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Sleep problem

Fitness tips, Relaxation, Mind and Body
Gersemi
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Sleep problem

#386883

Postby Gersemi » February 15th, 2021, 12:02 pm

Hi

over on a thread (viewtopic.php?p=386839#p386807) on Beerpig's Snug I mentioned that I had a sleep problem and AsleepInYorkshire suggested that I post about here. Here goes.

For about three years (or maybe longer, don't you find it hard to judge time?) I have had a sleep issue. I have no problem in falling asleep when I go to bed, but I wake again about 2 or 3 O'clock in the morning and struggle to get back to sleep. Sometimes I get an hour or so after that but, basically very little. This happens virtually every night.

I have completed a sleep course accessed through the NHS, this involved staying awake until a couple of hours after my usual sleep time and getting up at a fixed time in the morning. You gradually brought the bed time forward. There was other advice along the normal lines of keeping to a routine, avoiding alcohol and caffine late in the day etc etc. I didn't find it terribly helpful. I found it very hard to stay awake until the appointed time (I often struggle to stay awake in the evenings) but on going to bed, as usual I fell asleep straight away, but I still only slept for about 3 or 4 hours. To start with, at the later time, this was an almost normal getting up time, but as soon as I brought the bed time forward at all (half an hour at a time), I just woke up earlier again.

I don't normally feel worried when I wake (though of course if there is anything on my mind my thoughts will turn to it). I don't have any particular stresses in my life. When it first started I was quite stressed at work and assumed that when that issue passed my sleep would improve, but it didn't. When I am on holiday there is no improvement. The only time I sleep for longer is if I've been drinking, but I know that isn't producing good sleep. I have tried cutting out alcohol and caffine all together, but that didn't help at all.

I am tired all the time (but don't sleep during the day). I know lack of sleep can be very bad for your health, but don't find being told that helpful!

I don't know what help anyone can give, but if anyone has any tips that have worked for them I'd be interested to hear them. I have read a lot about sleep problems, but they mainly concentrate about bed time rituals to get you ready to sleep, but that isn't a problem for me.

PhaseThree

Re: Sleep problem

#386887

Postby PhaseThree » February 15th, 2021, 12:20 pm

I "suffer" from the same type of sleep pattern. It is actually not that unusual and generally not a problem.
Have a read of the following:-

https://www.bbc.co.uk/news/magazine-16964783
https://en.wikipedia.org/wiki/Biphasic_ ... asic_sleep

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Re: Sleep problem

#386894

Postby ReformedCharacter » February 15th, 2021, 12:50 pm

Have you tried a Melatonin supplement?

RC

AsleepInYorkshire
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Re: Sleep problem

#386902

Postby AsleepInYorkshire » February 15th, 2021, 1:09 pm

Gersemi wrote:Hi

over on a thread (viewtopic.php?p=386839#p386807) on Beerpig's Snug I mentioned that I had a sleep problem and AsleepInYorkshire suggested that I post about here. Here goes.

For about three years (or maybe longer, don't you find it hard to judge time?) I have had a sleep issue. I have no problem in falling asleep when I go to bed, but I wake again about 2 or 3 O'clock in the morning and struggle to get back to sleep. Sometimes I get an hour or so after that but, basically very little. This happens virtually every night.

I have completed a sleep course accessed through the NHS, this involved staying awake until a couple of hours after my usual sleep time and getting up at a fixed time in the morning. You gradually brought the bed time forward. There was other advice along the normal lines of keeping to a routine, avoiding alcohol and caffine late in the day etc etc. I didn't find it terribly helpful. I found it very hard to stay awake until the appointed time (I often struggle to stay awake in the evenings) but on going to bed, as usual I fell asleep straight away, but I still only slept for about 3 or 4 hours. To start with, at the later time, this was an almost normal getting up time, but as soon as I brought the bed time forward at all (half an hour at a time), I just woke up earlier again.

I don't normally feel worried when I wake (though of course if there is anything on my mind my thoughts will turn to it). I don't have any particular stresses in my life. When it first started I was quite stressed at work and assumed that when that issue passed my sleep would improve, but it didn't. When I am on holiday there is no improvement. The only time I sleep for longer is if I've been drinking, but I know that isn't producing good sleep. I have tried cutting out alcohol and caffine all together, but that didn't help at all.

