Sleep needs can vary between individuals (see our Fact Sheet on How much sleep do you really need?), however, if you’re getting an unusually high or low amount of sleep, it is important to identify the cause. Once the cause has been determined, actions can be taken towards remedying it.
Is there something affecting my usual routine or health?
There are many factors that can influence your sleep. These can be either internal or external. Examples include:
- Physical environment: Are you sleeping in your usual bedroom? Has your room been uncomfortably warm or are you sleeping on a new mattress? It’s important to ensure that your sleep environment is comfortable and relaxing.
- Shift work or travel: This can disrupt your circadian rhythm (or “body clock”). Having an irregular sleep pattern can make maintaining a routine more difficult.
- Commitments and responsibilities: Being a carer or parent, workload, and other commitments can often overshadow sleep as a priority. If a full night’s sleep is not achievable, consider taking a short 20-minute nap during the day.
- Stress: This can interfere with sleep and can be related to external factors (work, an event, health, etc.) or based on anxiety around sleep itself. If you are limited in removing the cause of stress from your life, practicing mindfulness is a great way to help remove emotional attachments to sleep. If the stress is more significant, you may have Post-Traumatic Stress Disorder (PTSD). You may wish to seek a professional for help addressing your PTSD.
- Physical or mental health: Pain and discomfort, both physical and/or mental, can disrupt your sleep. Helping your sleep may improve aspects of your general health, pain and discomfort, just as helping your pain, discomfort or health may improve your sleep.
- Drug side effects: If you’re on new medication, this may be affecting your sleep. You should discuss this with your doctor to determine if your medication may be the cause of your struggles getting quality sleep, and if there are alternative options for you.
Have I been practicing sleep hygiene AKA good sleep habits?
Sleep hygiene refers to habits and behaviours that you can implement, or should be mindful of, that can help improve your sleep. These habits can begin from the time you wake up, to the period immediately before your fall asleep. If you’re not sure why you aren’t sleeping well, this should be your first step towards improving your sleep.
- Try to go to bed at the same time each night and get up at around the same time as often as possible. Consistent sleeping patterns are a key component of good sleep health.
- Set aside “worry time” in the evening if you are a worrier, write them down and then try to shut off your mind to these thoughts until the following day.
- Implement a relaxing pre-bed/wind-down routine.
- Turn off stimulating screen-based activity 1-2 hours before bed, if possible. It is best to keep your technological devices such as phones and laptops out of the bedroom entirely if possible.
- Leave the bed/bedroom if you are taking too long to fall asleep or do not feel sleepy enough to sleep. Do a quiet, passive activity in dim light until you are sleepy and tired enough to return to bed and fall asleep.
- Ensure your environment is comfortable. Avoid being too hot or cold, and make sure that your bed feels cosy, safe and relaxing.
- Get some morning light as close as possible to your wake-up time. Outdoor exercise is recommended, but even drinking your morning coffee or tea outside can help regulate your body clock and melatonin levels.
- Consuming caffeine, nicotine, and alcohol too close to your bedtime. Ideally cease caffeine 6 hours before sleep time, and alcohol 3-4 hours prior to sleep time.
- It is also important not to be hungry, but that you avoid heavy meals before you go to bed.
- Wearing a sleep-tracking device if you find yourself becoming anxious about sleep.
- Having a clock in your bedroom. If you have a clock in your bedroom, limit your access to looking at it while in bed.
- A big work-out just before going to bed. Exercise during the day can help you sleep just be cautious of not be too hot or stimulated just before sleep time.
- Taking naps within 4 hours of bedtime. Naps should be no longer than 15-30 mins for most people but of course may need to be longer for shift workers or people with certain medical conditions.
How long have I been struggling to get to sleep or with daytime sleepiness?
Implementing sleep hygiene can take a while to have an impact on your sleep. It is important to be consistent, however, there will always be nights when we struggle to sleep more than others, and times when we aren’t able to apply sleep hygiene practices. Just like you may not see progress immediately when making more nutritional food choices and it’s okay to indulge in a treat every so often, the same applies to sleep.
Try to maintain your routine, but don’t be hard on yourself if you have a rough night or you don’t go to bed at your usual time. The following day, try to reintroduce sleep hygiene practices and return to your routine. Improving your sleep health requires patience and may take a few weeks, or even a couple of months, to demonstrate effectiveness.
If it has been several weeks, even up to 6-8 weeks, of implementing good sleep routines, and also having adequate opportunity for sleep, and you feel that sleep isn’t improving and that there are negative impacts on your quality of life and the causes of the sleeping difficulties aren’t known to you, and if you can’t manage to improve sleep via your self-help strategies then it would be time to talk to your GP to enquire about the next steps in finding some more specialised support.
Has a bed partner or someone close to me noticed anything unusual about/during my sleep or daytime behaviour?
Perhaps a partner has noticed you’ve recently started snoring or has noticed that you stop breathing in your sleep, or that you are very restless in your sleep? Or perhaps someone from work has noticed you’re arriving late to work, which is unusual for you, or commented that you look like you’re having little micro-naps in meetings. Sometimes it can be others, rather than ourselves, alerting us to changes in our sleeping quality or quantity that could be indicative of a sleeping disorder. If any family, friends or colleagues have commented on the types of issues listed above this could be the prompt you needed to have an initial conversation with your GP.
Is my poor sleep and/or daytime sleepiness affecting my everyday life?
Example: Jane has been so tired recently that she hasn’t been able to perform to her usual standard at work. She has taken three sick days over the past month that she attributes to tiredness/poor sleep.
Example: John has been experiencing ‘brain fog’ and has been having a great deal of difficulty with staying awake during the day despite getting more than 8 hours of sleep every night. This has been affecting his memory and he recently reports falling asleep for just a couple of seconds whilst driving.
Example: Kim has been having trouble sleeping since her divorce. It’s been many years since her divorce, and the acute stress has settled but she has been becoming increasingly concerned about her sleep. She finds herself thinking about her sleep and planning for it all throughout the day, and has been not going out beyond 8pm for two years now just so she can have a strict pre-bed routine to increase her chances of a good sleep.
Have I spoken with my doctor about my health?
Having a discussion with your doctor about your overall health and habits can help identify the cause of your poor sleep or daytime sleepiness. They may also ask you for some more information about the trouble you’re having sleeping and experiencing daytime sleepiness. They may then refer you to a sleep specialist, who may arrange a sleep study or some blood tests, to further investigate the cause. To book with a sleep specialist, you are required to have a referral from your GP. It is important to ensure that the sleep specialist does have specific expertise in sleep.