The complete guide to a good night’s sleep

  • 30 Jan 2009
  • Reading time 14 mins
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All you need to know to tackle insomnia and get a restful night without resorting to sleeping pills.

The need for sleep

Researchers now pretty much agree you need around seven to nine hours of largely uninterrupted sleep a night. Insomnia is defined as difficulty falling asleep (on average taking more than 30 minutes to fall asleep); waking up frequently during the night and having difficulty getting back to sleep; waking up too early in the morning and being unable to return to sleep; waking up tired or exhausted which can persist through the day making you feel irritable, anxious or depressed. If this sounds like you, you have a sleeping problem. So what can you do about it?

Why not sleeping pills?

If you can’t sleep and you go to your doctor, the chances are that you will be prescribed sleeping pills, also known as hypnotics. Despite having a long charge sheet of side-effects1, these drugs still regularly feature in the top 20 most-prescribed drugs both in the UK and the USA. Not only that, but they aren’t actually very useful, according to a report in the British Medical Journal.2 Just how marginally effective they are was vividly illustrated by a 2007 study by the American National Institutes of Health, which found that the newer drugs like Ambien (zolpidem) made you fall asleep only 12.8 minutes faster than with a fake pill and sleep for just 11 minutes longer.3

Cognitive Behavioural Therapy

Long-term sleep problems can be the result of an illness like diabetes or a painful condition such as arthritis. Otherwise the most likely root is psychological – stress, anxiety or depression. Therapy such as CBT is able to help by encouraging patients to acknowledge the stress that is preventing them from sleeping and then helping them to deal with it. This might be by identifying negative or unhelpful thoughts – “I just can’t sleep without my pills”, for example – and changing them.

A 2006 review in The Lancet found that various forms of counselling and psychological help are not only the most effective but also the safest way to tackle chronic insomnia.4

A more recent study compared CBT with one of the new sleeping pills called Zopiclone. While CBT improved the percentage of time spent asleep from 81.4 per ......

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