I am tired all the time (but don't sleep during the day). I know lack of sleep can be very bad for your health, but don't find being told that helpful!

I don't know what help anyone can give, but if anyone has any tips that have worked for them I'd be interested to hear them. I have read a lot about sleep problems, but they mainly concentrate about bed time rituals to get you ready to sleep, but that isn't a problem for me.

Hi Gersemi,

You're tired during the day because you're not getting enough sleep. In particular the amount of REM sleep you will be getting will be extremely low.

May I suggest the first thing to do is begin a process of elimination to attempt to find out why you are struggling to maintain sleep. My best guess is that your initial sleep of 4hrs is probably more a sedation sleep from alcohol. Once that wares off you wake, having not really been asleep. This is probably a "circadian" disruption. That is a broken 24hr sleep wake cycle. If this isn't the case then another probable cause is obstructive sleep apnea.

As we age some of us do find sleep becomes an issue too. However, it is I believe very much a myth that as we age we need dramatically less sleep.

I'm aware that you are not just tired. I think you should consider that you are probably exhausted. It's not a word I use lightly.

I'm assuming you have been tested for thyroid issues, diabetes, gluten intolerance and other stuff which will impact your sleep negatively?

I'd suggest you take this little test. It's called the Epworth Sleepiness Scale. If you don't mind discussing the result here that would help. http://www.epworthtest.co.uk/

Also do you have any times of the year when you feel less tired?

Take care

AiY

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Re: Sleep problem

#386919

Postby Gersemi » February 15th, 2021, 1:51 pm

AsleepInYorkshire wrote:

Hi Gersemi,

You're tired during the day because you're not getting enough sleep. In particular the amount of REM sleep you will be getting will be extremely low.

May I suggest the first thing to do is begin a process of elimination to attempt to find out why you are struggling to maintain sleep. My best guess is that your initial sleep of 4hrs is probably more a sedation sleep from alcohol. Once that wares off you wake, having not really been asleep. This is probably a "circadian" disruption. That is a broken 24hr sleep wake cycle. If this isn't the case then another probable cause is obstructive sleep apnea.

As we age some of us do find sleep becomes an issue too. However, it is I believe very much a myth that as we age we need dramatically less sleep.

I'm aware that you are not just tired. I think you should consider that you are probably exhausted. It's not a word I use lightly.

I'm assuming you have been tested for thyroid issues, diabetes, gluten intolerance and other stuff which will impact your sleep negatively?

I'd suggest you take this little test. It's called the Epworth Sleepiness Scale. If you don't mind discussing the result here that would help. http://www.epworthtest.co.uk/

Also do you have any times of the year when you feel less tired?

Take care

AiY


Hi AiY, thanks for your comments. I agree that I am very tired, and it does affect me. Re alcohol, I don't drink every day, two or three times a week and not that much. Occasionally I will drink more, but I don't think it is an alcoholic stupor that is getting me to sleep most nights.

I do have an under active thyroid, following treatment for an over active thyroid many years ago. I am on levothyroxine and have been for many years, tested every year to check my hormone levels are correct. The sleep problems started long after the under active thyroid started. I am pre-diabetic, as I indicated on the original thread, but only marginally. I did the Epworth Sleepiness scale and came out at a 10, so just within the normal level. I don't think my sleep problems vary across the year.

PhaseThree wrote:I "suffer" from the same type of sleep pattern. It is actually not that unusual and generally not a problem.
Have a read of the following:-

https://www.bbc.co.uk/news/magazine-16964783
https://en.wikipedia.org/wiki/Biphasic_ ... asic_sleep


I have read about this - sometimes I do try getting up and doing something - reading or doing a puzzle (not watching television of course!), but I don't find I go back to sleep, though I do tend to be tired.

ReformedCharacter wrote:Have you tried a Melatonin supplement?

RC


No, I haven't tried that, I will do some reading around this.

Thanks everybody
Gersemi

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Re: Sleep problem

#386987

Postby Itsallaguess » February 15th, 2021, 4:28 pm

Gersemi wrote:
I don't know what help anyone can give, but if anyone has any tips that have worked for them I'd be interested to hear them.


