The Sleep Good, Feel Good Guide

Why is getting a good night's sleep important?

Everyone has experienced a bad night's sleep and knows what it's like. Yet most people's experiences are slightly different - some react by being tense, others have headaches or upset tummies, sore backs, or sore eyes. However, the universal reaction is that no one feels great when they don't sleep well.

A good night's sleep, though, can be quite elusive for some. Simply extending the duration of sleep doesn't always work; it might if you spend the working week not getting enough sleep (this is called Sleep Insufficiency Syndrome) and catch up over the weekends, but then it might not. Getting a good night's sleep can involve getting everything right, so that extra time in bed works for you.

Is insufficient sleep bad for you? Disturbed sleep can make you feel depressed and out of control which can lead to extra stress in your life. But, although inadequate sleep is stressful and unpleasant, it's not necessarily harmful - thanks to looking after babies etc., we have evolved with lots of reserves to draw on. However, inadequate sleep does lead to impaired concentration particularly in monotonous situations. The danger of driving with insufficient sleep is just one, prime example, now getting just recognition.

Falling asleep rapidly when you're ready and waking up when you want to, feeling refreshed and ready for the day; and remaining bright, alert and happy until you next want to sleep constitutes a good sleep.

Science has extended what the ancient Hindus knew, that there are three states of mind: wakefulness (vaiswanara), dreaming sleep (taijasa), and dreamless sleep (prajna). We now recognise at least 5 stages of sleep using electroencephalography (EEG or "brainwaves" - the electrical activity of the brain measured using electrodes glued to the skull): Stage 1 (drowsiness), Stage 2 (light sleep), Stages 3 and 4 (deep sleep or slow wave sleep) and Stage 5 REM (dreaming sleep).

Using this technology it has been possible to quantify how different factors disturb sleep. For example, when someone wakes up in the morning, feeling that they have slept well through the night, but nonetheless feeling awful, it's usually possible to see how the EEG has been disturbed.

People suffering from sleep apnoea, for example, can stop breathing hundreds of times a night, causing many short awakenings, which aren't registered by the sleeper's mind. This causes daytime fatigue and tiredness even though the sleeper wasn't aware of it.

The same can happen with an uncomfortable bed. Moving around in bed during the night is quite natural and necessary but when someone tosses and turns because they are getting sore and stiff, then their sleep is likely to be less refreshing than it should be and consequently, despite the amount of time spent in bed, they still won't feel good. The quality of sleep is just as - if not more - important, than the duration of sleep.

What constitutes a good night's sleep?

However, the foundation of good sleep is the bed. Beds are where we are taught to sleep best - they have to feel comfortable. If you get up in the morning with aches, pains, stiffness or irritations then you need to consider whether your bed is the problem.

Other times you may feel your sleep is OK but not refreshing. Dust mites could be the reason. Their waste contains allergens, which can promote breathing problems like asthma, which causes unrefreshing sleep. Pillows and duvets can contain significant amounts; under-bedding increases the levels and mattresses older than 10 years may contain significantly more. Signs of dampness, mattress age, how often it and the bedroom are cleaned, ventilation, temperature and humidity all effect allergen concentration.

Similarly, snoring which may lead to sleep apnoea (stopping breathing) is a common cause of disturbed and unrefreshing sleep. Less common is stomach reflux - bringing up small quantities of acidic fluid into the throat; this can produce the same symptoms as asthma or may cause choking sensations or possibly nightmares. (Sometimes raising the head of the bed a few inches is enough to solve the problem).

Finally the firmness of the mattress is important. People vary with weight and age. If a mattress doesn't provide sufficient support then not only might aches and pains result the next day, but the sleep may be so disturbed that you are left feeling unrefreshed.

Why am I not getting as good a night's sleep as I could?

A healthy lifestyle consisting of adequate and sensible nutrition and sufficient exercise is important for good sleep. Eating too much, too late and the wrong things can disturb sleep, as can feeling unwell through lack of exercise.

However, the foundation of good sleep is the bed. Beds are where we are taught to sleep best - they have to feel comfortable. If you get up in the morning with aches, pains, stiffness or irritations then you need to consider whether your bed is the problem.

