. A lack of sleep can even make you prone to medical conditions, such as obesity, heart disease, high blood pressure and diabetes.

Other potential effects of a prolonged lack of sleep on your health and wellbeing include:

A weakened immune system

You’re likely to catch more colds and coughs as a lack of sleep disrupts your immune system.

Prone to weight gain

It’s believed that sleep-deprived people have reduced levels of leptin (the chemical that makes you feel full) and increased levels of ghrelin (the hormone that makes you feel hungry).

A loss of libido

Research suggests that both women and men who don’t get enough sleep experience a loss of interest in sex.

Woman using phone

Chapter two

Managing insomnia

Having a couple of nights of restless sleep doesn’t mean you have insomnia. You may experience occasional episodes of short-term insomnia throughout your life. Sometimes it may go if you manage it yourself, but for some people, insomnia can last months or years. It can be debilitating, with a massive impact on quality of life. Some long-term sufferers told the BBC what it was like living with insomnia, describing it as follows:

“Going to sleep for most people is as easy as breathing and walking but for me it’s the hardest thing in the world”

“Everything revolves around my insomnia. I have no problem getting to sleep but after four and a half hours, I wake up and that’s it. If I go to the cinema or theatre I start nodding off because I’m so tired.”

Whether insomnia is new to you or you’ve been suffering for some time, managing it is essential.

The importance of environment, exercise and diet

Have you ever heard the term ‘sleep hygiene’? It refers to efforts to create the ideal conditions for a good night’s sleep and it’s often the first step for people suffering insomnia. Indeed, self-care is an important first step to promote good sleep routines. Self-care simply refers to any activity you do (and enjoy doing) which takes care of your health. This could be physical, mental, emotional or spiritual health, and includes steps you may take to improve your sleep.

Everyone’s ideal conditions for sleeping will vary, but there are some common themes. Poor sleep is often caused by bad sleeping habits, so if you can tackle these, you may start to see marked improvements in your sleep.

How modern life affects our ability to rest

We rely on technology. And for some of us, perhaps we rely on it too much. But it isn’t just the stress of getting an important email late at night that keeps us up, the blue light affects our ability to sleep easily too. Screens (computers, tablets, smartphones and some TVS) emit blue light and it’s been shown this light suppresses the sleep-inducing hormone ‘melatonin’.

But it’s not only about the blue light. If you’re checking your phone or laptop before bed and you read something exciting or upsetting, it could impact your ability to fall or stay asleep. Similarly, reaching for your phone in the night because you’ve seen notifications light up the screen will disrupt your sleep.

Tips for minimising the effect technology has on our sleep include:

If it’s necessary to use any device with a screen that emits blue light late in the evening, turn down the brightness (you can download apps like f.lux and Twilight to do this for you), keep the device far away from the eyes and consider using anti-blue light screen protectors or glasses which shield your eyes from the blue light.

Keep your phone out of the bedroom. You can buy an alarm clock so you don’t need to rely on your phone to wake you up, and keep your bedroom technology-free. Similarly, making calls, watching TV or eating in bed are all activities that could be done elsewhere. The idea is that you create a bit of a restful sanctuary in your bedroom, one that’s dedicated to sleeping.

Item Caffeine (mg) per
serving
Caffeine (mg) per
100g
Brewed coffee 72 40
Brewed tea 36 20
Cola 30 8
Reduced sugar cola 53 15
Red Bull 77 30
Source: The Guardian

Both tea and coffee, as well as other beverages and foods, contain varying amounts of caffeine. It’s caffeine which gives you the awake feeling so many people crave, especially in the mornings. Many people have a coffee or a tea to get their day started. Caffeine makes people feel more alert as it helps stimulate the body, increasing heart rate and blood pressure.

Caffeine also blocks the actions of adenosine. Neurons in our brains produce adenosine as a by-product of the cells’ activities throughout the day. All the time we’re awake, adenosine accumulates and levels remain high. In fact, scientists think it’s this build up which then promotes our drive to sleep. While we sleep, adenosine is cleared from our systems and we wake up feeling refreshed. By blocking adenosine in the brain, caffeine also helps to keep the feeling of sleepiness at bay.

The effects of caffeine may be great during the day, but when you’re tossing and turning because you’ve had too much, it can be frustrating. Even more so when you wake up and need a cup of your favourite beverage to get started again.

