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Sleep problems in later life

Strategies for good sleep

When we asked people to tell us the strategies they used to try and achieve good sleep they gave us many examples of what worked for them, or what might help others.
 
Being calm and relaxed was commonly mentioned by people as being helpful to achieve good quality sleep. Relaxation techniques were used by quite a few people and they described how tensing and relaxing all of the muscles of the body, very slowly, one at a time, can help, sometimes accompanied by slow breathing exercises.
 
Mary calms herself down before going to sleep by relaxing, meditating and breathing deeply and finds this helps, although it can still take her half an hour to go to sleep. These methods also work for Roy, but he warned that it does take practice to get them right before you reap some benefit from them. A few people had also found listening to relaxation tapes helpful, some of which were of people talking quietly and others were of relaxing music.
 

Roy practices relaxing and tensing his muscles and breathing slowly to help with calming himself...

Roy practices relaxing and tensing his muscles and breathing slowly to help with calming himself...

Age at interview: 82
Sex: Male
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But also if I can’t sleep I have one or two devices to help myself sleep.
 
What are they?
 
I try a quick relaxation formula, which is you know, tensing yourself quite steeply to begin with just for a few seconds and then relaxing and moving every movable part of your body that is possible. You know, I would even waggle my ears if I could. Eyelids and facial muscles and mouth. Everything, you just do a quick relax in other words, all your joints, and then take some deep breaths afterwards and that quite often makes me go to sleep.
 
Oh I will have to try that. I have not tried that.
 
A quick relaxation and the other system is counting down, have you heard of that one.
 
No. Do you start at a number?
 
I start from number twenty and then I gradually count down and then I go 20, and then 19, 18, I make each number two syllables and an intake of breath and then expel of breath, down to … if you do it very slowly and regularly and you go down to say zero and say zero a few times then you can go into minus one if you want.
 
If you are still awake?
 
And that, I don’t know how long ago I first found that method. And when I first started it I had to work at it for about a month before it seemed to work. And then after that it worked.
 
That is interesting. So it wasn’t a quick fix for you, it took a while for you?
 
No it took quite a time and I had to keep on doing it, before suddenly it worked. I don’t know why that was. About a month … 
 
One person we spoke to said that if she wakes up in the night, rather than relaxing and trying to get back to sleep, she needs to get up and wake herself up completely by going to the toilet or watching television.
 

Juliet knows that if she wakes up in the night she will have to wake herself up fully before she...

Juliet knows that if she wakes up in the night she will have to wake herself up fully before she...

Age at interview: 69
Sex: Female
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So you wake up and do you try and get back to sleep straight away?
 
No, the minute I wake up, I get out of bed, go to the loo, which is often, if I don’t need to I will still go. I will have a drink perhaps and I thoroughly wake myself up actually, because I will not go and lie in or sit up in bed and try and pretend to sleep if I can’t.
 
So you are choosing to wake yourself up?
 
Yes. Well it is a strategy as far as I am concerned because I find that then actually I will get into a better mode of sleep and I will go back and I do go back but sometimes it takes very long and sometimes it takes… I just know when I am ready to get back into bed. It is difficult to describe it.
 
Does it vary then from night to night?
 
Yes. It can vary.
 
What is the shortest time it takes you, and what is the longest?
 
I would say the shortest probably, out of bed, have a drink, probably put the television on, and see what is on. And if it is boring it will send me off to sleep in about fifteen minutes.
 
Reading was often a good way to get to sleep before going to bed or once in bed, and most people read books, but some take newspapers or magazines to bed. Many people had difficulty staying awake for very long when they started to read a book in bed and often read the same pages every night and so took a very long time to finish a book. But for some people reading a book could be a distraction and stop them from sleeping, so it was better to read something less interesting.
 

Margaret finds the best strategy for getting back to sleep if she wakes up in the night is to...

Margaret finds the best strategy for getting back to sleep if she wakes up in the night is to...

Age at interview: 72
Sex: Female
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That’s very interesting because you may have had this experience, things seem dramatic and terrible at night, you wake up in the morning and think oh I can cope with that.
 
Yes, what was all that about?
 
Yes. You actually do.
 
And you have these arguments in your head with people and you wake up in the morning and you think well what would be the point of that really, why did I make a mountain out of a molehill?
 
