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How To Improve Your Sleep

We take a look at the causes of poor sleep and what you can do to improve sleep quality.

Woman asleep in bed

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Sleep is essential for our physical and mental health with virtually every function in the body being impacted by long term sleep disturbances.

Several bodily processes occur when we sleep, this includes memory consolidation, clearance of brain metabolites, restoration of our nervous system, immune system and skeletal and muscular systems [1].

The impact of long-term, chronic sleep issues include an increased risk of developing cardiovascular disease, diabetes [2], metabolic dysfunction and psychiatric disorders.

You can read more about the importance of sleep in our article ‘Why is Sleep So Important to Our Health?’, but in this article, we take a look at the top causes of poor sleep and what you can do to improve your sleep quality.

Man sat at a desk looking tired

Causes of Poor Sleep

Poor sleep is categorised as not being able to get to sleep, waking up regularly throughout the night, or waking up and not being able to get back to sleep again.

Many factors can impact our sleep quality, here are the top 8 causes of poor sleep:

1. Age

As we get older our circadian rhythm, which rules our sleep/wake patterns, is disrupted by the deteriorating function of the suprachiasmatic nucleus (SCN) found in the hypothalamus in the brain. SCN controls the 24-hour circadian rhythm and acts as the body’s ‘master clock’ As we get older, our sleep patterns change due to the effects of an ageing SCN, this means that older people will see changes in when they feel tired and how long they sleep. In addition, as we get older, changes to key sleep hormones cortisol and melatonin also impact sleep patterns [3].

2. Hormone Changes

Hormone changes in women due to their menstrual cycle and later the changes in hormones as a result of the perimenopause can cause sleep disruption. Symptoms such as stomach cramps, night sweats and increased anxiety as a result of hormone changes can all contribute to a poor night’s sleep.

3. Medication

A number of medications used to treat certain conditions can affect sleep quality. For example, heart medication such as anti-arrhythmic and beta-blockers, high blood pressure medication such as clonidine or diuretics, corticosteroids used to treat inflammation and even cold and flu medicines that contain alcohol or caffeine can all impact sleep [4].

4. Lifestyle Choices

Poor lifestyle choices such as drinking too much alcohol, caffeine or energy drinks, a poor diet high in fats, salt and sugar as well as a lack of exercise can all contribute to poor sleep quality.

5. Mental Health

Mental health issues such as stress or anxiety can have a huge impact on the quality of sleep. Being stressed raises cortisol levels which control the sleep/wake pattern. Consistently high cortisol levels over a long period of time will have an impact on sleep. Insomnia is a common symptom of anxiety due to sufferers often lying in bed at night worrying. It can also get wrapped up in worrying about not sleeping, causing a vicious cycle [5].

6. Poor Work/Life Balance

Having a poor work/life balance where too much time is spent at work can impact sleep quality. This is mainly due to the long hours worked resulting in increased stress levels, leading to poor diet and increased alcohol and caffeine consumption. In addition, working longer hours can result in shorter sleeping hours and increased difficulty in falling asleep – most likely due to worry and stress [6].

7. Night Shift Work

Working night shifts disrupt the body’s natural circadian rhythm which regulates our sleep/wake cycles. Studies have shown that the biggest health complaint amongst shift workers is disturbed sleep.  Night shift work has also been reported to result in a greater loss of sleep of around 1-4 hours, compared to other types of shift work [7].

8. Poor Sleeping Habits

Poor sleeping habits often referred to as Sleep Hygiene can also result in a decline in sleep quality. For example, using electronic devices that emit blue light can delay or reduce melatonin production, which makes us feel sleepy. In addition, it has been shown that blue light from electronic devices can impact your sleep quality by reducing the amount of time you spend in slow-wave and REM sleep both of which are vital for brain function [8].

The good news is that many of the issues that result in poor sleep are within our control to change.  Here are our top 5 tips on who to get a good night’s sleep.

Woman in bed looking at her phone

Ways To Get A Good Night’s Sleep

The first step towards getting a good night’s sleep is to first improve or remove the contributing factors that are within your control. 

Here are our top 5 tips for getting a good night’s sleep:

1. Eat A Healthy Diet

The gut and the brain are closely interlinked, and a poor diet can have a detrimental impact not only on our physical wellbeing but our mental wellbeing too.