Over the years, there’s been some concern about how much caffeine is too much. A study by the Harvard School of Public Health, and reported by the BBC, suggested that “coffee drinking doesn’t have any serious detrimental health effects” and that drinking up to six cups a day was “not associated with increased risk of death from any cause”.

However, drinking six or more cups of caffeinated drinks a day may lead to a dependency. You could find it difficult to stop drinking as much or experience withdrawal symptoms, such as feeling tired and anxious or getting headaches. Too much caffeine can also:

  • Make you feel irritable or wound up
  • Increase your blood pressure
Using laptop in bed
But it’s not just technology we’ve come to rely on. In the UK, we now drink approximately 95 million cups of coffee per day.

Caffeine isn’t the only thing that can help you feel more energised. It’s widely accepted that exercise contributes to better sleep. What’s more, depending on your fitness levels, you might only need around 30 minutes of moderate aerobic exercise to feel the difference in your sleep that same night. You don’t need to start training for a triathlon to feel the effects.

But why does exercise help with sleep and overall energy levels? There are two main reasons:

Exercise makes us feel good

When we exercise, the body releases endorphins. These feel-good hormones that follow a workout create what you’ll often hear described as a ‘runner’s high’. It’s a positive and energising feeling, and can even relieve pain.

Exercise improves our sleep

Studies have shown that an increase in exercise can help with insomnia symptoms and mood. One study encouraged people with insomnia to engage in a minimum of 150 minutes of moderate-intensity physical activity spread over the course of a week. They experienced a significant reduction in the severity of insomnia symptoms and an elevation in mood.

Unfortunately, when you’re tired, it can be even harder to find the motivation to exercise – despite knowing the benefits it has on sleep. Adults who experience trouble sleeping tend to be less active than those who sleep well. Indeed, research has shown that adults with insomnia symptoms are less activeand have lower cardiorespiratory fitness levels.

But what’s even more interesting about research into the relationship between sleep and exercise is that poor sleep is a strong predictor of physical activity undertaken the next day. Not only has this been found in naturally-occurring sleep problems, but with an imposed sleep durations too. When participants were restricted to less than six hours of sleep a night, it resulted in lower activity levels in the day.

What all this means is that while exercise is often – and rightly – recommended for improving poor sleep, a lack of sleep itself can be a real impediment to starting or maintaining a more active lifestyle.

There’s also the debate about when to exercise. Because exercise can make you feel alert, some people struggle sleeping if they’ve done a workout later in the day. A lot of it is down to the individual. Charlene Gamaldo, M.D., medical director of Johns Hopkins Center for Sleep, says:

“We have solid evidence that exercise does, in fact, help you fall asleep more quickly and improves sleep quality. But there’s still some debate as to what time of day you should exercise. I encourage people to listen to their bodies to see how well they sleep in response to when they work out.”

If you’re struggling, start by increasing your levels of exercise slowly. Try and find something you enjoy – whether that’s playing tennis with a friend or a long walk – because it’ll help you stick with it and reap the benefits.

Person running
Studies have shown that an increase in exercise can help with insomnia symptoms and mood

Is your bedroom set up for sleep?

Whatever you’ve done in the day to try and help you sleep can easily be undone by the wrong sleeping environment. If you suffer from sleeping problems, you need to give yourself the best chance of rest. Environments that are too hot, cold, noisy or bright often contribute to problems falling or staying asleep.

Start by setting fixed times for going to bed and waking up – and stick to them. It doesn’t matter what time you choose to wake up every morning; it’s the consistency that helps with a full night’s rest.

Then turn to your bedroom. There’s a pretty strong association in our minds between sleep and bedrooms. But this can be affected when we use our bedrooms for other things. If you work from home, for example, you might be tempted to work from bed. Ideally you shouldn’t be sitting or lying on your bed until you actually need to sleep, so working from bed is a bad idea.

Similarly, when we spend a lot of time watching TV or browsing through our phones in bed, it weakens the link. The NHS advise that you keep your bedroom just for sleep and sex. Over thousands of years, we’ve evolved so that sex makes us quite sleepy.

Other environmental factors to consider include:

Light

For most people, it’s easier to sleep if it’s as dark as possible. You can use thick curtains or blackout blinds to block out the outside light. You might find an eye mask useful.

Temperature

The ideal temperature is between 18C and 24C. Depending on the season, you may need to open a window or have a thicker duvet to feel a comfortable temperature.

