Are you one of those people who finds it difficult to switch off before bedtime? How many nights have you lain in bed awake with your mind racing? Or gone to bed later than you should have and ended up with very little sleep? If this sounds familiar, you’re not alone.

A new report, commissioned by Horlicks and set to be released at the end of October, is expected to reveal that millions of Brits are suffering from ‘semisomnia’, a new term coined in the report to describe daytime tiredness or low-grade exhaustion, thought to be caused by our inability to wind down before bedtime.

While the subject of sleep is often written about, past studies have tended to focus on the minority of people who suffer from chronic sleep problems like insomnia or sleep apnoea. Sleep research has traditionally failed to provide advice for the average person, but this report seeks to redress the balance.

Dr Neil Stanley, the report’s author and former chairman of the British Sleep Society, has reviewed more than 30 years of bedtime behaviour and will be joining us online to reveal his concerns on the impact that the nation’s poor sleep habits are having on our health and wellbeing. He’ll also be sharing key hints and tips on how to wind down more effectively at the end of the day and unlock the key to a better night’s sleep.

H: Host, Lis Speight
N: Dr Neil Stanley

H: Hello and welcome to the Healthcare Show, I’m Lis Speight. Now are you one of those people whose juggling a very busy life, always too much to do and never quite enough time to do it in? And do you always feel that you could do with just a little bit more sleep? Well you’re not alone, and I’m pleased to say that to talk about the whole subject of sleep and the nation’s changing sleeping habits we’re joined by an expert in sleep, Dr Neil Stanley. Thanks very much for coming in Neil

N: It’s a pleasure

H: Now you’ve been watching people sleep for 25 years – is that right?

N: It’s all I’ve done for my professional life is watch other people sleep

H: You must be exhausted!

N: It does take it out of you watching other people sleep and seeing that they’re enjoying it and you’re not so – but yes it’s something that I’ve always done and something that I’m passionate about

H: Now Neil you’ve put together this new report haven’t you about the nation’s sleeping habits and the way that they’ve been changing over the years. We all know a little bit about insomnia, we all know we should be getting sleep – why do we need this report?

N: Well this report was commissioned by Horlicks who are interested in the idea of you know reinvigorating the importance of sleep in society, and what I did was look at the – what’s come out of science that is helpful for the man on the street to get a better night’s sleep, and essentially there’s nothing! You know it’s very good for sort of medical conditions like as you say insomnia

H: Right

N: But insomnia’s about 3% of the population who have a medical condition which you know they should be going to the doctor and getting treated that way. But what about the rest of us, the man on the street, how do they get a better night’s sleep? And essentially there’s very little advice – we have advice on diet, we have advice on exercise, sleep is just as important

H: But it’s not taken very seriously really

N: It’s not taken seriously by anybody and you know there’s common sense but we’ve forgotten common sense about, you know, the importance of a good night’s sleep and the 24 hour society which you know is something that we really can’t cope with and yet we’re embracing evermore

H: And people just simply aren’t getting enough. So what’s the basis of the report then, what did you actually find?

N: The basis of the report, there was a little survey that was done of 1000 adults with it that showed that about 70% of us suffer from this daytime tiredness which the report coins the term ‘semisomnia’

H: Semisomnia?

N: So it doesn’t really matter how much sleep you get in a night, what matters is the daytime consequences of it

H: Right

N: So if you’re tired, you’re probably not getting enough sleep, and yet somehow we find it acceptable to be tired during the day

H: Do people need different amounts of sleep then, Margaret Thatcher famously survived on 4, always said she survived on 4 hours sleep, whereas I really need 8 and probably could do with 10 actually – can you train yourself to need less sleep?

N: You can, what would be the worry would be why you’re doing it, because each of us have a sleep need and anywhere between 3-11 hours is normal, but it’s like height – if you’re an 11 hour a night person you need to get 11 hours

H: Right

N: And so there’s – you can of course change that, but then you’re doing yourself medical damage, it’s not good to get – even one hour a night less sleep than you need is poor sleep, and poor sleep has been linked to increased rates of depression, divorce, heart disease, obesity, diabetes, etc etc

H: So it’s a big health issue then really isn’t it?

N: it’s a massive health issue and as you say it’s not something that we take seriously, the medical profession don’t take it seriously, there’s very little training of it, you know half of UK doctors have had no training in sleep medicine, the other half have spent time of 5 minutes in 7 years learning about something that you do for a third of your life. There’s 89 recognised sleep disorders, and yet it’s pretty safe to say that doctors essentially know nothing about sleep. They know about insomnia, they may know about sleep patterns

H: So these are really serious conditions but not this semisomnia that a lot of us are walking around not having had enough sleep the night before?