You've not mentioned regular exercise, so I thought I'd specifically ask if you get any?

Cheers,

Itsallaguess

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Re: Sleep problem

#387000

Postby Gersemi » February 15th, 2021, 5:00 pm

Itsallaguess wrote:

You've not mentioned regular exercise, so I thought I'd specifically ask if you get any?

Cheers,

Itsallaguess


Since March last year I've been going for a walk first thing about 2.5km. Before that I was doing a bit more. If I do complete a longer walk I don't notice any improvement.

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Re: Sleep problem

#387109

Postby Nimrod103 » February 15th, 2021, 11:12 pm

I used to suffer similar sleep problems. I would go to sleep easily, then wake up about 2am. Usually I can get off to sleep again eventually, often after having something to eat e.g. warm porridge.

I drink less tea and coffee, which helps, and only a little alcohol late afternoon/early evening.

However one thing which has really made a difference is taking extra Vitamin D tablets. I have no idea if it helps my immune system fight Covid, but one thing is for sure, Vit D is giving me much better unbroken sleep at night.

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Re: Sleep problem

#387118

Postby servodude » February 16th, 2021, 12:06 am

Nimrod103 wrote:However one thing which has really made a difference is taking extra Vitamin D tablets. I have no idea if it helps my immune system fight Covid, but one thing is for sure, Vit D is giving me much better unbroken sleep at night.


I think people are coming round to this fact - here's a study I came across a while ago (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213953/)

One thing that can be tried easily is the 4-7-8 breathing technique which seems surprisingly effective in helping some get (back) off to sleep.

Sleep can be affected by many different factors; environmental, physical, emotional, diet

People react in different ways to the environment when they are asleep
- temperature, light, weight of bedding can all have an impact
- it's changes in light that's the killer for me!

It's worth keeping a sleep diary for a while - it can help identify what works as well as what doesn't
there's an example here https://sleepaustralia.com.au/docs/Sleep-Diary-7-Days-Sleep-Australia.pdf

There have been some excellent suggestions already in this thread and if you haven't already it's certainly worth raising the chance of possible obstructive sleep apnoea (OSA) with your GP
- I know that sleep studies have pretty much been abandoned everywhere during Covid (even at the Epworth for a while!)
- but they should be able to run through a bit of an examination of the possible risk factors of OSA (which all too often can go undetected)

-sd

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Re: Sleep problem

#387149

Postby Gersemi » February 16th, 2021, 9:36 am

Thanks again everybody who has taken the time to reply.

I did complete a sleep diary when I was doing the sleep course (in 2019). I have to say I found it a trial trying to remember each morning just when I'd been awake and for how long. It meant that when I was lying awake I was trying to take note so I could write it down in the morning - so I felt it was making it worse. There is a sense that worrying about not sleeping actually causes anxiety that leads to worse sleep. Hence the long gaps when I'm not doing anything to try to improve it because I'm just hoping that by not obsessing about it, it might improve by itself. In fact at the start of lockdown last March (when I stopped commuting and started working at home, which I've done ever since) my sleep did improve (I remember a day when I overslept, just the one though!), but it's gone back to where it was again.

I probably would have approached my GP about this by now if it wasn't for the COVID situation. I do feel that there are more urgent things around at the moment. I suppose I should mention that I am a female who has just gone through the menopause, which could also be a factor. I'm not on HRT and I wonder if that could help. I don't have any other real symptoms from that, except possibly mental issues that could also just be lack of sleep.

Anyway off to ponder whether to try taking vitamin D and if so how much.

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Re: Sleep problem

#387169

Postby Nimrod103 » February 16th, 2021, 11:32 am

Gersemi wrote:Anyway off to ponder whether to try taking vitamin D and if so how much.


If it is any help I take 1 tablet of Boots high strength Vit D, which is 25 micrograms or 1000 international units. Some of the anti Covid Vit D believers take up to 4000 i.u., which seems to be regarded as still safe.

