The 5 most common types of insomnia and the best ways to treat each – plus experts answer your burning sleep questions

The Sun

9 hours ago

WE all need good quality sleep, ideally seven to nine hours a night.
Without it, we put ourselves at increased risk of cardiovascular disease, anxiety, obesity and diabetes - not to mention being short-tempered and bleary-eyed.
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Worryingly, however, one in three of us suffers from insomnia, which can mean struggling to fall asleep, stay asleep or get restful sleep.
Dr Kat Lederle, a sleep and circadian rhythm specialist at The London General Practice, tells Sun Health: 'The definition of chronic insomnia is three or more nights of poor sleep per week for three months, and daytime impairment.
'This can make you feel tired and irritable during the day, and you may have difficulty concentrating.
'Often, poor sleep is triggered by a stressful period or event.
'However, if poor sleep continues after the event and has been replaced by the worry about not sleeping, then it might be helpful to seek help.'
But what intervention or treatment you need depends on what type of insomnia you have.
Here are five of the most common, and expert-approved tips to combat each one for good…
1. Menopausal insomnia
ABOUT half (40 to 60 per cent) of menopausal women complain about disturbed sleep, according to research published in the journal Sleep Medicine Clinics.
'Fluctuating levels of hormones can be the cause,' says Dr Lederle.
'These hormones send signals to many places, including to areas involved in the regulation of sleep in the brain.
Doctor reveals the dangerous effects going to sleep after midnight has on our brain
'When these areas get confusing or mixed messages, they don't quite know what to do: whether to push for sleep or wakefulness.'
Menopausal hot flushes, as well as stress or anxiety, can also lead to disturbed sleep.
'A healthy diet, topped up by supplements if your body needs them, and exercise so your physical health is looked after, is important,' says Dr Lederle.
When it comes to supplements, Dr Elise Dallas, women's health GP at The London General Practice, recommends taking magnesium glycinate, 'which absorbs well and has calming properties to help relax the muscles and nervous system'.
Tuck into magnesium-rich foods too, such as leafy greens, nuts and seeds, whole grains, legumes including beans, lentils and chickpeas and oily fish, such as salmon and mackerel.
The best and worst foods to eat before bed
By Katrina Turrill, Health News Editor
IS your diet keeping you up at night?
There are lots of things that can influence how well we sleep - screen time usage, caffeine and alcohol, relationship stress and bedroom temperature.
You may be aware eating too soon before bed may also disrupt sleep, causing things like indigestion and acid reflux.
But certain vitamins and minerals could help you have a better night's sleep, according to research.
For example, a 2012 study found magnesium could help improve sleep issues in people with insomnia.
While there is no conclusive evidence pointing to a diet that improves sleep, it's clear there are some foods worth eating as a late-snack over others.
Benjamin Bunting, sports nutritionist, military physical training instructor and founder of beForm Nutrition, reveals the best sleep-friendly snacks...
Bananas
Cheese, yoghurt and milk
Porridge
Cherries
Wholemeal bread
However, there are some foods you want to stay well clear of before bedtime, said Benjamin, as they can cause blood sugar spikes and digestion issues that impact sleep.
'Calcium may also help,' Dr Dallas adds.
'It supports melatonin production, which regulates sleep-wake cycles, and is essential for muscle relaxation.
'Women over 50 should aim for 1,200mg of calcium per day, preferably from food such as dairy products, leafy greens like kale and bok choy, fortified foods, small oily fish with bones, and calcium-set tofu.
'If you're taking a calcium supplement, combine it with vitamin K2 and vitamin D to prevent calcification in the cardiovascular system.'
Research in the journal Frontiers has also linked a lack of vitamin D with poor sleep.
The UK Department of Health recommends a daily supplement during the winter months, when sunlight - our main source of vitamin D - is scarce.
Adults and children over the age of one need 10mcg (or 400IU) a day.