Eating a healthy, balanced diet low in fat, sugar, and salt and high in fruit, vegetables, whole grains, and fibre will provide your body with all the nutrients it needs to function properly – this includes promoting good sleep.

A vitamin deficiency can have an impact on sleep and there is more evidence emerging that diet affects the hormone pathways involved in sleep.  Being deficient in vitamins such as calcium, magnesium and vitamins A, C, D and E are associated with sleep problems [9].

Foods that help promote sleep include:

  • Kiwi Fruit – contain vitamin E and C as well as potassium and folate. Studies have found that people who ate a kiwi fruit 1 hour before bed had a better night’s sleep [10].
  • Nuts - especially almonds, walnuts, pistachios and cashew nuts as they contain melatonin as well as magnesium and zinc.
  • Tart (Sour) Cherry Juice - studies have found that people who drink 1-2 cups of tart cherry juice were found to have longer time asleep and better sleep efficiency [11].
  • Malted Milk Drinks – such as Horlicks have been found to help with sleep. Although it’s not known exactly why it may be due to vitamins B and D that malted drinks contain.
  • Fatty Fish – such as salmon eaten 3 times a week has been found to improve sleep quality [12].

Studies have found that people with raised blood sugar levels experience poor sleep and that 62% of people with blood sugar levels in the pre-diabetes range are likely to suffer from poor sleep quality compared to 46% of people with normal blood sugar levels [13].

Finally, when you eat also plays a part in sleep quality with eating a large meal late in the evening contributing to poor sleep quality. This is due to the digestive system having to work hard to process the food, and that requires energy.

2. Alcohol

Cut back on alcohol. Regularly drinking alcohol can disrupt your sleep patterns, reduce the quality of your sleep, and leave you feeling sluggish.

Although an alcoholic drink in the evening may relax you and help you to drift off to sleep quicker, it has a negative impact on your natural sleep cycle by suppressing REM sleep in the first two parts of the sleep cycle and this, in turn, can cause an imbalance between slow-wave sleep and REM sleep meaning your quality of sleep decreases and you wake up feeling less refreshed.

Alcohol is also a diuretic so you may need more frequent trips to the toilet at night, thereby further disturbing your sleep pattern. This is a particular issue if you have trouble falling to sleep.

Alcohol also causes dehydration and if your body is dehydrated it can cause you to wake so you can rehydrate with a glass of water.

Woman holding a cup of coffee

3. Caffeine

We all know that caffeine is a stimulant which is why many of us reach for a cup of coffee first thing in the morning. This is why it’s best to limit your caffeine intake and not drink any caffeinated drinks in the afternoon, and certainly not before bedtime.

4. Exercise

For a long-time exercise has been associated with better sleep, suggesting it’s the perfect, non-medicated solution to disrupted sleep [14].

Studies have found that people who participate in moderate to vigorous exercise reported better sleep quality and increased daytime energy.

Exercising helps improve overall health, as well as relieving stress and anxiety and releasing endorphins that give us a natural high.

More studies still need to be carried out on what time of day is the best time to exercise to promote better sleep. In some studies, it was found that exercising late in the evening resulted in poor sleep as exercise raises our heart rate, adrenalin levels and body temperate.   However, other studies have found that people how exercise after 8 pm had a more restful night’s sleep [15].

5. Sleep Hygiene

Ensuring that you employ good sleep hygiene is another way to improve your sleep quality. Let’s take a closer look at what we mean by sleep hygiene and if it’s the right solution for everyone.

Learn more about sleep hygiene.

Summary

Sleep is crucial to our physical and mental health and suffering from poor sleep can have a huge impact on our lives.

If you are suffering from poor sleep, the first step is to ensure there are no underlying health conditions that may be causing it. The next step is to look at your lifestyle and ensure you have a healthy balanced diet, a good amount of exercise and where possible reduce any stress that may be impacting your ability to sleep.

Medically Reviewed
Dr Nicky Keay
Chief Medical Officer, BA, MA (Cantab), MB, BChir, MRCP.​
This article has been medically reviewed by Forth's Chief Medical Officer, Dr Nicky Keay.
Nicky has extensive clinical and research experience in the fields of endocrinology and sport and exercise medicine. Nicky is a member of the Royal College of Physicians, Honorary Fellow in the Department of Sport and Exercise Sciences at Durham University and former Research Fellow at St. Thomas’ Hospital.

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