Noise

All electric gadgets should be off, on silent mode or, ideally, away from the bedroom to avoid any notification noise. If you’re disturbed by noise coming into the bedroom, earplugs might be helpful.

Comfort

Your bed needs to be as comfortable as possible, including the mattress, pillows and covers. Make sure it’s washed and changed regularly.

Trying to sleep
The NHS advise that you keep your bedroom just for sleep and sex.
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Medication and treatment from your GP

The treatment of insomnia can often require medication or therapy. The first steps are often making sleep hygiene changes, as outlined above. If this doesn’t help, then your GP may recommend cognitive and behavioural treatments or prescription sleeping tablets.

The NHS recommend seeing a GP if:

  • Changing your sleeping habits has not worked
  • You have had trouble sleeping for months
  • Your insomnia is affecting your daily life in a way that makes it hard for you to cope

Sleeping tablets are only prescribed as a short-term solution and after trying other methods first. That’s because they can be highly addictive. Zopiclone is one of the medications used to treat bad bouts of insomnia, but will only be prescribed for two to four weeks. Your body gets used to it and the tablets won’t have the same effect after that amount of time. If you keep using them, your body may become dependent on the tablets. Other non-benzodiazepine sleeping pills may be prescribed, with varying side effects. But sleeping pills are never recommended for long-term use.

Your doctor may also recommend cognitive behavioral therapy (CBT) for chronic insomnia. CBT for insomnia is also referred to as CBTi. CBTi is a type of therapy which gets you to challenge any unhealthy beliefs or fears you might have around sleep. If you’ve struggled with sleep for some time, it’s likely you’ll have built up unhelpful thoughts or habits. CBTi encourages rational thinking. Unlike medication, it can help you overcome the causes of your insomnia rather than just temporarily deal with the symptoms.

Challenging self-defeating thoughts that fuel insomnia
Self-defeating thought: Sleep-promoting comeback:
Unrealistic expectations: I should be able to sleep well every night like a normal person. I shouldn’t have a problem! Not every night is the same. Some nights I do sleep better than others.
Exaggeration: It’s the same every single night, another night of sleepless misery. Not every night is the same. Some nights I do sleep better than others.
Catastrophizing: If I don’t get some sleep, I’ll tank my presentation and jeopardize my job. I can get through the presentation even if I’m tired. I can still rest and relax tonight, even if I can’t sleep.

Hopelessness: I’m never going to be able to sleep well. It’s out of my control.

Insomnia can be cured. If I stop worrying so much and focus on positive solutions, I can beat it.

Fortune telling:

It’s going to take me at least an hour to get to sleep tonight. I just know it.
I don’t know what will happen tonight. Maybe I’ll get to sleep quickly if I use the strategies I’ve learned.
Source: Help Guide

Research has shown that CBTi is an effective and long-lasting treatment for 50%-70% of patients. What’s more, patients who received CBTi online showed a reduction in insomnia as well as improvements in depression, anxiety, and psychological well-being.

It’s also quite different to other forms of CBT. So if you’ve had experience with it in the past – for example, for anxiety or depression – and it didn’t work for you, don’t be put off CBTi. It can help you identify those thoughts and behaviours that could be causing sleep problems and replace them with long-term healthy habits that encourage good sleep.

You can register as an NHS patient with Sleepstation to go through an online CBTi programme or buy privately.

Sleeping pills
Sleeping tablets are only prescribed as a short-term solution and after trying other methods first.
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How a sleep diary can help you

The NHS guide to getting better sleep recommends keeping a sleep diary. It can help uncover themes which contribute to your sleeplessness. You can make note of lifestyle habits or daily activities and see how they contribute to your sleep, or lack of it. It may help identify certain triggers or issues to solve. It can also help reveal underlying conditions that explain your insomnia – for example, a medicine you take, or stress.

You can start a diary yourself (the NHS and The Sleep Council both have templates) or there are apps available to help you start recording. If you’ve visited a GP, it’s likely they may have asked you to keep a sleep diary to help diagnose the problem.