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2. Sleep-maintenance insomnia
IF you're waking up once or several times during the night and struggling to get back to sleep, then you might have sleep-maintenance insomnia.
'Often it's stress-related, but it could also be a sign of a health condition such as diabetes, kidney disease, chronic pain or urinary problems, to name a few,' Dr Lederle says.
'Alternatively, it could be down to too much fluid intake during the evening, or blood sugar imbalances.'
Some medications can cause insomnia as a side effect, particularly when you first start them or adjust your dose
Dr Elise DallasGP
Dr Dallas adds that sugary or refined-carbohydrates - such as white rice, pasta, pastries and fizzy drinks - close to bedtime can cause rapid spikes in blood sugar.
This then leads to a swift insulin release followed by drops in blood sugar levels.
'This drop triggers stress hormones such as cortisol and adrenaline, which can disrupt sleep by inducing anxiety or alertness,' she says.
'Low blood sugar can also cause fatigue, weakness and sweating, making you wake up during the night.'
Try to leave a couple of hours between your last mouthful and going to bed.
Keep sugary foods to a minimum too and focus on slow-release carbohydrates with dinner, such as wholemeal grains.
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3. Sleep-onset insomnia
IF you're struggling to fall asleep, it might be down to a racing mind triggered by stress.
'That morphs into worry about not sleeping and its consequences on the next day,' says Dr Lederle.
To help your body and mind relax and fall asleep, giving yourself downtime is a must.
'Allow the mind enough time to process the day, learn to notice the thoughts that hook you at night and then step back from them without trying to get rid of them,' Dr Lederle says.
'In many cases, this 'getting rid' can make you feel even more helpless and anxious.'
You could try journaling before bed, to get your thoughts out on paper.
Avoid screens at least one hour before hitting the hay too, and make sure your room is cool and your bed is comfortable.
4. Short-term insomnia
HAVING sleep difficulties for less than three months is classed as short-term insomnia.
'This is usually caused by external stress or a lifestyle change, such as a new job, divorce or loss of a loved one,' says Joshua Piper, sleep clinician at Resmed UK.
'For the most part, once the blunt impact of the stress leaves, so does the insomnia.'
It's important to try to maintain your usual schedule in spite of your stress.
'It's the things we start to implement when we are struggling to sleep that have a longer-term implication, such as turning to alcohol, changing our bed/wake times, Googling 'sleep cures' at 2am, and so on,' adds Joshua.
'We call these perpetuating factors, and they become the problem, not the original trigger.'
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5. Terminal insomnia
IT sounds scary, but terminal insomnia refers to waking up hours before your alarm and struggling to get back to sleep.
Older age and mental health difficulties, such as anxiety and depression, can cause this, says Joshua, but it can also be a byproduct of spring and summer.
It's now significantly lighter in the morning, which can have a huge impact on our body clocks.
'A simple sleep mask to block out the light can be a really easy and cheap solution,' says Joshua.
But even with a mask and blackout blinds, you may still have issues with early waking.
This could be caused by your medication.
'Antidepressants can cause insomnia as a side effect, particularly when you first start them or adjust your dose,' Dr Dallas says.
'Stimulants such as amphetamines (used for ADHD) can also increase alertness and energy, making it hard to fall asleep, while corticosteroids can cause increased energy and mood changes, leading to difficulty sleeping.
'Beta-blockers may cause sleep disturbances, including nightmares, decongestants can stimulate the nervous system, affecting sleep, and even antihistamines can lead to disrupted sleep patterns.'
'A discussion with the prescribing doctor is needed,' adds Dr Lederle.
5 SLEEP QUESTIONS, ANSWERED
1. Can I die from no sleep?
Yes, but it's not an overnight thing.
'It's the chronic deprivation that slowly chips away at your health, increasing the risk of things like cardiovascular disease, diabetes, cancer and let's not forget, depression,' says Joshua.
