Sleep & fatigue

Last updated 13 February 2017 — Last reviewed 17 February 2014

Insomnia and not getting a good night's sleep can be frustrating and impact on your day to day living and quality of life. Sleep problems can be caused by changes in your daily routine, times of worry, a new baby, shift work or sleep apnoea, but the good news is there are many things you can do to help yourself.

Sleep problems

It is estimated some form of sleep disturbance will affect approximately 90% of people at some point in their lives. In most cases the disturbance is temporary and will resolve, but for some people sleep problems don't go away.

Insomnia & sleep disorders

Insomnia is the name given to the inability to go to sleep or to stay asleep. Insomnia is more common in older people and twice as many women experience insomnia than men.

Twice and many women experience insomnia than men

There are several types of insomnia including:

Type of insomnia/sleep disorder What happens When people seek help How it is treated
Primary insomnia About 2% of the population need less than 5 hours a night and can still be highly productive, manage to function and are generally not tired when awake. When you are unhappy to lie awake until 1:30am, or you find it affects your quality of life i.e. you would rather go to bed at the same time as your partner.

This type of insomnia may be very resistant to non-drug strategies. The recommendations are to go to bed for fewer hours and to listen to your body clock for clues about when to go to bed. Some simple lifestyle changes may also have an impact.

Insomnia stimulated by an incident

 

Sometimes people who have not experienced sleep problems before can begin to experience insomnia because something has triggered a change in sleep patterns including:

  • a period of emotional trauma
  • shift work
  • a new-born baby 

Habits persist beyond the trigger period because the body learns that this is the norm.

When you feel frustrated or anxious and can't change the habit.

 
  • A range of psychological techniques aimed at 'unlearning' the conditioned sleep pattern may be useful
  • Strategies to overcome anxiety or frustration and changing lifestyle habits can help
Disorders of the body clock

When your body clock is disrupted, you have difficulty with timing when to go to sleep so you generally feel sleepy during the day and crave recovery sleep on the weekend. It is common in adolescents and young adults.

If you have trouble getting to sleep and are then unable to get up in the morning.


 
  • The body clock can be manipulated with carefully timed exposure to bright light. The timing of light exposure and the form of light used are best managed by a sleep specialist or sleep psychologist
  • Melatonin, a hormone secreted by the brain that regulates the body clock is now available in prescription form (Circadin) –however, light is substantially more potent than capsule forms of melatonin

Sleep disturbance

If any of the following are causing sleep disturbance, speak to your doctor, who may refer you to a specialist if necessary:

Cause What happens Treatments available
Sleep apnoea

The airways block, causing airflow and breathing to stop for a short time during sleep. These periods when you stop breathing can last for ten seconds and may happen up to several hundred times a night. This leads to repeated arousals from sleep (which you may not remember) but you may feel tired the following day.

Studies have found an increase of sleep apnoea in women around perimenopause, regardless of their age or weight.

Sleep apnoea can lead to health problems.

  • Lifestyle changes
  • Devices or surgery to improve breathing
Depression and anxiety Depression and anxiety can affect sleep or be caused by lack of sleep. Counselling may be helpful.
Pain Pre-existing and chronic conditions can impair sleep. Treating the pain may help.
Snoring

Snoring without sleep apnoea may waken you but is not proven to be associated with increased health risk.

  • Lifestyle changes
  • Regular sleep patterns

Sleep problems for women in midlife & menopause

Menopause is a time many women experience insomnia and sleep disorders. Insomnia, snoring and obstructive sleep disorder become more frequent but may be under-recognised.

This is a really important time for women to stop and think about their health and to make taking care of themselves one of their top priorities, so if sleep is bothering you it can really impact on your quality of life.

Managing sleep problems

The following may help you get a good night's sleep, sometimes a change in routine is all it takes.

Reduce your caffeine intake
  • Have only two caffeinated drinks per day preferably before lunch – this includes cola, tea, coffee and chocolate
  • Try caffeine-free herbal teas such as chamomile
Avoid heavy meals late at night
  • Allow 2 hours after dinner before going to bed
  • Sip a glass of warm milk if you need something after dinner
Limit your alcohol consumption
  • Have no more than 1-2 standard drinks a day (and at least 2 alcohol free days per week), as too much alcohol reduces sleep quality
  • Although alcohol is a sedative and can make you fall asleep faster, it tends to make you wake later in the night
Be physically active

A falling body temperature helps to encourage falling asleep and remaining asleep, so if you exercise you increase your temperature but you need to allow time to cool down. Don't exercise in the 4 hours before going to bed as exercise is also stimulating.

Maintain a regular time to go to bed and wake up Try to go to bed and to get up at the same time each day as this helps settle your sleep pattern.
Restrict time in bed Leave bed for sex and sleep, not eating, reading or watching TV, so as to train yourself to sleep when you get there.
If you are not able to fall asleep, get out of bed Do a quiet, relaxing task in another room, as frustration at your inability to sleep can make the problem worse.
Hide the clock

Turn any clocks away from view so as to not clock gaze during the night, as this accentuates the sense of frustration.

Try relaxation

Relaxation exercises or meditation can help some people to relax and get off to sleep.

Medications for sleep disturbance

Sleep medications (e.g. benzodiazepines or stilnox) may be prescribed for short-term use. However, these medications may cause you to become too dependent on them so they should be taken with care. Speak to your doctor for more information.

Eating to help you sleep

Some foods are considered to contribute to restful sleep and others contribute to wakefulness.

Tryptophan, an amino acid found in many foods, helps sleep. Tryptophan produces serotonin, which is related to relaxation, restfulness, and sleep. Tryptophan also produces a hormone called melatonin. Serotonin and melatonin send calming messages to the brain to support sleep.

When you eat a meal high in carbohydrates, your blood sugar levels rise and insulin, a hormone, is released. Insulin helps transport amino acids, including tryptophan, into the brain. The best night time meals are those that contain both carbohydrates and protein, and some calcium. Calcium helps the brain use the tryptophan to manufacture melatonin.

Dairy products, which contain both tryptophan and calcium, are considered one of the best foods to induce sleep.

Good sources of tryptophan Moderate sources of tryptophan
  • Fish
  • Seafood
  • Chicken
  • Turkey
  • Red meat
  • Legumes
  • Eggs
  • Soy (beans and tofu)
  • Dairy (yoghurt, parmesan)
  • Nuts
  • Seeds
  • Oats
  • Bananas
  • Spinach
  • Cottage cheese

Read more tips in the article 'The best foods to beat insomnia'

This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at February 2014.

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