For every day, a good sleep diary could include:

  • Timings of when you went to bed
  • What your bedtime routine included
  • How many caffeinated drinks you’ve had after a certain time
  • Whether you’ve done exercise and at what time
  • Any alcohol consumption
  • Any medication
  • Whether you’ve napped during the day
  • How long it takes you to fall asleep
  • How many times you wake up
  • When you wake up, how long it takes you to drift off again
  • What disturbed your sleep
  • Timings of when you wake up and get up
  • How long you spent in bed
  • Ratings of the quality of your sleep
  • How you feel in the morning (e.g. refreshed or tired)

It might feel like a lot of effort to record all these details, but it can pay off if you identify some issues contributing to poor sleep. It can also help your doctor advise on the best course of treatment.

Writing in sleep diary
Keeping a sleep diary can help uncover themes which contribute to your sleeplessness.
Woman reading book in bed

Chapter three

Trying to improve your energy levels

The idea of all the sleep hygiene tips and tricks shared is to break the cycle which tends to lead to on-going sleep problems. Rather than relying on unhealthy habits to try and get by with limited rest, you create new habits and routines that optimise your chance of good sleep.

But energy levels won’t improve overnight and it’s often this lack of energy which leads us to make poor decisions or slip into bad habits. We’re sometimes our own worst enemies.

Unfortunately, when we repeat these poor patterns over many years, they become habits. If you can start to combat these, you may notice differences in how you sleep. And a great area of focus is what contributes to or detracts from our levels of energy.

Sleep chart

Should you nap?

Sometimes a nap can be just what you need to feel refreshed. It feels like a great way of catching up on lost sleep. But you can also wake up from a nap feeling even worse than before, groggy and irritable for the rest of the day. A nap can also make it harder to sleep at night time. So where’s the logic?

Well, according to Professor Kevin Morgan, a psychologist from Loughborough University who runs sleep studies, routine is the most important factor in getting a good night’s sleep. It helps your body and mind sync up with when you need to feel awake and when you want to feel sleepy. A nap can disrupt that routine.

Even during major changes to your lifestyle, such as we’ve experienced during the coronavirus pandemic, he recommends sticking to the same sleeping schedule where possible – no matter how tempting it is to lie in. And on the subject of naps, he said:

“You’ve got to save your sleepiness for bedtime. Treat being sleepy as a precious resource and don’t waste it on a short daytime nap.”

It can feel like a bit of chicken or egg situation. You feel tired and want to nap, but napping affects when you can finally drift off at night. There’s no quick fix to feeling tired and the idea of ‘catching up’ on poor sleep is misleading. Napping in the daytime can affect your sleep drive.

Neuroscientist Ivana Rosenzweig, who leads the Sleep and Brain Plasticity Centre at King’s College London, explains that:

Napping affects the natural drive we should have to sleep. Avoiding it can help to break the cycle which exacerbates poor sleep.

Napping affects the natural drive we should have to sleep. Avoiding it can help to break the cycle which exacerbates poor sleep.

Writing in sleep diary
You feel tired and want to nap, but napping affects when you can finally drift off at night.
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Avoiding typical energy stealers

You may feel like you’ve listened to all the dos and don’ts of a healthy sleeping routine, but still struggle keeping up your energy throughout the day. You might be experiencing some fatigue. It’s an overwhelming feeling of tiredness unsurprisingly common in people who have unrefreshing sleep. People can feel fatigued even after rest, and you can feel fatigued in your body or mind.

Because fatigue is invisible to others, it can be hard to explain. You might look fine, so even friends and family may struggle to empathise with how exhausted you feel. But insomnia-related daytime fatigue is very different to just feeling tired.

A lack of sleep is a common cause of fatigue, but it’s not the only one. Make sure you speak to your GP to address any potential underlying issues.

According to the NHS, some common energy stealers are:

Not moving enough

It might seem counterintuitive, but because our body associates stillness with going to sleep, sitting in the same position for a long time actually makes us feel less energetic. Being a couch potato will make you feel tired.

Poor posture

Your spine can be put out of alignment by bad posture (e.g. slumping in your seat or hunching forwards) and your muscles have to work harder to compensate. It actually takes a lot of energy keeping yourself upright.

Crash diets

If someone is overweight, losing weight would help their energy levels. But a crash diet – one which encourages very low calorie intake – isn’t helpful for anyone. It can make you feel exceptionally tired and there are more sustainable ways to lose weight.

Too much sugar

Relying on sugar can give you a quick boost of energy, but your energy levels will slump a few hours later. You want to focus on getting a steady release of energy from what you eat. For example, for breakfast, swap processed cereals or toast with sugary spreads in favour of wholemeal cereal or home-made porridge with fruit.

