How do I know if I’m getting enough sleep?
Poor sleep can manifest in terms of:
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Sleep Deficiency
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Difficulty staying asleep
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Waking up multiple times during the night
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Having non-restorative sleep (still feeling tired upon waking)
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Poor quality of sleep
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Worry about your sleep disturbance itself
Poor sleep can have a small but significant impact on our daily activities including:
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Daytime fatigue and drowsiness
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Irritability
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Impaired memory
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Poor concentration
Sleep is an ever-changing process and is different from person to person. For some people, having 6 hours of sleep is enough whereas others may need to sleep 10 hours to feel refreshed the next morning. There's no definitive right or normal amount of sleep. It does seem however that the amount of sleep we need decreases as we get older.
What factors contribute to my sleep?
Sleep can be a very complex and sensitive process and, for some people, small changes can make a big difference in our sleep
Changes in our pattern, quantity or quality of sleep may be linked to:
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Underlying medical conditions (eg. sleep apnoea/snoring, restless leg syndrome, depression)
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Psychological state (eg. strong emotions, stress, high stimulation before bed)
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Environment (eg. bed, temperature, time zone, noise, light)
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Behaviour (eg. consuming caffeine, using electronics, napping during the day or eating too close to bedtime)
Poor sleep may be the result of a range of different factors and the exact cause can often be difficult to pin. Using a sleep journal to record details of your sleep and activities surrounding your bedtime routine may be helpful to determine what may be affecting your sleep.
I’m having trouble sleeping, what can I do about it?
Several pathways are available for you to follow to help with your sleep concerns, ranging from over-the-counter, herbal, prescription medications and psychological therapy. Not all our suggestions may be appropriate for you, and having a conversation with your healthcare provider about how these therapies can help you is always recommended.
Over-the-Counter
Over-the-counter products are only available from your pharmacy. Although these medicines do not require a prescription, they still come with their own benefits and risks, and a conversation at your pharmacy can best assess which options may be best for your situation.
What’s Melatonin?
Melatonin is a natural hormone produced by a small organ in the brain called the pineal gland. The pineal gland secretes this hormone in response to darkness which contributes to your sleep-wake cycle. The pineal gland is most active in infants and children but as we age its capacity to secrete melatonin decreases.
Melatonin, despite being naturally produced in the body, has since been developed as a safe medication to supplement levels in the body and is available over-the-counter from pharmacies.
However, not everyone is able to access melatonin over-the-counter. Melatonin has only been approved for over-the-counter supply in individuals:
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Over the age of 55
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Not taking any other medications for sleep
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Taking melatonin for short term (less than 3 weeks)
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Experiencing poor quality of sleep
For those who do not meet these requirements, melatonin may still be attainable with a prescription after a discussion with your doctor to determine if melatonin is right for you.
Over the age of 55
Short term use for less than 3 weeks
Improvements to sleep quality
Not taking any other medications for sleep
Can I increase my melatonin naturally?
Melatonin is produced from an essential protein we attain from our diet called tryptophan. There has been evidence showing that eating foods rich in melatonin and tryptophan as part of the evening meal can boost melatonin levels in the body before bed. Although all plant produce contains melatonin to some degree, some foods have been shown to contain more than others.
Foods rich in Melatonin
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Tomatoes
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Olives
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Barley
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Rice
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Walnuts
Foods rich in Tryptophan
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Firm tofu
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Chicken/Turkey breast
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Edamame
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Milk
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Sockeye Salmon
Is there anything else over-the-counter I can try?
A few active agents are accessible over-the-counter to address temporary sleep concerns, most of which are sedating antihistamines such as:
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Diphenhydramine
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Doxylamine
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Promethazine
The efficacy of these agents lack concrete evidence and may come with their own side effects including next-day drowsiness. Sedating antihistamines were initially used to help with allergic conditions such as hay fever, but their observed drowsy side effects have since been used to help with inducing sleep.
Usage for more than 10 consecutive days is not recommended due to the buildup of tolerance to the medication. This often means that for the same amount of the medication you take the effectiveness decreases the more you use it. If you’d like to learn more, speak to your pharmacist to discuss your options and determine if such treatment is suitable for you.
Complementary and Alternative Medicines
Complementary and alternative medicines for sleep are widely available from many pharmacies, supermarkets and health food shops.
