Difficulty Sleeping

1 Introduction

Lots of people have a problem with sleeping at some time during their lives. If you are ill, sleep can be hard because of anxiety, worry about treatment, fears about the future, or just because you are going through a stressful time in your life.

We all need different amounts of sleep and this often changes as we get older, but insomnia can be a symptom of a more serious problem, so it is advisable to discuss your sleeplessness and how it affects you with your St Christopher’s nurse.

If you can’t sleep because of pain, don’t suffer in silence. Talk to your St Christopher’s nurse, who will be able to advise you on pain relief.

This leaflet offers you some suggestions for getting a good night’s sleep, whether you’re finding it difficult to fall asleep, or waking too early in the morning.

Not every strategy will work for everyone – look for one that feels right for you.

2 Preparing for a good night’s sleep

  • Try to take regular exercise every day, within the limits of what you can do. Go for a walk or do some simple stretches. Any activity can help by tiring your body and giving it the oxygen it needs to relax more so that you sleep better.
  • Some people find that daytime naps help them sleep better at night, but this does not work for everyone. Limit yourself to one rest or sleep each day to see if it helps. Find out what suits you best.
  • Keep a regular bedtime routine. Try to go to bed at the same time each night. Pick a reasonable time and keep to it even if you don’t feel tired when the time comes. Get up at the same time every day and don’t sleep in.
  • If you are having bad nights, try not to think about it all day long, this may make it harder to sleep when you go to bed.
  • Some people find that it helps to have a break of at least half an hour between reading or watching TV and going to bed so that their mind quietens down before they sleep. Other people find that reading takes their mind off their worries and helps relax them. Listening to soothing music may help.
  • Before you go to bed, have a drink of warm milk. Milk contains calcium which has a soothing effect. Avoid stimulants – tea, coffee, cola and chocolate all contain caffeine. Alcohol and tobacco are also stimulants and are best avoided. If you don’t like milk, try a herbal tea such as valerian, camomile, fennel or passionflower. Sleepytime Tea® is a combination of herbs. Red bush tea is a caffeinefree tea. (However if you find yourself having to get up in the night to go to the bathroom, then avoid drinking too much liquid before bedtime). If you have any concerns or questions about the interaction of any herbal preparations with your prescribed medication, the St Christopher’s pharmacist will be happy to advise and your St Christopher’s nurse can arrange this for you.
  • Have a warm bath. Do not have the water too hot or bathe for too long. Adding a few drops of aromatherapy oils can enhance your relaxation. Lavender or camomile are soothing.
  • Sleep in a well-ventilated room on a firm bed using supportive pillows as required. Try and keep your bed for sleep only so that you identify it with sleeping.
  • Eliminate noise. If your bedroom is noisy you could mask some of the noise using a small electric fan or you could use ear plugs.
  • Avoid illuminated clocks; the light can be annoying if you’re having difficulty getting to sleep, and being reminded of the time is unhelpful if you are worried about not sleeping. Try to keep your bedroom as dark as possible.

3 Once you’re in bed

  • Try not to clock-watch. Counting the hours will tend to increase your anxiety about not sleeping, which makes it harder to relax and get to sleep
  • If hunger disturbs your sleep, keep a carbohydrate snack handy.
  • Don’t lie awake tossing and turning. Get up and do something quiet and unstimulating, such as listening to music you find relaxing. When you feel tired again go back to bed.
  • Relaxation exercises can help. Try this relaxation technique: first concentrate on relaxing your face, especially your jaw and your eyes (closed). Open your mouth a little and unclench your teeth. Then work your way upwards from your toes, relaxing each area before moving onto the next, imagining that each area tingles as you relax it. Check from time to time that your face, jaw and eyes are still relaxed. As you relax, imagine the tension flowing out of your body, and your worries floating off from the crown of your head. Feel your heart beating gently and your breathing slowing down. As you breathe in say ‘calm’ to yourself, as you breathe out, say ‘tension’. When your body is completely relaxed you can try visualising a peaceful scene, imagining yourself in a peaceful place, hearing peaceful sounds, and feeling the warmth of the sun, for example. Just relax and enjoy it. Ask for a copy of our CD if you’d like to practice this exercise.
  • An alternative is to visualise something you’ve always found boring and recapture that bored, tired, heavy sleepy feeling. Even counting sheep can work – provided they are inactive sheep!
  • If you find that thoughts are racing through your mind, have a pen and note pad by the bed so that you can write them down. This gets them out of your mind and reminds you that you can deal with them in the morning if you need to. You can also imagine putting your thoughts in a box and closing the lid, locking the lid tight and putting the box in a cupboard. Tell yourself that you can open the box again in the morning if you need to.
  • Sometimes although you may feel as if you have been awake all night, you may have managed to have several hours of good quality sleep. Try not to worry – your body will still benefit from resting even if you are not actually asleep. The important thing is that when you wake up in the morning you feel refreshed and able to cope with your day.

4 What else can help?

Some people find complementary therapies helpful for relieving insomnia. At St Christopher’s we have trained therapists who are also nurses. They offer aromatherapy, massage, reflexology, hypnotherapy and relaxation, any of which may help. Ask your St Christopher’s nurse to refer you.