Improving your sleep

Problems with sleep are very common for children and young people with chronic health conditions. Sleep is essential for your health and wellbeing, and it improves your energy. Not having enough sleep can make symptoms such as pain feel worse. It can also affect your mood and reduce concentration and memory. Common sleep difficulties include:

• having difficulty getting to sleep at night
• frequently waking up during the night
• waking early
• sleeping too much

Factors which can contribute to poor sleep

Factors which can contribute to poor sleep include:

• lack of routine for getting to sleep (not going to bed or getting up at regular times)
• daytime inactivity which can make you feel more tired and want to have naps in the day
• daytime naps will make you need less sleep at night
• caffeine, such as coffee, tea, and coca cola, particularly at night
• bed and environment, such as uncomfortable mattress, noise, and feeling too hot or too cold
• worries can lead to tension and not feeling relaxed at bedtime
• change of routine can unsettle your sleep

Ways to improve your sleep

Preparing for sleep

A set routine will help you to prepare mentally and physically for sleep.

Try to wind down in the hour or so before you go to bed.

Include relaxing activities in your schedule such as watching television, having a warm bath, listening to music. Avoid stimulating activities which will keep you alert, for example, studying, decision-making, computer games. Turn off mobile phones, tablets, laptops at least 30 to 60 minutes before you go to bed.

Develop a regular order of doing things, for example, turning out the lights, brushing your teeth and so on. This will act as a signal to your body that it is preparing for sleep.

Get into a good routine

Go to bed when you begin to feel sleepy. Try to go to bed at a regular time, so your body knows when to expect to go to sleep. Do not change things too much to start with. Fix a time close to what you do already and aim to be consistent. You can always bring the time earlier or later gradually.

If you are not asleep within 20 minutes, do not just keep waiting to go to sleep. Try relaxation and breathing techniques. You may need to get up and have a drink or read for a while. Repeat this step as often as is required, and also if you wake for long periods in the night.

Get up and out of bed at the same time each day. It may be helpful to set your alarm clock. Aim to get up within 15 minutes of your alarm going off.

Other tips

• try not to nap during the day, as this can lead you to sleep less well at night
• avoid exercising close to bedtime as it can make sleeping more difficult. However, exercise in the day can help you sleep better at night
• eating a large meal before bedtime, or drinks with caffeine in them, can make sleeping more difficult
• if you have pain try other strategies to help such as hot water bottles or wheat bags
• use your bed only for sleeping. Do not watch TV or do other activities such as homework on your bed. Try not to use it during the day. Your bed will become a signal only for sleep.

Try to stick to this plan. Remember it can take several weeks to get into a good routine

Reducing worries at night

Lying in bed at night worrying about problems can make you feel tense and prevent you from going to sleep. The following problem-solving strategy may help you to reduce worries at night.

Set aside 20 minutes and write down problems or loose ends that you have not dealt with the next day. Decide on a time when you will tackle the problems. Write down the first or next positive step of action to take and when you will take it, then put your piece of paper away.

If you cannot go to sleep or wake up worrying about a problem, remind yourself that you have the matter in hand, and that worrying about it now will not help.

If new worries occur at night, ‘postpone’ them to the next day.

How to deal with frustrations of not being able to sleep

If you become frustrated about not being able to fall asleep, and worry about the possible consequences the next day, it is likely that sleeping will become more difficult the harder you try to fall asleep.

• do not try too hard to fall asleep.
• tell yourself that ‘sleep will come when it is ‘ready’ and that ‘relaxing in bed is almost as good’
• try to keep your eyes open in the darkened room and as they (naturally) try to close tell yourself to ‘resist closing them for another few seconds’. This will “tempt” sleep to take over. Or tell yourself to try and stay awake as long as possible
• imagine a pleasing scene or try repeating a word (such as “calm” or “relax”) every few seconds
• practice relaxation and breathing techniques in bed at night. These can also be practiced at other times of the day as well

How to reduce your sleep at night if you sleep too much

If you sleep for more than 10 hours a night, you may waken feeling unrefreshed, and feel that you may need to go back to sleep. You are probably sleeping for too long, and would benefit from cutting down your sleep.

• cut down your sleep time gradually, either by going to bed 30 minutes later, or getting up 30 minutes earlier
• set a set waking time and going to bed time
• be consistent in either getting up earlier or going to bed later
• do not try to catch up on sleep by getting up later or going to bed earlier if you feel more tired. Stick to the same waking time and going to bed time
• check on your sleep pattern weekly, and continue to reduce your sleep time gradually until you are sleeping for the amount of time with which you are happy

After changing your sleep pattern, you may feel more tired for the first few weeks, but in the long run you can expect to feel more energetic.

The quality of your sleep should increase, as the quantity of your sleep decreases.