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Re: Sleep problem

#387181

Postby servodude » February 16th, 2021, 12:34 pm

Gersemi wrote:There is a sense that worrying about not sleeping actually causes anxiety that leads to worse sleep.


That's more than a sense, it's a well known fact among those that work in "sleep" ;) I work in the design of the equipment used for diagnosis and treatment of this stuff ( or did until sequestered for ventilation protects for COVID!) and I find it impossible to sleep if I'm thinking about it (which is a bit of an impediment if I'm trying to test something :? )

The important thing is that you manage to rule out any "physical" issues (which it sounds like you have gone a long way towards)
- it's getting better than it was but sleep science is still a "relatively" new domain and things are often misdiagnosed ( e.g. OSA mistaken for depression is quite common, and probably understandable when you consider the doc really only sees what's in their surgery?)

There is a strong connection between (peri/)menopause and insomnia; part seems to be hormones (which are what drive your body normally), part that you will probably feel temperature differently and part just because "something's changed" (have a link that will do a better job than I can at explaining stuff https://www.healthline.com/health/menopause/menopause-and-insomnia)
but don't worry... that doesn't mean you have to just accept it!

Have a look at the guides for "sleep hygiene" and see what you can try; cool, dark, quiet is a good start normally for your room (but then different folk like different things!)
- try and keep your bedroom for bed if you can
- get done what you need to for the day
- get your exercise at the point in the day that works for you
- avoid blue lights before bed
- no phone in the bedroom (I try and get rid of clocks also)
- etc

Then...once you've done what you can.. take comfort from the fact that you've set up your bedroom, and yourself as well you can so that you're mentally in the best state for "drifting off"
- that way you know you've got less you worry about!

For what it's worth I get my best sleep by reading in the dark on my kindle with its light turned almost as low as I can make out until I realize that I'm re-reading parts... and then just put it down
- whereas if I read in another room I'll wake myself up walking to bed!

-sd

....and try the 4-7-8 breathing thing!

AsleepInYorkshire
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Re: Sleep problem

#387185

Postby AsleepInYorkshire » February 16th, 2021, 1:11 pm

For Gersemi,

I'm 58. Looking back I recall my symptoms of daytime tiredness starting when I was about 13. I first spoke to a GP about the issue when I was 17. I was prescribed sleeping tablets. They didn't help. Over the following 21 years I visited several GP's many times and no explanation could be given for my tiredness. In February 2000 I saw a different GP. Within five minutes of telling her my symptoms she diagnosed clinical depression. She remained my care provider for 16 years until she retired. Over that time my health deteriorated. My behaviour became very anti-social and my personality exhibited many changes, none of which those around me could tolerate. In 2014 I was referred to single point access as I had made plans to bring my problem to a close. I was exhausted, emotionally, physically and mentally. In 2015 when my GP informed me she was retiring I was still in a dark corner and continuing to struggle on under the weight of serious health issues. I decided I needed to help myself more. I (quite legally) ordered some Modafinil from a reputable Indian supplier in January 2016. I remember taking one at 7am in the morning. An hour later I felt slightly more awake than normal. So I took another. And boom, an hour later I was wide awake. And then in that moment the penny dropped. I picked up the phone and made a private appointment to see a sleep specialist at the Royal Brompton Hospital in London. I travelled down in late February. By the middle of June I had been diagnosed with severe obstructive sleep apnea and was getting care related to that condition. Since then I have slowly but surely recovered. Recently we've determined that I do suffer with both winter and summer SAD and have a few food intolerances which have among many symptoms also caused tiredness.

I know in your opening post that you said you understand lack of sleep is bad for your health but don't like being told that. I'd like to comment if I may please and I have no wish to be anything other than helpful.

My condition(s) are congenital. On my Father's side I have 8 cousins and 1 sister.
Of which
  1. Three have taken their own lives
  2. Three have severe mental health issues
  3. One - that's me has recovered from the mental health issues which were a symptom of lack of sleep.
  4. Two I'm not sure about as they are very private, but I suspect that privacy may be a symptom in itself
  5. One shows no symptoms at all
  6. Of those ten mentioned above 50% of their children have various issues with sleep, mental health problems and non sociable behaviours.

