Ensuring healthy sleep

The brain is predisposed to wind down at specific times of the day. The first period is between one and four o'clock in the afternoon, when alertness and concentration slow down. They gradually speed up again to reach a peak around six, when it is most difficult to sleep, then decelerate again a few hours later. Both these periods of sleepiness are accompanied by a drop in body temperature. When people are woken up during a body temperature low, their mood is at its worst; their mood is brightest if woken when their temperature peaks.

There is an incorrect popular belief that older adults need less sleep. In fact they need as much sleep as other adults, but their night-time sleep is interrupted more frequently. Consequently, they need to make up for the interruptions with naps during the day. Insomniacs should avoid napping, schedule a standard wake-up time no matter what time you go to bed and to to go another room if they cannot sleep at night. Restricting actual time in bed helps. The strategies worked well for both the elderly and the younger patients.

The most common way to treat insomnia, especially sleep maintenance insomnia, is with drugs. The elderly are even more likely to be prescribed drugs and are usually the patients studied for insomnia treatment. But a cognitive behavioral insomnia therapy can be just as effective.

To counteract mild insomnia, experts are recommending what they call "sleep hygiene" -- changes in habits that favour a good night's rest. Timing is crucial, and should coincide with natural sleepy periods. Useful is the avoidance of alcohol, tobacco, tea and coffee in the afternoon and night. Consumption of high-protein food at night restricts the release of serotonin, a hormone that helps maintain sleep. But calcium-rich dairy foods are good. Always sleep in the dark, since light suppresses the release of the hormone melatonin, which aids sleep. Exercise during the day helps release physical tension and increases stimulating alpha brain waves, aiding relaxation later. But exercise late in the evening raises adrenalin, blood pressure and heartbeat to stimulating levels, which prevents sleep. Problems can cause insomnia and should be left until the morning or sorted out before going to bed.

Aids to good sleeping include (1) a good mattress; (2) a few sessions of acupuncture to release opiate-like substances in the brain called endorphins and enkephalins and the natural tranquilizer serotonin; (3) soporific plant oils like lavender vera, ylang ylang, neroli and Roman camomile; also infusions of herbs, including valerian, hops and passiflora; (4) homeopathy is widely used in France, where a recent study showed that passiflora drops worked as well as sleeping pills (valerium and coffea are also effective); (5) light therapy helps reset sleep rhythms by stimulating wakefulness hormones during the day; (6) hypnotherapy can remove the psychological block that is preventing sleep; (7) leave your bed if you don't fall asleep within one half hour; (8) save your bed for sleeping and sex; (9) get up and go to bed at the same time every day; (10) avoid daytime naps if you have trouble sleeping at night; (11) establish a relaxing routine for going to bed, such as taking a hot bath or meditating.

The Health Social Invention Award 1993 of the Institute for Social Inventions went to the author of a detailed manual on how to block out insomniac thoughts by filling the mind with a previously prepared "sleep-thought".