N: Exactly, the man on the street there’s the advice of you must eat 5 fruit and veg a day, you must do 10,000 steps a day, where’s the advice on sleep? Now the advice is get a good night’s sleep, but -

H: What does that mean?

N: What it means is if you can feel awake, alive, energised the next day, you’re probably getting enough sleep. Everybody knows how good they feel after a good night’s sleep

H: Yes

N: You could feel like that every day, just imagine how much better life would be if you actually felt like that, whereas we seem to accept sort of going through life feeling 5 out of 10, and so we’re not actually doing the best we can for ourselves, and you know there are societal costs as well – tired drivers now kill more people than drunk drivers on Europe’s roads

H: That’s scary

N: And yet the government spend all this money on don’t drink and drive, and yet most of us pretty much every day are driving just as impaired, but because of tiredness and we find that acceptable

H: Slow reactions, yes

N: You meet new parents ‘oh I haven’t slept for 18 months’ – and you think hang on, do you actually get in a car and drive to work

H: Yes

N: Because if you do, you’re just as impaired as if you were drunk and that is a worry because we wouldn’t do it if we were drunk but somehow if we’re tired we think oh you know we’ll get through it, we’ll tough it out

H: Yes

N: Stiff upper lip sort of thing so -

H: Yes it’s the wrong attitude isn’t it towards sleep?

N: Exactly you know if you were hungry you would eat, if you were tired why aren’t you sleeping?

H: It’s a very good point. Why aren’t we sleeping? We went out onto the streets and asked how much people were actually getting, how many hours sleep they’re actually getting, take a look at this

Video footage

‘I get about 5-6 hours sleep a night. I go to bed about 12, between 12-12.30 and I’m up at 6’

‘My sleeping habits are quite varied, sort of response to like my workload in London, but I’d probably say my average time of sleep would be about sort of 7-8 hours every night really’

‘6 hours sleep is good – you won’t be too restless and you probably won’t be too tired so it’s a good balance’

‘I think I try to get 8 hours if I can but usually it’s anywhere from 6 to 4 to 8 hours probably’

‘On a weekday I try and get about 8 hours. I think I get enough, yes. About 7, 8 hours on the weekend maybe 6. But overall I think I get enough, yes.’

‘I get at least 8 hours every night, yes’

‘I’d say I get about 6 hours sleep and I don’t think I get enough, because I’ve got a little boy and he drives me insane at night. He doesn’t sleep all night, so about 6 hours sleep a night’

Some interesting stuff there, and it seems as though people are getting about 6 hours on average, that doesn’t seem enough to me?

N: It doesn’t, I mean the average is 7 hours and 12 minutes

H: Exactly, and counting!

N: But yes –it’s horses for courses, and as I say some people need more sleep than others, but I think what’s interesting is probably those people are allowing themselves to have 6 hours, they don’t need 6 hours, that’s all they’re allowing themselves to have

H: In their busy lives

N: In their busy lives, and that’s the problem we face

H: So you’ve been looking at people sleeping for over 25 years, how have – how has our lifestyle changed so that - are we getting less sleep than our parents basically?

N: We’re probably not getting less sleep, but the sleep we’re having is not enough for the society we now live in, because the most important bit of sleep is for the brain, we lay down memories, we deal with worries and concerns, we learn things when we’re asleep, and so we live in this sort of 24 / 7 culture, we have information overload, you know 20 years ago the Times was 20 pages long, now it’s 100 pages long

H: Where am I going to find time to read that and watch my TV program and do all these things?

N: Exactly and you know work, you know you may have got three or four letters a day that you had to reply to, now it’s 300 emails

H: Yes

N: So you know our brains need to relax and so we’re probably getting the same amount of sleep but we probably need more because of the way the society -

H: That’s interesting

N: in 30 years, the 24 / 7 society has been a massive change to our lives and we frankly haven’t caught up

H: Right

N: You know evolution takes millions of years, not 30 years

H: I was going to say will we evolve?

N: We may be evolved to it, but we haven’t done and we won’t do for a very long time so it’s wrong to think that we can always be on, our computer maybe, but we can’t

H: We’re more likely to crash

N: We will crash and you know that’s the problem, we should be awake during the day and asleep at night and the minute it gets dark, your body is being told go to sleep

H: Right ,so your brain is actually connected to the light on outside, the sun being up?

N: Absolutely the sun is what’s known by science as the Zeitgaber which is a German word meaning ‘time giver’

H: Right

N: But basically 4 minutes of sunlight in the morning says it’s time to wake up, and the minute it goes dark you release melatonin which is the signal which says go to sleep. And you’re always fighting that, and what we do in society is we fight against that, and you know even now, instead of in the past when you went home, you maybe watched a bit of the TV but it went off at half ten anyway so you didn’t have anything to do after that, now you can go home, you can watch TV and then oh, that important I need to look at my emails, or I can work – I know one company where it’s a badge of pride who sends the latest email because that’s the macho thing. You know the problem is we can’t do that because then we won’t be preparing ourselves to go to sleep when we need to do it

H: So on that subject then Neil, what tips do you have for people trying to get to sleep, trying to get a good night’s sleep?