A lack of sleep can have a devastating impact on individuals, their family and friends. One of the largest issues of trying to deal with a lack of sleep is that the individual is aware they are tired. However, the underestimate just how tired they are. And this is a constant.

I would strongly suggest you seek further help from your GP regarding your sleep issues. It may be beneficial to take an advocate with you if you do decide to speak with your GP. Having someone there with you, when you're tired out and can't understand is extremely beneficial. Tiredness plays havoc with the short term memory. You may also have to think outside of the NHS box[es] and I may I urge you to rule nothing out and keep searching for the answer[s] which will allow you to sleep well and enjoy the day without having to struggle through tiredness. Don't give up trying.

Take care

AiY

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Re: Sleep problem

#387189

Postby Gersemi » February 16th, 2021, 1:23 pm

servodude wrote:
The important thing is that you manage to rule out any "physical" issues (which it sounds like you have gone a long way towards)
- it's getting better than it was but sleep science is still a "relatively" new domain and things are often misdiagnosed ( e.g. OSA mistaken for depression is quite common, and probably understandable when you consider the doc really only sees what's in their surgery?)

There is a strong connection between (peri/)menopause and insomnia; part seems to be hormones (which are what drive your body normally), part that you will probably feel temperature differently and part just because "something's changed" (have a link that will do a better job than I can at explaining stuff https://www.healthline.com/health/menopause/menopause-and-insomnia)
but don't worry... that doesn't mean you have to just accept it!

Have a look at the guides for "sleep hygiene" and see what you can try; cool, dark, quiet is a good start normally for your room (but then different folk like different things!)
- try and keep your bedroom for bed if you can
- get done what you need to for the day
- get your exercise at the point in the day that works for you
- avoid blue lights before bed
- no phone in the bedroom (I try and get rid of clocks also)
- etc

Then...once you've done what you can.. take comfort from the fact that you've set up your bedroom, and yourself as well you can so that you're mentally in the best state for "drifting off"
- that way you know you've got less you worry about!

For what it's worth I get my best sleep by reading in the dark on my kindle with its light turned almost as low as I can make out until I realize that I'm re-reading parts... and then just put it down
- whereas if I read in another room I'll wake myself up walking to bed!

-sd

....and try the 4-7-8 breathing thing!


Hi - as you have surmised I did go through most of this stuff when I was on the sleep course. I have read about the connection with the menopause and sleep problems, but they always seem to be connected with hot flushes. I'm a cold body, always have been, and still am. I have had a few, mild, short lived hot flushes, but they've pretty much worn off now. I don't recall ever having any in bed.

Getting rid of the clock was one of the sleep station things - but, you guessed it, it made me anxious. I did try a few nights, but I'd just lie awake thinking "I seem to have been awake for ages, what time is it? How long has it been? How can I fill in the sleep diary?" I gave it up. I have a kindle, but it's old fashioned - it isn't lit! You can't read it in the dark. What I do quite a lot is use an audible book, but of course I need my mobile phone for that. I do 15 minutes at a time. At one point that was working quite well, and I'd drift off and could sleep after the 15 minutes were up. However now, apart from endlessly having to rewind because I've not been listening - and I know that suggests I'm going to sleep, but if I am it doesn't last after the section has finished - it doesn't seem to work any more. Anyway I've tried stopping that, but after an hour or so lying awake (night after night) you get so bored.

I've have tried breathing as well, but I'll give the 4-7-8 thing a go.

Sorry, this sounds really negative, but I have tried various things, apart from drugs.

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Re: Sleep problem

#387191

Postby ReformedCharacter » February 16th, 2021, 1:30 pm

Gersemi wrote:I probably would have approached my GP about this by now if it wasn't for the COVID situation. I do feel that there are more urgent things around at the moment. I suppose I should mention that I am a female who has just gone through the menopause, which could also be a factor. I'm not on HRT and I wonder if that could help. I don't have any other real symptoms from that, except possibly mental issues that could also just be lack of sleep.


My OH is at the perimenopause and has suffered badly from sleep problems and mental issues. Her GP was pretty useless and tried to persuade her to take anti-depressants which she declined. She then contacted a private specialist in female hormone issues who has proved to be extremely helpful and she is now practically back to normal, appointments are conducted remotely. Feel free to PM me if you would like details.

