The amount of sleep that an individual needs to be healthy and alert in the daytime varies at different times in their lives.
Some people are by nature short sleepers and should not be concerned that they do not sleep for as long as others that they know, so long as they feel well. Over and above these normal variations, an inability to fall asleep or to stay asleep at night is common and usually short lived. In most cases there is an obvious stress whether it is related to emotional difficulties, work pressures or ill health and once the underlying issue is resolved, sleep returns to normal. For some people a change in treatment for chronic illnesses causing for example pain or breathlessness at night may be necessary. Anxiety at night and feelings of despair related to underlying mental ill health should also be addressed.
When difficulty sleeping at night persists for longer than a couple of weeks
When difficulty sleeping at night persists for longer than a couple of weeks, without an obvious cause, it is helpful to analyse all of the factors that might be contributing. Often adopting simple self-help measures will lead to a considerable improvement in sleep quality. Factors to consider include:
- Keeping regular hours
- Reducing caffeine and alcohol intake
- Ensuring the bedroom is dark, quiet and at a comfortable temperature
Sleep Phase Delay Syndrome
Some people who cannot get to sleep at night find that they can sleep for a normal amount of time from the small hours of the morning into the next day. This is particularly common in the later teenage years and in older people. It is known as Sleep Phase Delay Syndrome and can be addressed with behavioural techniques that we offer at Royal Papworth Hospital.
Sleep disorders which require specialist intervention
An inability to sleep at night may indicate other specific sleep disorders which require specialist intervention. Restless Legs Syndrome and limb movements in sleep are very common particularly as we get older and can present with difficulty getting to sleep or staying asleep. Specific treatment can improve sleep quality. Obstructive Sleep Apnoea and narcolepsy can on occasion present with disturbed sleep at night although excessive daytime sleepiness is much more common.
Primary insomnia
There are a considerable number of people who continue to struggle to establish or maintain sleep at night when all of the other possible causes have been addressed and would then be said to have primary insomnia. There are some helpful self-help books and on-line applications on approaches to insomnia management.