N: Well there’s no tips as such, I mean that’s the problem with what’s happened in the last 30 years, we’ve relied on these top 10 tips known as the sleep hygiene rules, and even that’s problematical because they’re rules, they’re black and white

H: Right

N: Something like ‘avoid caffeine’ or ‘avoid alcohol’ and these are written in tablets of stone, thou shalt do this, and the issue that has come out is actually the wind down is a personal thing, you have to find your own way to sleep

H: Right

N: Now there’s 3 steps to that, which is resolve, relax, release. Resolve is making the day end. You’ve worked, you’ve come home and that’s it, you’ve put all your worries of the day aside, that allows you then to relax, and that’s the sort of physical relaxation, so that’s a warm bath, listening to music, whatever works for you. And then there’s release which is as your head hits the pillow you should be thinking about nothing in particular

H: Right, not worrying about your inbox and -

N: Not worrying about your inbox and just as your granny would have said to you don’t go to bed angry, you need to be thinking about nothing, and whatever that can be, so that can be listening to your favourite piece of music, reading a trashy novel or -

H: Right

N: Or a magazine or whatever

H: So it’s individual then, whatever works for you?

N: Whichever path you take through those three steps is up to you, and one man’s relaxation is another man’s stress,

H: Right

N: Some people say you know you should use lavender, I can’t abide the smell of lavender

H: It keeps you awake!

N: It keeps me awake, I’d have to hunt it down and burn it in order to be able to get to sleep, but it is that, whatever works for you, so there’s no rules, there is just this, these are the three steps that you should try and take, you should try and make a natural end to your day so you can get on with the night

H: Yes so that’s resolve,

N: Relax

H: Relax

N: And release

H: Release. There we are, I hope you’re all writing this down at home! Now we have some questions in from you actually, people obviously wanting to get a little bit more sleep. Catherine Procter has written in and she says ‘I tend to need more sleep in the winter than in the summer. Why is this?’ what we were talking about earlier actually

N: Very simply, it gets darker earlier and that is a very strong biological signal that says you should go to sleep, so we find it easier because it’s cold, it’s dark and it’s actually quite easy to get into bed, whereas in the summer again there’s the daylight which is making your body think that it should be awake and -

H: it’s so much easier to get up when the sun’s out isn’t it?

N: Absolutely

H: When it’s dark and your alarm goes off and oh dear it’s awful isn’t it?

N: It’s miserable because you’re going against nature

H: Yes

N: And so you know from an evolutionary point of view, summer is the time of plenty, it’s a bountiful time, there’s a lot of work to be done, winter’s a time of hibernation

H: Right

N: So you want to stay in bed, so the other thing is of course the clocks change which you know causes us -

H: it takes a while -

N: It takes 3 days to get over the clocks changing even, I mean our body is that sensitive to you know the day / night cycle that even a one hour change causes us problems, so you know it’s nice to snuggle down in bed and it would be lovely if society ran to our needs for sleeping in the winter but unfortunately you still have to work 9 to 5

H: So you can’t ring your boss up and say I’ve been medically advised that I’ve got to stay in bed, I don’t think they’d buy that would they?

N: Probably a sackable offence!

H: Now Neil’s put together a report looking at how nation’s sleeping patterns have changed over the years and we’re apparently not getting enough sleep and this term for not getting quite enough sleep is being coined as semisomnia, and Spencer has written in and he asks ‘is semisomnia a recognised medical condition?’ Because he’s obviously hoping for some time off work

N: This is the thing you know, it’s not a medical condition because it’s a problem with our lifestyles, it’s a problem with us and you know you shouldn’t medicalise issues like this

H: No

N: And that’s the problem. Sleep has, sleep science has concentrated on the medical side, not for the rest of us, and we need a handle for people to actually understand that they’re doing themselves damage by not sleeping

H: And what sort of damage then, you touched on that a little bit earlier, what – if I don’t get enough sleep, what potentially could happen to me in the long run? Is it bad for society for example?

N: Well it’s bad for society, it’s poor for you. They say poor sleepers have an increased risk of divorce, depression, diabetes, obesity, heart disease, they have more car accidents, you know there’s no good thing about poor sleep. But there is also the societal cost, you know we estimate in the report that sleep problems cost the NHS about £290 million a year

H: Crikey

N: So you know just by improving our sleep just a little bit, we can make a profound difference, but as I say people don’t see that

H: Yes

N: As I say in the same way we eat healthily if we exercise we’ll reduce the societal burden, if we sleep well or if we try to sleep well and actually see it as an issue that is down to us to sort out – you know a lot of people go to their doctors and say doctor, doctor I can’t sleep – but what are they doing about it?