RC

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Re: Sleep problem

#387192

Postby AsleepInYorkshire » February 16th, 2021, 1:39 pm

ReformedCharacter wrote:
Gersemi wrote:I probably would have approached my GP about this by now if it wasn't for the COVID situation. I do feel that there are more urgent things around at the moment. I suppose I should mention that I am a female who has just gone through the menopause, which could also be a factor. I'm not on HRT and I wonder if that could help. I don't have any other real symptoms from that, except possibly mental issues that could also just be lack of sleep.


My OH is at the perimenopause and has suffered badly from sleep problems and mental issues. Her GP was pretty useless and tried to persuade her to take anti-depressants which she declined. She then contacted a private specialist in female hormone issues who has proved to be extremely helpful and she is now practically back to normal, appointments are conducted remotely. Feel free to PM me if you would like details.

RC

Ah ha ... just to reinforce RC's comments. My good lady has also had some serious issues with peri-menopause. She's been on HRT for two years now and sleeps a lot better.

AiY

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Re: Sleep problem

#387213

Postby Lootman » February 16th, 2021, 3:46 pm

Gersemi wrote:There is a sense that worrying about not sleeping actually causes anxiety that leads to worse sleep. Hence the long gaps when I'm not doing anything to try to improve it because I'm just hoping that by not obsessing about it, it might improve by itself. In fact at the start of lockdown last March (when I stopped commuting and started working at home, which I've done ever since) my sleep did improve (I remember a day when I overslept, just the one though!), but it's gone back to where it was again.

One option, at least if you are retired, is to decide that it just doesn't matter if you don't sleep when everyone else sleeps, and instead just sleep when you feel tired rather than when society says you should be sleeping.

I often experience similar sleep disruptions, often brought about by needing to pee at night, which is a curse of getting older anyway. If I don't fall back asleep quickly afterwards, I just decide to get up and do something. When I do that I often find that I can go back to sleep during the day for a couple of hours, thereby fixing the sleep deficit.

Particularly during the lockdown, it is possible to adopt a "sleep when I feel like it and otherwise don't worry about it" approach. Daytime napping can be your friend.

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Re: Sleep problem

#387239

Postby Gersemi » February 16th, 2021, 5:49 pm

Lootman wrote:One option, at least if you are retired, is to decide that it just doesn't matter if you don't sleep when everyone else sleeps, and instead just sleep when you feel tired rather than when society says you should be sleeping.

I often experience similar sleep disruptions, often brought about by needing to pee at night, which is a curse of getting older anyway. If I don't fall back asleep quickly afterwards, I just decide to get up and do something. When I do that I often find that I can go back to sleep during the day for a couple of hours, thereby fixing the sleep deficit.

Particularly during the lockdown, it is possible to adopt a "sleep when I feel like it and otherwise don't worry about it" approach. Daytime napping can be your friend.


I've decided to retire at the end of June, so maybe I can try this then! I'm not much good at sleeping during the day, but I feel I could easily go to bed about 8pm. I don't really fancy getting up at 3am in the morning though . . . it's a bit cold then (well in winter anyway) and I think I would get objections if I put the heating on then!

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Re: Sleep problem

#387865

Postby Dod101 » February 19th, 2021, 12:27 am

Lootman has produced some sensible comments but to be honest I am long retired with sufficient money that I do not need to worry about it. I recommend a warm shower just before you go to bed and use say Moulton Brown's GInseng. I find it the most amazing scent for relaxation. I am not in any way deviant but it is lovely stuff and most relaxing........and just switch off. The problems will not be as bad tomorrow and some will have disappeared.

Dod

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Re: Sleep problem

#387885

Postby Gersemi » February 19th, 2021, 9:02 am

Hi all

following your comments I have tried to go back to some basics. I've reduced the number of cups of tea I drink during the day (by about half), none after 6:30pm, no computer for a couple of hours before bed and I've restarted the sleep diary. Last night I slept through to about 5:15am, which increased my total sleep by over an hour. Early days, and I've been here before, but I'll keep trying. It probably helps that I've been on leave this week.

Gersemi


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