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Difficulty Sleeping

A good night’s sleep!

Good sleep can feel elusive which can lead to feelings of frustration as well as tiredness. First of all, know that you are not alone……There are many people awake with you at any time of the night.
Factors which can interfere with sleep:
  • Physical issues such as medical causes, pain, fatigue, breathing difficulties, bladder and bowel
  • Treatments you maybe undergoing or pain following surgery
  • Drugs: e.g. caffeine, nicotine, alcohol, steroids, blood pressure, decongestants, asthma meds, also herbal: ginseng, guarana, anti-depressants
  • Emotional issues such as stress, anxiety and depression
  • Our age can make a difference, as well as attitude to sleep
  • Environmental reasons such as temperature, noise, allergens, lack of comfort
  • Reduced or interrupted exposure to daylight and darkness, such as jet lag or blue light from mobile phones, computer screens or even televisions
  • Light sources all emitting light such as TV LEDs, electric alarm clocks, toothbrush chargers
  • Disruptions in rhythm, caused by illness, food, exercise, shift-work, naps
Hospice staff and patient
When our sleep is disrupted we can struggle with our:
  • Mental and emotional health, including mental clarity and mood
  • Immune response can be compromised, increasing possibility of infection
  • Physical health, inflammation, hypertension. heart disease, dementia
  • Social functioning, not looking after yourself, being irritable, difficulty in relationships
  • Performance in day to day activities, poor concentration
  • Hormone balance

Sleep Hygiene

Sleep Hygiene is about trying to improve healthy sleep habits to help with insomnia and other sleep problems or bad sleep habits we may have developed. We can try to improve this by looking at ways to actively help ourselves, such as:
Reducing Mind ‘noise’:
  • Address intrusive thoughts, be compassionate with yourself
  • Recognise the value and joy of sleep
  • Check thoughts and beliefs about sleep – don’t ‘TRY HARD’ to fall asleep
  • Daily relaxation and stress management, relaxation, breathwork, such as diaphragmatic breathing, mindfulness, visualisation, guided imagery
  • Accept wakefulness (for now) and enjoy rest and relaxation
Reducing Sleep-disrupting ‘noise’. It can be helpful to try:
  • Reducing stimulus – things like screens or music
  • Avoiding caffeine or alcohol
  • Keeping to a daily routine, going to bed at a similar time
  • Avoid napping during the day if possible, or if you do keep to no more than 45 minutes
Willow Room at Cottage Hospice

Managing your sleep space:

  • Green therapy, getting outside in nature, clean fresh air, natural light
  • Creating a space for sleep; you may want to use plants, lavender can be a helpful and calming scent. Ensure you have comfortable bedding and pillows which are right for you.
  • Get the light right, consider black out blinds
  • Darkness signals it is time to rest, and triggers the production of melatonin, which is the hormone largely responsible for helping us to go to sleep
  • Keeping your bedroom dark and cool
  • Just like darkness can help us sleep, try to embrace the natural cycle of morning light to wake up – this will help you sleep again in the evening
People in the hospice run

Nutrition and exercise

It can be helpful to consider:
  • Timing of meals, don’t eat too late or too much in the evening,
  • Avoid caffeine, meat, alcohol and nicotine at night
  • Try and follow healthier eating options such as magnesium rich foods – green leafy veg, nuts and seeds, cherries/cherry juice, pistachios
  • Some people find herbal teas helpful in moderation: chamomile, valerian, hops, lemon balm. Green tea contains caffeine so is best avoided close to bedtime.
  • Think about exercise. The timing, intensity, too much or too little. Adequate, well-timed physical activity such as swimming, Yoga, Tai Chi, Yoga or Walking can be helpful.
  • If you practise sports allow at least four hours between the end of exercise and going to bed
Top Tips:
  • Avoid going to bed until you are feeling sleepy
  • Try to go to bed and wake up at the same time every day to help your body’s (circadian) rhythm
  • Build in a relaxing routine before bed. Have a bath, read a book or listen to relaxing music.
  • If you’re still wide awake after 20 minutes, get up and do something relaxing such as reading a few pages in a book. Try again when you’re feeling drowsy.
  • Get any thoughts about tomorrow out of your head by writing them down. To do lists, reminders, text messages about errands can all be picked up in the morning rather than running around in your head.

If you find writing helpful, try writing a gratitude journal. Before you go to bed, try and write down at least 3 things that have gone well, or that you are grateful for.

Sleeping disturbances 

Many people with who are unwell have sleeping difficulties at some point during their illness. There can be a number of reasons for this, including anxiety and symptoms such as pain and breathlessness. These symptoms can often be treated, so speak to your doctor about them. For example, if you have pain, ask your doctor about long-acting painkillers that will last through the night. Some people may benefit from having a short nap during the day. However, too much sleep during the day can cause problems sleeping at night – try limiting yourself to one or two sleeps each day if you can’t sleep at night. If possible, avoid sleeping in the late afternoon or evening. If you do have difficulty sleeping at night, remember your body will still benefit from lying quietly in bed resting, even if you’re not asleep. 

Sleeplessness can sometimes be a sign of depression. Talking through your worries and concerns may be helpful. Some people benefit from counselling or relaxation therapy. Sometimes a short course of sleeping pills can help you get back to a regular sleeping pattern or help you through a particularly difficult time. They usually work by helping you get to sleep, so they’re best taken before bedtime rather than in the middle of the night. 


If you have an urgent enquiry for our medical and nursing teams (which may be for help and advice) please phone 01892 820515.  This phone number is answered 24 hours a day, 7 days a week.