FEELING tired all the time might seem like your normal, everyday state now, but extreme tiredness and consistently broken sleep shouldn’t be ignored.
We all feel a little worn out sometimes and can wake in the night if we’re stressed or need a wee, but if your daily life is suffering through lack of kip, look at your sleep hygiene habits and try making some changes. I outline a few below.
Dr Zoe Williams answers some common questions sent in by readers
For new parents, or those with toddlers climbing in and out of their beds at all hours, shut-eye can become a distant dream.
But you’re not alone.
Visit nhs.uk for tips and strategies for good sleep and coping with tiredness after having a baby.
Here are some of what readers asked me this week . . .
Q) MY sleep has become terrible since getting into my 40s a few years ago.
I drop off quickly but wake around 1am or 2am and struggle to get back to sleep. What can I do?
A) You would be surprised at how many people are affected by this.
If you wake in the night with your mind racing, write down your thoughts before you nod off
If you had trouble falling asleep, I could tell you all about establishing a sleep routine and making sure your bedroom is set up for rest — for example, no TVs in it, a cool temperature and darkness.
But your issue is staying asleep, not falling asleep, which is entirely different.
Firstly, what happens when you wake up? If it’s because you need the bathroom, try to drink nothing after 6pm.
If you suddenly wake and feel very alert, look at when you’re having your last caffeinated drink — a coffee after dinner could be a culprit.
It’s advisable to not consume caffeine after lunchtime, if you’re having sleep issues, as it takes, on average, five hours for half of it in your system to be cleared.
If it’s to check your phone, try sleeping with it out of the room — phones are notorious sleep thieves so don’t have it in your bedroom environment and if you have to, make sure it’s out of arm’s reach and not next to you.
There are lifestyle factors too that could be at play: Are you exercising during the day? Do you go to sleep tired enough? Do you find yourself napping on the sofa or nodding off while you watch TV?
It could be you’re going to bed thinking you’re tired but you’re not as sleepy as you believe.
Certain mental health conditions can interrupt shut-eye too such as anxiety and depression, so if you have a history of those it might be worth talking to your GP.
If you haven’t done so already, try guided meditation apps.
Calm is a good one to start with and has free programs.
Think about the hours leading up to sleep too.
If you find you’re waking up with your mind racing, keep a notebook by your bed and write down the things you’ve been thinking about before you go to sleep.
Lots of people find a “to do” list for the next day gets things out of their mind and onto paper.
If you like warm baths, try one before bed. And a small-scale study found nodding off with the window open improved sleep quality in participants too, so if it’s safe to do so, think about that.
The answer to your question is likely to be in how you’re spending your waking hours and what you’re consuming in the second half of the day, so keep a diary and see if you can see any patterns.
If it continues after changes and you’re getting less than six hours a night, it might be worth considering sleep CBT.
There’s an app called CBT-i Coach that you could take a look at first off.
Q) I’M on hormone replacement therapy but my sleep is broken every two hours. What can I do to stop this?
A) Like lots of our biological processes, sleep can be affected by our hormones.
Hormones such as oestrogen, progesterone and testosterone can all contribute towards our ability to sleep well.
Oestrogen and progesterone levels decrease significantly at menopause, and testosterone levels gradually fall with age.
In fact, sleep problems are one of the commonest reported symptoms of perimenopause and menopause.
There is lots of evidence that HRT can be useful for many in resolving menopause-related insomnia, because it replaces some of the hormones that have been lost.
In addition to this, some small-scale studies have also found that HRT can cause sleep disturbances.
You don’t say how long you’ve been on HRT, or whether there is an additional reason that you wake, such as night sweats, but either way I’d make an appointment or try to get a phone consultation with your GP.
Maybe adjusting the HRT you’re on could be a sensible first step to solve the problem.
Your GP will be interested to know if falling asleep is an issue or whether it’s just staying asleep that’s the problem.
Sleep can fluctuate a lot with HRT and menopause but it’s important to try to improve things, as sleep deprivation in the long term can cause other health issues, such as difficulty concentrating, and is linked to heart disease, diabetes, stroke, obesity and depression.
Many factors influence how you poo. The key is to monitor what is normal for you.
Poo habits vary wildly
Q) I GO to the toilet to have a poo a couple of times a week and my partner goes twice a day. Which of us is normal?
A) Healthcare professionals generally agree that healthy bowel movement frequency can range from three times a day to three times a week.
Many factors can influence how often you poo, including your diet, how much water you drink, your genetics and your stress levels.
It’s more important to monitor what is normal for you, and if there is a significant change to your bowel habit that persists for more than a few weeks, it is worth getting this checked.
This is especially so for people over 60 or if it is accompanied by other symptoms, such as blood in the poo, abdominal pain or unexplained weight loss.
These could raise the suspicion of a serious underlying health condition, like bowel cancer.
We should also look at our poo, as otherwise we won’t know if something changes.
It should be brown, moist and log shaped and usually have a mildish odour.
If it’s runny or darker than normal or has an overwhelming odour, it could be down to a stomach upset or poor diet.
For good gut health it’s important to make sure your diet includes a diverse range of plant foods, such as fruit, vegetables, wholegrains, nuts, seeds and legumes (eg. chickpeas, lentils, beans).
It’s also important to try to limit ultra-processed food.