Absolutely and that’s this same situation, with emotional ups and downs that we’ve all been through. We all go through. And I think there’s nothing, absolutely nothing you can do about it. It’s gone, it’s finished, you did your best at the time and that’s it. And it’s taken a long time, it just doesn’t happen you have to think about it. Make sure that you don’t get worked up about stuff.
 
Do you think you’ve reached that point now then?
 
No, not totally, not totally. That’s why I have incredibly boring books to read.
 
It’s a really good strategy that. When did you find that out that that worked?
 
Oh not so long ago, although yes, come to think about it, some time ago, about just three years ago. My brother died and that caused a lot of emotional stress. And it was driving me bananas thinking to myself what can I do with all of this, because as I said there’s nothing else you can do, once he's gone he's gone and I know I’ll get a book and unfortunately I have got an extremely interesting book which led me to read the whole book in one sitting. So I never slept at all.
 
You just stayed up at night and read the book?
 
Yes. I got through it and had a thoroughly miserable day. Dragging through the next day. So I thought no, the thing is to get yourself really boring books. But I’m very, very lucky because he died having left a huge amount of books, most of them history and actually they are quite interesting but some are very, very boring. So I find the boring ones, really boring books. 
Similarly, people talked about trying not to have too many thoughts in their head because this distracted them and stopped them from sleeping. Otto, for example, tried counting to help him get to sleep, but unlike Roy, discovered that this led him to start thinking about other things and kept him awake. Others found that thinking about doing something, like building a boat trailer or playing a round of golf, actually helped them get to sleep.
 

Robert, who has recently been bereaved, finds that thinking about interesting problems, such as...

Robert, who has recently been bereaved, finds that thinking about interesting problems, such as...

Age at interview: 77
Sex: Male
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Yes, in a sense I am experimenting because of my recent history. I am experimenting in, by going to bed early. 10 o’clock being early, and late one o’clock to see if there’s a difference.
 
There really isn’t but the constant factor is waking up. Again, we might discuss later on, I think there’s a reason for that. It might or might not be, I am not a sleep man. Waking up like last night for example, I went to bed relatively early and I generally don’t have too much problem getting to sleep because my technique for getting to sleep is to think about interesting problems, not about world problems or personal problems, but I am making a boat trailer for example and where I want the bearings of the wheels and that sort of thing. And I play the game and just thinking interesting things, which I am inventing things, making things. I must make things. I usually make them badly, but I would rather make something badly then not make it, not being able to make things would be hell on earth.
 
But therefore I can usually go to sleep fairly quickly, but generally speaking I wake up after probably about an hour, or I can sit in here in the afternoon and I could go to sleep. Yesterday I thought it was ten past two and when I looked at the clock and then I looked up and oh my gosh someone is coming at two o’clock but it wasn’t it was about quarter to nine. I had just sat down to drink a cup of coffee and I didn’t know where I was.  
Several people, who had difficulty sleeping, had tried a number of different strategies over a longer period of time to help them sleep, some of which worked and some of which didn’t.
 

Ron has tried several different strategies over the years to help with his sleep and has found...

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Ron has tried several different strategies over the years to help with his sleep and has found...

Age at interview: 74
Sex: Male
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One last thing if you could give some advice to people on what to do if they are not sleeping, what would you suggest, what would you say to people?
 
Well you know I have often said to people, this was years ago, I would say the best thing to do probably if you don’t want to take a pill is warm some milk and go and get a banana and slice it up and eat it before you go, and that will help you to sleep.
 
And that works?
 
Well it does work.
 
Anything else?
 
No I don’t know an awful lot about it, all I am suggesting is that they have got to try and forget what the problems are, because it is always problems that keep you awake. There is always something there that you, and the other thing too, I have learned I used to be able to, at one time hypnotise myself. Because I did a course with somebody and I did it for about a year or so, and I don’t know why I stopped doing it. But I could actually hypnotise myself and put myself down and what I told people to do when they had problems is to go through the hypnotist route which is where we start and that is to make all of your limbs and muscles sleep. Do you know that one?
 
No.
 
Well if you actually relax completely and you think about your toes. And you think about, and you try to make them sleep, then you go down to the ankles and you come up the legs and all the muscles you think about them sleeping. That is how you hypnotise. And then when you get to a certain, if you come up all over the body and then when you actually get to the point, which you have to do, your body should be relaxed at that stage, then you start to relax your brain by thinking of something lovely and you will enjoy or you like or something you want. Not miserable things, but generally going swimming, in the garden, enjoying the flowers and that is when you start to go down with your hypnosis and you go right the way down. I am telling you that seems to do it.  
A number of the people we spoke to had some ideas about what would be the right strategies for getting good sleep, but were aware that they didn’t follow these strategies, so their advice would be to not do what they did!
 

