Top tips for a good night’s sleep

KHP chats to sleep expert Dr Alanna Hare, Consultant Physician, Department of Sleep and Ventilation at Royal Brompton and Harefield hospitals, about things to do and things to avoid to get a restful sleep.

Dr Hare [pictured], who has just become the President of the British Sleep Society, recently wrote the National Outpatient Pathway for Sleep Medicine on behalf of NHS England and GIRFT [Getting It Right First Time, a national programme designed to improve the treatment and care of patients through in-depth review of services].

What are your top tips for a good night's sleep?

I get asked this a lot, and I think if I had to pick one it would be maintaining a regular sleep/wake schedule. This means going to bed at about the same time every night and getting up at about the same time every morning, and ideally trying to achieve this for at least five nights per week, with no more than two consecutive nights off that schedule each week to give a bit more flexibility at the weekends.

When we have that regularity our brains and bodies know when they're supposed to be sleeping, and when they're supposed to be awake. When we're off that schedule all the time, our natural 24-hour rhythms get really out of sync, and that can lead to things like struggling to wake up in the morning or struggling to fall asleep at nighttime.

I tend to use the four R principle: rhythm; routine; relaxation; and room.

Rhythm is about having that regularity, as I’ve just explained. Routine and relaxation work alongside each other - it's about trying to give your brain and body a signal that it's about to be bedtime. It can be something as simple as dimming the lights in the evening, stopping work, and ideally switching off devices to have a bit of time to switch off from the day.

It allows your body and brain to start getting prepared to fall asleep, both physiologically with the low light levels, but also mentally switching off from anything that's quite stimulating from the daytime. And then make sure your room is really designed as a place of calm relaxation, so again low lighting and ideally do not have your laptop sat blinking in the corner reminding you of all the things you haven't done - so a lovely comfortable space.

You don't have to spend lots of money on things like expensive pillows and mattresses, but just somewhere that feels cocooning and relaxing, and somewhere that you want to snuggle up in.

If you can stick to some of those principles, that can really help bring about more restful sleep.

What should people avoid doing?

There are some really simple things, like avoiding caffeine after lunchtime. Caffeine is great at alerting you, and I have no problem with people having coffee in the mornings, but after lunchtime we should switch to decaffeinated drinks. It can take quite a long time for caffeine to get out of our systems.

And again there's a lot of talk about blue light and devices, and some of the research is a little bit unclear on whether or not this really does impact on our ability to sleep.

I know lots of people will tell me that they can be on their phone until the minute they want to fall asleep, then they turn it off and go to sleep and it’s not a problem for them. There probably is a degree of variability in how people respond to it. However, it's not just the blue light it's also the content of what you tend to be consuming on a mobile phone or device late at night.

Often it may be work emails, which is obviously quite stimulating and can remind you of all the things you need to do, or it might be social media or news, which again can be really quite stimulating.

I still recommend, even though the blue light story might be a bit unclear, that you switch off those devices for at least half-an-hour and ideally an hour before bedtime, and get back to something like reading or listening to a podcast or music rather than consuming things on a device right by your face.

What are the health risks of not getting a good night's sleep?

I try to avoid an overfocus on the consequences of a bad night's sleep because one of the problems for people when they're already struggling with their sleep is the added anxiety of worrying about the fact that they're not sleeping and the consequences.

Lots of people have read Matthew Walker’s book Why We Sleep, and another problem is that there's lots of stuff in the popular press about awful things that will happen to you if you don't sleep.

I would certainly say that there is good evidence that poor sleep does result in poor mental and physical health outcomes over time. But I think that's only important for those of us who are relatively healthy sleepers and are just a bit rubbish about turning our phones off at nighttime and maybe giving ourselves enough opportunity to have sufficient sleep. So those of us who maybe burn the candle at both ends, stay up a bit late working or seeing friends, and then getting up early for work.

For those people I would want to give the message that insufficient sleep or not paying enough attention to your sleep will, over time, result in poor health outcomes.

For individuals who have poor sleep for other reasons, they might have insomnia or another sleep problem, I think the message is seek help and see your GP.

Ask for a referral to a sleep specialist and get help, because actually we can treat these disorders really effectively, and when we treat them those negative health outcomes are improved.

What are the health benefits of getting a good night's sleep?

What we know about people who sleep well, or when we improve someone’s sleep, is that there's a relatively immediate improvement in emotional wellbeing.

Nights of good sleep tend to be followed by good days. You tend to interact more productively with people and be more empathic, as well as being able read other people better so your relationships are better. You tend to perform better at work, you’re safer at work, and on the road.

In the long term, there do seem to be benefits from a cardiovascular health perspective, and there's probably a number of mechanisms in which that is achieved. And we know that better sleep is associated with better mental health outcomes in the long term as well.

So the immediate benefits from a good night's sleep are in terms of how you feel and how you perform in the daytime. And yes, in the longer term, there are definitely both mental and physical health benefits from sleeping well.

To find out more about the work of Dr Hare, visit her Royal Brompton and Harefield hospitals webpage here.