Say Goodnight

New research suggests sleeping pills do more harm than good among the Modern & Mature generation, but there are plenty of alternatives. Lyndsay Moss reports.

Popping a pill to ensure a decent night's sleep sounds like the perfect solution to a frustrating and often debilitating problem. But what might seem a panacea could become a curse, with the side effects and addiction associated with sleeping pills sometimes worse than the insomnia itself.

Researchers in Canada have warned that the risks of giving sedatives to older people, who are more prone to sleeping troubles, could outweigh the benefits. The study, published in the British Medical Journal, found that sleeping pills could cause dizziness, loss of balance, falls and disorientation. The evidence of the side effects considered by the experts from the Centre for Addiction and Mental Health in Toronto included six serious falls and a car crash - all linked to sedative use to aid sleep.

"Sleeping pills in the long run actually don't help and have side effects and can lead to addiction."

In the UK, The Royal College of Psychiatrists says that sleeping pills should only be used for short periods of less than two weeks, most obviously in cases where a person is so distressed that they cannot sleep at all. But if someone has been on sleeping pills for a long time they should not stop immediately. The best way of weaning off the tablets is to gradually cut down the dose after advice from a doctor.

Jessica Alexander from the UK's Sleep Council believes that the widespread and long-term use of sleeping pills was becoming a thing of the past as doctors woke up to their downfalls. "A lot of doctors who have used sleeping pills more in the past have come to realise that there are a lot of drawbacks to using them, certainly on a long-term basis," she said. "They are often prescribed over a short-term to get people through a crisis or to get them back into good sleeping habits. But sleeping pills in the long run actually don't help and have side effects and can lead to addiction. As with any medication people should not stop taking pills suddenly but should seek advice from their doctors to cut down."

But if a prescription from your doctor is not to answer, what alternatives are there? Over-the-counter remedies are available, often containing an antihistamine drug like those found in medicines for hayfever, coughs and colds. But as with prescription sleeping tablets, these can lead to sleepiness the next day and long-term use is not recommended.

Those who favour herbal alternatives may wish to try treatments containing the herb valerian, although evidence for its effectiveness is mixed. Anyone who is taking any other medication should talk to their doctor before starting another treatment to help them sleep in case it affects what they have already been prescribed. But it could be that simple changes in lifestyle could be enough to solve sleeping blues, rather than reaching for a medical solution. "One of the best pieces of advice, as simple as it may sound, is to stop worrying about it," says Jessica. "It may be that getting older means that you need less sleep too. If you are getting a reasonable nap in the afternoon, you may not need to be in bed for eight hours. Really the first thing to do is to ask yourself do I really need to be worrying about this? People get fixated on the idea of having to get eight hours. It is a good guideline but it isn't the same for all people."

She says if people really are having problems sleeping, there are better things to do than lie in bed worrying about it and a change of scenery could be the best medicine. "People get really worked up about not having enough sleep. During the night people can feel very isolated if they are struggling to go to sleep. If you are not sleeping you are better off getting up and doing something rather than lying there worrying about it."

NHS Direct, the health service's patient advice phoneline and website, also suggests it is better to get up and try reading or watching TV than lying in bed becoming anxious about lack of sleep. Jessica says that a winding down routine before bedtime, such as having a hot milky drink - although not with caffeine - and a relaxing bath could all aid sleep. "Getting fresh air and exercising can help, particularly as we get older," she added. NHS Direct says that people should not use their bedroom for working, eating, watching television or talking on the phone. "Associate it only with sleep and sex," its website bluntly states. And of course the importance of a good bed and mattress cannot be underestimated. The Sleep Council suggests giving your bed an MOT every three to five years, to check it is giving support in the right places and is not too hard or too soft. Experts believe that buying a new bed could be more effective than taking a sleeping pill when it comes to getting a good night's kip.

Look out for our special guide to beds in the next issue of Modern & Mature

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Here are The Sleep Council's top tips for getting a better night's sleep:

Keep regular hours. By going to bed and getting up at roughly the same time, you will programme your body to sleep better.

Create a restful sleeping environment by keeping your bedroom for rest and sleep. It should be neither too hot, nor too cold and as quiet and dark as possible.

Make sure your bed is comfortable.

Take more exercise to relieve stresses and strains, but not too close to bedtime or it may keep you awake.

Cut down on stimulants such as caffeine in tea or coffee - especially in the evening. Have a hot milky drink or herbal tea instead.

Don't over-indulge. Too much food or alcohol, especially just before bedtime, can play havoc with sleep patterns.

Don't smoke. Smokers take longer to fall asleep, wake more often and can experience more sleep disruption.

Try to relax before going to bed, for example by having a warm bath, listening to some quiet music or doing some yoga.

Deal with worries or a heavy workload by making lists of things to be tackled the next day.

If you cannot sleep, don't lie there worrying about it. Instead, get up and do something you find relaxing until you feel sleepy again.

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INFORMATION:
As with many problems there is no single cause and no single solution to insomnia. But help and support is available from a range of sources.

More information is available from the Sleep Council's website: www.sleepcouncil.com or from NHS Direct at www.nhsdirect.nhs.uk

The NHS Direct phone line 0845 4647 can also offer advice on sleep disorders, while the Medical Advisory Service (MAS) helpline - 020 8994 9874 - can also deal with insomnia-related queries. The MAS service, which is staffed by nurses, is open from 6-8pm, Mon-Fri.