Carol’s suggested strategy for a good night’s sleep is to not do what she does.

Carol’s suggested strategy for a good night’s sleep is to not do what she does.

Age at interview: 66
Sex: Female
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If you could give somebody, anybody any advice, about strategies, helping you get to sleep or keeping asleep or what to do if they wake up. What kind of things would you suggest? What would be helpful?
 
All the things that I don’t do. Seriously. You know, like having just lately I have not been eating until about, it could be eightish, maybe later. A lot of that is to do with going to visit my Mother at lunchtimes. So I don’t get lunch so then I come home and possibly have lunch round about half two which is too late really. So that makes my dinner time in the evening further back. So I don’t think any of that helps. And then I sit down and stay sitting down and I know it’s all the things you shouldn’t do. I am sure I should get up and go for a walk somewhere. But … in the summer it is different I have got to admit until it is dark I potter and I sit on the patio and I read and I see something and I will get up and go oh I will pull it up. Back and forth like a ditherer but I quite enjoy it. 
Also there was a sense that sleep is very individual and personal and that a strategy which works for one person may not work for another. Some people said that to find the right strategy you should speak to the person and find out what their particular problem is. Jim has diabetes and he sometimes experiences episodes of hypoglycaemia in the night, which can occur when blood glucose drops below normal level and the body and brain can’t function properly. His strategy was therefore particularly focused on those who had this type of problem at night.
 

Jim’s strategy for good sleep focused on how to prevent having a hypoglycaemic episode in the...

Jim’s strategy for good sleep focused on how to prevent having a hypoglycaemic episode in the...

Age at interview: 78
Sex: Male
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So if I said to you if you could give some advice to other people who are having problems like you sleeping, what kind of advice would you give? Have you got any strategies or anything you could give to people and say I recommend this to you?
 
Well it depends really what problems they have got. Whether they are diabetic or not. Or what I could say that if are diabetic all you could do is you take your medication, stick with that, be aware of these hypo things, the bad times they are. Make sure you know how to deal with it you know, your doctor will tell you what to do and that sort of thing. And make sure you have always got something handy to take, especially if you go out, you know, you should always have a disc on you. I haven’t got one but I will get one. Always take some sugar with you or something, because like I say if anybody comes across you and you are collapsed in the street, they don’t know whether you are drunk or what unless you have got that disc on and if you are working with people make sure that they are aware that you are a diabetic so that they know what to do to help you at that time. You know. If you make sure they know you have got some sugar with you or something or you can get an injection you carry something for an injection and make sure these people know how to administer it, you know. It is quite difficult really for people at work to do that for you. But if you only see a lot of friends they would wouldn’t they.
 
Yes.
 
As for being in the street, well it is anybody’s luck isn’t it. The only thing is they might whip you into an ambulance and they would be able to tell. The ambulance people would know you hadn’t been drinking, so they would know what it was. I have got a book on there all about hypos. 
Deciding when and what to eat and drink were also strategies people used to help with their sleep. Many people were aware of the need to avoid drinking too much caffeine, particularly during the evening, and some also avoided drinking tea. Mary stopped drinking both tea and coffee at 6 pm, but would continue to drink water. Dessie will only drink decaffeinated coffee in the evening. A few people were aware that coffee, tea and also alcohol may have a detrimental effect on their sleep, but continued to drink them.
 

Sue B. avoids having coffee because it may interfere with her sleep, although she may drink a...

Sue B. avoids having coffee because it may interfere with her sleep, although she may drink a...

Age at interview: 70
Sex: Female
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And are there any kind of drinks you avoid with the thought of sleep in mind?
 
Well I wouldn’t have full on coffee. I have got some quite good stuff called dandelion coffee. I have it occasionally but that's meant to be absolutely fine for night. I don’t really like what is the other kind.
 
The decaffeinated?
 
The decaffeinated no.
 
Is that just a night time thing or day do you avoid drinking caffeinated coffee?
 
No. I don’t drink much coffee, but I do drink ordinary coffee, just ordinary instant coffee in the day but at night I would either have the decaf or this dandelion but it is very, very rare that I have coffee at night. I drink a lot of tea at about between five and six.
 
So when you are having your evening meal?
 