H: No

N: Some people have a medical problem and that has to be taken seriously, but for the rest of us it’s mostly in our power to get a better night’s sleep not in somebody else’s

H: Like eating more healthily, get yourself a few more zzzzz’s in the bank and you’ll feel a lot better for it

N: You’ll feel much much better for it

H: Ok. Well let’s crack on with some more questions actually, we’ve had quite a few coming in. Sandra says ‘as I get older I’m finding I need more sleep yet my young kids keep me up late – what is the solution when you’re juggling a job, two young children and a household?’

N: Well in a way the answer’s in the question, to juggle implies that she’s having a stressful time of it and really what she needs to do is to develop some sort of relaxation, it only takes 20 minutes, half an hour to find that time in the day, and even if you say I don’t have time for it, well actually you do because you’re probably going to spend 30 minutes tossing and turning in bed, desperately

H: Yes, worrying that you’re not getting enough sleep!

N: So to use that time to have the wind down so then when you do go to bed when your head hits the pillow you should gently drift into sleep rather than trying to force yourself to sleep at the end of the day, so even if you don’t feel you have time you probably do

H: And what about naps in the middle of the day, I know the old Spaniards take their siestas don’t they, is that a good idea to try and get a quick cat nap?

N: They’ve always had the cat nap, the siesta and it’s basically to keep out of the bright sunshine, the hot part of the day that they have the siesta, and that of course is why they can have the café culture that they do where they don’t eat until late. Northern European country like the UK it gets dark so quickly that if you had a nap you potentially in the winter would wake up and it would be dark, so if you have a nap during the day, that uses up some of your sleep needs, so you won’t get the same amount of sleep at night

H: So maybe not such a good idea

N: So you know, it’s – if it works for you fine, but it’s not something that we should all -

H: Not to be advised

N: Adopt

H: Ok. Well we’re running out of time actually so let’s try and get through a few more questions quickly, Sam Williams said ‘sleep is for wimps. Coffee is the best tool to keep me going.’ What would you say to that?

N: It will keep you going to an early grave

H: So there you are, be told, no more espresso for you. Another one in from Thomas Whiteman, he said ‘I sleep about 6 hours a night and feel quite comfortable with that, but every now and again I crash and need a big deep sleep and a lie-in.’ Is that a good idea?

N: That’s like having feast or famine, you know you should get a good night’s sleep every night because as I say it makes you feel so good during the day, so you know if you go for weeks on end feeling five out of ten and then you need this big sleep, that’s saying that actually you know you’re not sleeping right

H: Right

N: And you’re short-changing yourself, you know if you could feel ten out of ten every day, life would be so much better so why are we going through it, trudging through it as a five out of ten, so -

H: Yes so there you are, I hope that’s some help. Another one from Lucy in West London, she said ‘I feel tired all the time, yet I tend to get 7 hours sleep and eat a well-balanced diet. So I need to get stress out of my life because sometimes I feel stressed with the commute etc.’ So she thinks she’s getting enough sleep, she eats a good diet, but she still feels really tired -

N: But she says she’s stressed, and you know the last thing that you can do, you know if you’ve had a stressful day at work, you’ve had a long commute home, you get home, all you want to do is relax, but the rest of your life intrudes on that relaxation, and so what she’s probably not doing is not breaking, you know not having that resolve, you know putting the day aside and then saying this is me time, you know I can treat myself well, I mean none of this is painful, none of this is hard, it’s actually being nice to yourself which is the attraction of it, you know having a nice, warm bath or a hot milky drink or whatever is actually fun compared -

H: But it is different for everyone, can you just reiterate that really that you need to find your own -

N: Find your own way to sleep, whatever relaxes the body and the mind is good for getting to sleep but you have to do it, you have to find that time to do whatever helps, so if you like doing yoga, if you like listening to Pink Floyd, whatever puts you to sleep is a good thing, but you have to find that time, because as I say if you don’t you’ll just lie in bed, mind racing, tossing and turning, getting more and more het up about it, and the last thing you’re going to do is fall asleep

H: So good wind-down tips then, what would you say?

N: Good wind – whatever works, you know and as I say there’s no rules, there’s just the if it works for you to resolve, to relax, to release and then head hits the pillow -

H: Nice hot, milky drink, hot bath, that would do it for me

N: Absolutely

H: Well Dr Neil Stanley thanks very much, it’s been really interesting talking to you, and if you want to know any more about this report and semisomnia and how it might affect you then you can go to the website and the report is all on there, it’s www.horlicks.co.uk, so thanks very much Neil, thanks to all of you who sent in your questions as well, and I think I’m off to get an early night! We’ll see you next time, bye bye

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