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Complementary and alternative medicines are a great way to sustainably improve sleep by promoting the natural sleep wave cycle and supporting the body's own sleep processes.
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However, there is little evidence to definitively support their effectiveness. Although most complementary and alternative medicines are relatively safe for most individuals, if you are taking other medications it is best to notify your doctor and/or pharmacist when you decide to take these medicines to prevent interactions and check if the product is of high quality.
Can I use Magnesium for sleep?
Magnesium is involved in hundreds of processes within the body ranging from immunity to muscle and nerve function. Some studies have shown that magnesium has a role in supoorting melatonin production, relaxing the mind, muscles and may help with symptoms of restless leg syndrome, therefore making it easier to fall asleep.
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Magnesium may be beneficial especially for individuals who:
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Are older adults
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Have type 2 diabetes
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Have gastrointestinal disorder
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Have alcohol use disorder
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Have low magnesium levels
There are many forms of magnesium available but magnesium glycinate, magnesium citrate and magnesium amino acid chelates are better absorbed by the body compared to other forms such as magnesium oxide. Ask your pharmacy for more information and to ensure that the products you're using are of high quality.
Magnesium is a relatively safe supplement however it is also known to interact with some medications. If you are unsure about how magnesium can be used to help you or if you have concerns about interactions with your medications seek your doctor and/or pharmacist for further advice.
Is there anything herbal I can try instead?
Valerian
Valerian herbal supplements are made from the root of the Valerian plant. We are unsure of how it works in the body, and there is limited evidence to support the use of valerian. However the medicine is known to have calming effects and can also induce drowsiness.
Hops
Hops are the flowers of the hop plant. Although the properties of hops haven't been studied extensively, it's thought to work similarly to valerian. Based on the clinical studies, a combination of Valerian and Hops was more effective in inducing sleep than using them separately.
Passionflower
Passionflower is used traditionally for both inducing and promoting refreshing sleep. Although the sleep-inducing properties have not been supported by research, it is used commonly in western herbal medicine.
Psychological and Behavioural Interventions
Psychological and behavioural interventions are always recommended as a practical approach to address various factors impacting your sleep. However, despite the availability of various interventions, not all interventions will work for you. Ask your doctor and/or pharmacist about potential interventions that may benefit you and Sleep Self Care Cards for tips to optimise your sleep routine.
Cognitive Behaviour Therapy
Cognitive behavioural therapy is especially useful for those who have been experiencing long standing difficulty sleeping. Sometimes we can start to worry about not sleeping as much as we think we should be and that can lead to a cycle of stress. This can cause the brain to become too active to sleep which often further contributes to the problem.
Cognitive behavioural therapy aims to address unnecessary worries and misconceptions about our sleep. It intends to change behaviours to optimise our sleep and to reduce overstimulation when trying to fall asleep. Ask your doctor for more information about a range of available cognitive behavioural therapy programs for sleep that are suitable for your needs.
Sleep Hygiene
Sleep hygiene is a term that describes good practices that help promote healthy sleep. It can guide us to improve our sleep quality by simply changing small habits in our life. Good practices aim to prepare our body and mind for sleep and help us associate our beds with healthy sleep.
For a comprehensive list of sleep Dos and Don’ts ask your pharmacy for a Sleep Self Care Card. These suggestions can help guide you in building a sleep or bedtime routine that best works for you.
Relaxation Therapy
Relaxation therapies include:
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Mindfulness
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Deep breathing
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Progressive muscle relaxation
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Meditation
These techniques are useful for those with trouble relaxing. Relaxation therapies are most effective during the day, before bedtime and in the middle of the night when you are having difficulty falling back asleep.
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You may find some apps useful to guide you through this. Both apps below come with free and paid options depending on your requirements.
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Other Interventions
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Acupuncture
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Guided Imagery
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Yoga
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Hypnosis
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Biofeedback
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Aromatherapy
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Massage
Visit the Links Below for more Information
Better Health Channel
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/sleep-hygiene
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Sleep Health Foundation
https://www.sleephealthfoundation.org.au/
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Fact Sheets for Centre of Clinical Interventions (CCI)
https://www.cci.health.wa.gov.au/Resources/Looking-After-Yourself/Sleep
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MedlinePlus
https://medlineplus.gov/sleepdisorders.html#cat_78
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Healthy Sleep SA Health