Dear Dr Nina: 'I can't sleep after having my two children – one of whom didn't sleep for more than three hours at a time'

Q I have always been a good sleeper and am a mother to two small children, one of whom didn’t sleep for more than three hours at a time until earlier this year. To my surprise, I have lost the ability to sleep. Even though my youngest sleeps through, I find it impossible to stay asleep. My doctor has prescribed sleeping tablets, but I am hesitant to take them as I have no problem falling asleep. Any advice?

A We all know that an occasional poor night’s sleep leaves us feeling less than well. What many don’t know is how important regular sleep is for our overall health and well-being. Long-term poor sleep is associated with an increased risk of mental health disorders, increased risk of obesity, reduced immune system function and increased risk and severity of chronic disease such as high blood pressure, diabetes and heart disease.

Insomnia is the medical term for poor or reduced sleep. Acute insomnia results in disturbed sleep that lasts for a few days. It is often related to changes in lifestyle such as jet lag or in times of illness, stress or anxiety. Although you may feel very tired during this time, sleep usually returns to normal. The second or more problematic type of insomnia is chronic insomnia. This is difficulty sleeping on at least three nights a week for a period of a month or more. It is more common in women, those over 60, in people with chronic pain or illness, and in those who travel across time zones or work shift.

In order to help improve sleep, it is really important to try and identify the cause of insomnia. In your case, the chronic broken sleep you suffered due to your toddler’s waking has most likely impacted on your own sleep-wake cycle. Your brain may be constantly “on call” for your child’s waking.

Sleeping tablets can help give a few nights’ sleep in the short-term but they should never be used for more than days to short weeks as they have a high risk of dependency and, particularly in the elderly, increase the chance of falls, and daytime sleepiness and accidents. They also interact with alcohol and other drugs.

Your brain needs to learn to sleep again. Good sleep hygiene is important. This simply means having good sleep habits. Avoiding stimulants such as caffeine and nicotine is very important. Don’t drink any caffeine after the early afternoon. Alcohol, although making you sleepy, leads to broken and unrefreshing sleep and should not be used as a sleep aid. Avoid large meals late, but a light snack may help. The bedroom should be a restful, well-ventilated space and should only be used for sleep or sex.

Daytime naps should be avoided. Sleeping too much during the day will make it harder to sleep all night. This can be difficult to follow if you are exhausted but is important. Stick to a sleep routine; go to bed and get up the same time every day, even on weekends no matter how long you have actually slept. Things like a warm bath, reading or soft music can aid relaxation. Keeping a pen and paper by the bed to write down any distracting worries or thoughts can help the mind relax.

Cognitive behavioural therapy (CBT) has been scientifically proven to help improve sleep. This may work very well for you.

The goods news is that with motivation and good sleep hygiene most episodes of insomnia should pass.

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