There are also some things which are harder to avoid. In winter, for example, many of us feel more tired or sluggish. The shorter days can disrupt the sleeping and waking cycle. It’s largely due to less sunlight, which means your brain produces more of a hormone called melatonin, which makes you sleepy. This can be helpful if it makes it easier for you to drift off at the right time, but can create bad habits in a routine.

You might have heard of the circadian rhythm. It’s a 24-hour cycle during which our energy levels grow or drop, leaving us feeling either alert or sleepy. It’s affected by numerous variables, including light, which is another factor you can try and control to influence your sleep patterns. For example, use blackout curtains if you need to create darkness or an alarm clock with a light that gradually brightens your room as a sunrise would.

The cycle of sleeping and waking is a delicate thing. Our bodies can’t handle huge shifts in our sleeping routines. It’s why we struggle with jet lag when we travel to other time zones.

But if you know there are going to be changes to your wake-up or sleep times, you can plan ahead so it doesn’t affect your energy levels as much. Smaller increments in the weeks or days leading up to changes will allow your body to adjust much easier. For example, if you normally wake up at 8:00am, but need to move this to 6:30am, do it over several mornings of moving your wake up time slightly earlier.

Bowl of cereal
Swap processed cereals or toast with sugary spreads in favour of wholemeal cereal or home-made porridge with fruit.
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Advice for managing stress and key relaxation techniques

Stress is one of the main causes of poor sleep. Indeed, there’s a relationship between sleep and mental health. Dr Ivana Rosenzweig, of Kings College, told the BBC that disturbed sleep is often caused by stress, and can itself increase stress levels, creating a cycle that is difficult to break.

If worrying or stressful thoughts are what keep you up at night, then what about setting aside some time earlier in the day to think about these? NHS Inform says this can help to reduce the amount of time you spend thinking about them at night. Instead of putting them off or ignoring stress, the idea is to dedicate a time in the day that’s ‘worry time’.

In order to keep this time focused and not let worries creep into the rest of your day too much, they recommend you:

  • Keep a notebook on your bedside table. You can write down any worries you have at night and remind yourself that you will have time the next day to think about these.
  • Spend around 10-15 minutes on ‘worry time’ during the day. Let yourself think and worry about the things you’ve written down.
  • Stick to the timings. Once the time is up, go back to writing things down for the next day.

Poor posture

Your spine can be put out of alignment by bad posture (e.g. slumping in your seat or hunching forwards) and your muscles have to work harder to compensate. It actually takes a lot of energy keeping yourself upright.

It’s hoped that this then allows you time to wind down that’s relatively free of stressful thoughts. Winding down is an essential part of preparing for bedtime. Around an hour before you want to go to bed, you need to start switching off from the day and focusing on relaxing. You may not be able to do all of these every night, and what people find relaxing will vary, but here’s some ideas of how to wind down:

Do: Don’t:
Have a warm bath – not hot, as this can affect the ideal temperature at which we feel sleepy Use your phone or laptop
Read a book Watch TV
Listen to the radio Exercise vigorously
Write a to-do list for the next day Eat a large meal
Relaxation exercises such as yoga stretches

You might also want to try relaxation exercises, if you’re struggling to switch off. These include:

Progressive muscle relaxation

You can do this lying or sitting down, but it’s important to be comfortable. You then start with your feet, tensing the muscles as tight as you can for around ten seconds. Then relax. Work your way up the body, repeating this tensing exercise for every muscle group.

Abdominal breathing

Also known as belly breathing, focus on breathing deeply and fully so that the belly moves in and out. The deep breaths involve the chest, belly, lower back and ribcage. You can also close your eyes and try to slow down the breathing so that each breath becomes deeper. Breathe in through your nose and out through your mouth.

Mindfulness meditation

By attempting mindfulness, you’re attempting to focus on the present moment. Lie or sit quietly and focus on how your body feels. Don’t worry too much if your thoughts start to wonder, but try and return them to how you’re feeling now. Allow these thoughts to come and go and focus on your breathing.

It’s likely that anyone suffering with a sleep problem will try numerous techniques before finding what works for them. It takes time and effort to break any bad habits and create a new sleeping routine that gives you the rest you need. Be patient with yourself and keep exploring ways to manage your insomnia.

Warm bath
Have a warm bath – not hot, as this can affect the ideal temperature at which we feel sleepy.