After I have had my evening meal then I have a cup of tea.  
 

Margaret wonders whether drinking coffee and wine in the evening might be affecting her sleep.

Margaret wonders whether drinking coffee and wine in the evening might be affecting her sleep.

Age at interview: 72
Sex: Female
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Do you avoid things like alcohol and coffee and tea at all or …?
 
No I don’t and I wonder whether I ought to but then we have our evening meal which is our main meal of the day at about 6 in the evening. And we certainly have wine, we don’t mind having wine, and sometimes if we have company, we will open another bottle, not so much if, when we have company we’ll open another bottle and that knocks me out and I imagine I snore then. Almost certainly, but not, I’ve forgotten what the question is.
 
You eat early in the evening but would you avoid eating later in the evening?
 
If I could yes. Because the tummy is working too hard at that time.
 
And then alcohol is something that fits in, but then what about coffee and tea?
 
Well we will have a cup of coffee somewhere at about 7.30.
 
Okay.
 
And that would be the last drink we have. But I think that’s probably too late for the way the bladder works.  
Drinking something milky before bed helped several people. This could be in the form of just milk, milk and honey, or drinks such as Horlicks. Occasionally though, if people woke up in the night, they might make a drink to help them get back to sleep. Instead of tossing and turning in bed if she wakes up during the night, Sue B will make herself a cup of milk and honey and take it back to bed and read until she feels tired again. However, John found that drinking Horlicks before bed helped him sleep better but also made him more likely to need to go to the toilet in the night.
 
Many people tried not to eat too late in the evening, largely because it made them feel uncomfortable if they went to bed with a full stomach. Daniel’s practice nurse told him that it is okay to eat later in the evening and that it won’t affect his sleep but Sue B.’s nutritionist advised her not to eat too late. Now and then, when people wake up in the night feeling hungry and finding it difficult to sleep, they said they may get up and have a small snack, such as a biscuit or toast.
 

Daniel, who is trying to lose weight, believed it would stop him sleeping well if he ate later at...

Daniel, who is trying to lose weight, believed it would stop him sleeping well if he ate later at...

Age at interview: 78
Sex: Male
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This is the thing as I said to you before about sleep, I take it as just something you do, you get, and so therefore I must admit I don’t avoid things. No I don’t think so.
 
And you wouldn’t worry about eating late at night, that wouldn’t worry you?
 
It’s an interesting point because I don't, I wouldn’t eat really late at night, now that is something I wouldn’t do, so you can say that is one thing, but it was interesting when I was talking to our practice nurse. I don’t know how it came out in conversation but she was saying it doesn’t matter if you eat in the evening. She was talking about if you had your meal later than we do that sort of thing.
 
You eat about five is that right?
 
Pardon?
 
Do you have your meal 5 ish your main meal?
 
Yes, well six say, before six. But she was saying it didn’t matter if we ate later and things like eating fruit or something I don’t eat those in the evening, 'oh yes you can'. I always thought, no, it doesn’t digest and that would keep you awake. But she said no, so I take her word. 
 
 

Dessie occasionally will have a drink and a snack in the night if she is awake and feeling hungry.

Dessie occasionally will have a drink and a snack in the night if she is awake and feeling hungry.

Age at interview: 73
Sex: Female
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Now this is something that I don’t know whether I am doing right or wrong because I think sitting here in the evening, I think, oh I fancy something. I wonder what’s nice. You know. If there is a box of chocolates open I will dive into that or if I have bought a new type of cereal, I think oh I won’t wait until tomorrow I will have some now. It doesn't matter, I will have some now. And my friend that I ring every morning she says well of course that is comfort eating you know, and I am thinking well what do I need comforting about. I don’t need comforting so why am I eating, but apparently that is what it is called.
 
So if you have something to eat in the evening, is that long before you go to bed?
 
Oh yes it is before I go to bed. I don’t take anything to bed with me to eat.
 
You said you might occasionally have a biscuit if you have been up for a long time in the night?
 
Yes, yes, if I come down or have a drink and a biscuit or I make a piece of toast or …
 
Because do you feel hungry?
 
That is right. Yes.
 
You can’t sleep when you are hungry can you?
 
No, no.
Others said that the timing of when they eat, or certain foods they eat will have an impact on how they sleep. Eating chocolate late at night keeps Anne awake. Mike is aware that he gets more indigestion now than when he was younger and thinks this may be related to how closely he eats to his bedtime.

Last reviewed October 2018.

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