What’s waking you?

A good night’s sleep is vital to all around health, but enjoying a n uninterrupted 8 hours in the heat of summer isn’t always easy. Dr Neil Stanley tells you all you need to know about the causes of sleep disturbance and what you can do to conquer them

Sleep is just as crucial – if not more so – than diet and exercise for overall physical, mental and emotional health. Sadly, though, it’s not considered that important – despite the increased risk of diabetes and obesity associated with poor or insufficient sleep. A recent study showed that poor sleep increases the risk of suicidal thoughts in people without psychological problems. We know that sleep is for the brain; it’s for memory function, for learning, and for forgetting the things we don’t need to remember each day. Years ago, our days comprised eight hours at work, eight hours at leisure, and eight hours at sleep – but now we work longer hours, and over-stimulate ourselves with televisions and gadgets, constantly receiving information that can disrupt the quality of sleep. And it’s not just a question of hitting the sack at a decent hour – if you’re waking up in the night, your sleep quality won’t be as good.

In summer, it’s often harder to sleep well as your body needs a drop in temperature in order to get a good night’s sleep. Cool bedrooms and light bed linen and clothes are important. If it’s a sultry night, try having a shower before you go to bed. There may also be other reasons you’re waking in the night – here are some common ones:

Night cramps
We’ve all been woken by these from time to time – a sudden agonising pain, usually in the calf. It’s caused by a muscle spasm and in most cases we don’t know why it happens. Stretching may help, as can massaging the affected area. If cramps trouble you regularly, some studies suggest taking magnesium salts and/or calcium may ease symptoms, while valerian may help to relax muscles..

Restless Legs Syndrome
Also known as Ekbom’s Syndrome, this is characterised by tingling and discomfort in the legs, and an urge to move them repeatedly to relieve the unpleasant feelings. About 10 per cent of the population suffers at some point in their lives, and it can really disturb sleep. Stretching, movement and massage can help relieve the discomfort. It is sometimes related to pregnancy, and occasionally to an iron deficiency too, so ask your doctor to check your iron levels.

Night sweats
These aren’t related to heat or the environment, so are just as common in winter as summer. The most likely cause is the menopause, but others include bacterial or viral infections, an overactive thyroid, or certain medications, especially those for diabetes.

Snoring
There are muscles in your throat, mouth and nose which keep your airways open during the day and which relax at night – this relaxation sometimes causes these airways to close up, restricting incoming and outgoing air. When this happens, you get snoring, caused by vibrations in your mouth and throat. It isn’t usually a problem unless it wakes you up and disturbs your sleep – or your partner’s. Smoking, alcohol, allergies and excess weight can all contribute. Some over-the-counter products, such as nasal strips and throat sprays, claim to help by opening up and lubricating the airways. You could also try elevating the end of your bed, or trying different pillows.

Sleep apnoea
This happens when the airways at the back of your tongue collapse completely. Deprived of oxygen, your brain wakes you up and you start breathing again. This can happen hundreds of times a night. You may not remember any of the incidences, but it can cause exhaustion the next day, making tasks like driving dangerous. It may also increase the risk of stroke or high blood pressure. It’s often associated with being overweight, but even slim people can be affected. If you think you suffer from it, seek medical advice. Treatment may involve using a continuous positive airways pressure (CPAP) machine to keep you ventilated at night.

Food and drink
Not eating a heavy meal late at night is important, but some people avoid eating late altogether for fear of it affecting their sleep – and then wake up hungry. A light snack shortly before bed can prevent this. Too much alcohol will stop you entering the deepest phases of sleep, and because of its dehydrating effects, sleep may be interrupted by thirst. Some people avoid caffeine, but if you’re relaxed and want to round off a meal with a coffee, I personally think it’s fine.

Acid reflux
Also known as gastro-oesophageal reflux disease (GORD), acid reflux occurs when the stomach’s acid contents spill back into the oesophagus (foodpipe). It can cause heartburn, and be troublesome at night when you’re lying down. It’s also aggravated by alcohol, coffee, fatty foods and smoking. Pregnant women and the overweight are more susceptible. Avoid heavy meals at night, and raise the end of your bed. Medications you can take include antacids, and traditional remedies like liquorice, aloe vera and slippery elm. It can also be caused by a problem with the valve where the oesophagus meets the stomach, so see your doctor if you have severe symptoms.

Your partner
If your partner snores or has a disturbed night, you will be woken too, so it may be worth experimenting with separate rooms. It sounds drastic, but sleep is such an important part of your health that it’s worth trying.

Nocturia
This is the need to get up more than once a night to empty your bladder. It could be an early sign of diabetes, benign prostatic hyperplasia (BPH) in men, and cystitis in women, but more often than not, it’s merely that you’ve drunk too much fluid before bedtime.

Top sleep tips
- Keep your bedroom cool and aired.
- Try to keep to a good, regular night-time routine.
- Herbal teas of chamomile, valerian roots or hops are traditionally used to promote sleep.
- A soothing hot bath, with relaxing essential oils, such as neroli, rose or lavender can work wonders.
- Wind down before bedtime – avoid any stimuli such as TV, music or computers.
- A little exercise during the day (not late at night) can help.
- If it relaxes you, it will probably help you sleep: yoga, light reading, massage from a partner… do whatever works to ease stress.
- Although an afternoon catnap of 20 minutes is okay, avoid too much as you may not sleep properly later.
- Always keep your bedroom dark and quiet at night.

Expert: Dr Neil Stanley is a sleep researcher and the manager of the Clinical Research and Trials Unit at the Norfolk and Norwich University Hospital, East Anglia. He has been involved with sleep research for 26 years.

[Compiled by Alex Gazzola]