Different people need different amounts of sleep. Adults usually need on average 7 to 8 hours sleep a night. It is normal to need less sleep as you become older. For people aged over 70 years about 6 hours sleep per night is average.

Insomnia is when a person cannot sleep properly. This can appear in a variety of ways:

• Difficulty in getting to sleep.
• Waking in the night.
• Waking early in the morning.
• Not feeling refreshed after a night’s sleep.

Causes

Poor sleep may develop for no apparent reason. However, there are a number of underlying causes.

Other illnesses

Insomnia can be caused by an underlying physical condition causing involuntary movement, pain or discomfort. Examples include arthritis, coughing and itching.

Temporary problems

Disruptions within the sleeping environment or to bedtime routines can cause restless sleep. Factors include noise, snoring, jet lag, a strange bed, anxiety or depression.

Loss or worry caused by events such as bereavement can also make sleeping difficult.

Stimulants

Such as alcohol, caffeine and nicotine can interfere with sleep as can some prescribed medicines. Sleeping problems can result from the effects of drugs such as anti-depressants or steroids.

Treatment

The first step of treatment is to identify the underlying causes and to treat them. For example if insomnia is being caused by depression, then once the depression is treated, the insomnia will often disappear without further medical help.

Non-drug treatments are usually the preferred first course of action. These treatments include: Patient education about sleep and relaxation. Lifestyle advice including restrictions on caffeine, nicotine and alcohol.

Drug treatment may be considered in a number of cases, either because the symptoms are particularly worrying or to alleviate short-term restless sleep. There are a number of conventional and herbal products that may be recommended by the pharmacist for short-term use. These tablets may cause drowsiness the next day so always read the label and don’t drive if you are affected.

Prevention

In order to get a good night’s sleep, there are some simple measures that can be taken:

• Set a specific time for getting up and going to sleep.
• Try to create a bedtime routine such as a warm milky drink every night.
• Avoid caffeine, alcohol and tobacco.
• Avoid eating a large meal just before bedtime.
• Do not nap during the day.
• If noise is a problem, wear ear plugs.
• Try to reduce stress levels.
• Take regular exercise during the day.
• Get up if you find you cannot sleep.