'Without some quite extreme measures, your brain will always prioritise getting sleep, so the main thing here is not to worry.
'A poor night, or even multiple nights, isn't going to be your demise.'
2. What's the minimum amount of sleep I can get away with each night?
GETTING little sleep is nothing to brag about.
We need at least seven hours of sleep each night to stay healthy, and consistently getting less than five hours can have huge impacts on your health.
'Stop treating sleep as something passive that you 'have to do' and encourage it as something you 'want to do',' says Joshua.
'Most people need seven to nine hours of sleep (with people either side of that boundary) and almost everyone thinks they are the person that needs far less.
'The chances are though, you need more.'
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3. Can I nap during the day to make up for lost sleep?
NAPPING is a brilliant way to claw back some sleep you might have missed in the night, Joshua says.
But you shouldn't nap if it affects your ability to fall asleep later that evening.
'When we nap, we chip away at our sleep pressure, typically building up over the daytime to encourage sleep later,' he adds.
'It's like blowing air into a balloon; you keep adding pressure until it eventually pops.
'But, if you release some of that pressure halfway through, it's not going to pop when you want it to later.'
However, if you fall asleep at the right time, with no problem, then napping is a useful tool.
4. Why am I so tired but can't sleep?
TIRED but wired? You might be sleepy all day then lie down and suddenly be wide awake.
'Tired is when you are drained mentally and/or physically. Sleepy is when you can barely keep your eyes open,' says Joshua.
'Being tired but wired is likely down to stress, poor routine and the brain learning some bad habits.
'The good news is there's an effective option called cognitive behavioural therapy for insomnia (CBTi).
'It helps break the mental loop and regain control over bedtime again.'
CBTi is available on the NHS and privately. Speak to your GP or visit betterhealth.com to find a therapist.
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5. Why do I overthink everything at night?
BEDTIME might be the first quiet moment you've had all day.
'That's when people think things over,' says Joshua.
'It's not ideal because the bedroom is for sleep, not thinking.
'It goes one step further, though; your brain doesn't power down all at once.
'The prefrontal cortex (your rational, calming voice) winds down before the amygdala (your emotional alarm system).
'For a short window, your worry centre is still active while your logic centre has gone offline so you lie there replaying old arguments or stressing about tomorrow.
'Your emotional brain's still firing, and the brakes are off.'
Try creating a calming bedtime routine, with relaxation techniques like meditation or deep breathing.
A simple YouTube search brings up hundreds of options, so find one that works for you.
The best sleep routine and environment
Thomas Høegh Reisenhus, TEMPUR® sleep specialist & sleep counsellor, reveals the key components of a good bedtime routine and environment...
A sure-fire way to facilitate a better night's sleep is to practice good sleep hygiene.
Establish a sleep routine that works for you and stick to it.
This will help your body establish a consistent, natural sleep-wake cycle which can do wonders for your overall sleep quality.
As such, try to avoid making up for lost sleep with a lie-in.
Instead of sleeping in, spend your morning reading a book in bed or having a leisurely coffee in the kitchen.
Ensure that your bedroom, bedding, and sleepwear are fit for purpose too.
The ideal sleep environment is dark, quiet, and cool – much like a cave.
If you find unwelcome sources of light are keeping you up, consider investing in an eye mask or black-out curtains.
Adding soft furnishings can be a great way to reduce noise, with the surfaces having an absorptive quality, but if this doesn't work, consider embracing a soothing soundtrack to block it out.
In terms of temperature, try to keep your bedroom at 18°C. You can further reduce the risk of waking up due to overheating by ensuring that all your bedding and sleepwear is made with natural, breathable materials such as cotton and linen.
Bear in mind that everyone is different; what might work for most, may not work for you!
Whilst knowing how much sleep you should get, how to overcome common barriers, and practicing good sleep hygiene can facilitate a great night's sleep, if you continue to struggle with sleep or fatigue persistently, do not hesitate to visit a doctor or health professional for support.