Assess your sleepiness.

Answer true or false to the following:

1. You can't "store up" your sleep.
2. Lots of physical exercise helps you sleep well.
3. Youngsters who can't fall asleep at nights should sleep more at weekends.
4. Caffeine can keep you awake.
5. Not dreaming is a sign of mental illness.
6. Sleep deteriorates with age.
7. Once a poor sleeper always a poor sleeper.
8. Daytime naps are bad for you.
9. Boring social and work activities make you go to sleep.

Answers - All the statements are false.

1. If you know that you may not get enough sleep, or are going to work a night-shift, then trying to get extra sleep the day before can improve your alertness.
2. Physical fitness is associated with good sleep, but too much exercise immediately prior to sleep causes wakefulness.
3. Regularity of bedtimes and getting up times helps ensure good sleep.
4. Caffeine is actually very complicated. For most people it may improve mental performance. However, it may not prevent sleep in the very sleepy whereas it may turn poor sleepers into outright insomniacs. To make matters worse its effects change with age. To stay awake, it's best to get enough sleep, not drink loads of coffee.
5. There is no association between not dreaming and mental illness - everyone has REM (dreaming) sleep but not everyone remembers their dreams.
6. Poor sleep is associated with ageing but this deterioration is invariably associated with other ailments.
7. It's always possible to achieve better sleep.
8. Planned daytime naps improve alertness without necessarily affecting nocturnal sleep. Naps caused by sleepiness may impair night-time sleep.
9. Boring occasions don't cause sleepiness, they reveal it.

Strategies for achieving a better night's sleep.

The 4 R's of good sleep:

1. Regularity,
2. Routine,
3. Restful bedroom, and
4. Right bed

Babies can sleep for a long time, but it is more like a mixture of siestas and naps than one continuous block during the night. It is mainly through a process of learning that infants learn to adopt a culture's sleep pattern. In learning to sleep through the night they also learn what it is to feel well. The combination of sleeping and working at the same time enables the brain's sleep-wake systems to work optimally with the brain's 24-hour biological clock.

Regularity of bedtimes and arising times reinforces this synchronisation and enables good sleep and good awakenings.

Routines that are associated with going to sleep signal the brain that it is time to wind down. Traditional hot drinks or a bath before bed are all helpful particularly if regularly associated with going to sleep. It is preferable to reserve the night-time bed for just sleep.

Reading, watching television, listening to the radio, eating, drinking, playing computer games and working should all be reserved for "day" rooms (or beds). However, if reading, for example, is an established routine which invariably guarantees sleep, then of course it should be maintained. It's only if sleep starts to deteriorate that care should be taken about what's done in bed.

A restful environment, both bedroom and bed, is essential for good sleep. A dark, cool, non-humid, quiet room associated with the right bed and bedclothes is the ideal.

Buying the right bed in the first place is one thing (our Bed Buyers Guide tells you more about how to do this). But, all too often people don't notice the gradual deterioration of their bed until the level of discomfort is quite extreme - and think of how much time you must have spent in a less than perfect bed by the time it reaches that stage. It's not just the bed's deterioration through use that you should be aware of, either. Our own individual needs and preferences change over time, too. Changes in lifestyles or physical conditions also affect our bed requirements.

Your mattress lifespan for offering optimum support and comfort will vary depending on its quality, its frequency of use, the wear and tear it undergoes (sadly, a heavier person will wear out a bed more quickly than a lighter one, a couple more quickly than a lone person), and how well it's been looked after. As a rough guide however, even a good quality mattress, in normal use, should not be expected to last more than about 10 years.

How to tell if your bed is up to scratch.

The Sleep Council have devised a simple bed MOT (Mattress Obsolescence Test), which they recommend should be done every year after the first three-five years. If you answer "Yes" to three questions, you're not getting the best possible night's sleep. Five or more "Yes" answers and it's time to buy a new bed.

Answer yes or no to the following:

• Is the bed 10 years old or more?
• Do you ever wake up with neck or back ache?
• Is the mattress cover torn or stained?
• When lying in bed, do you feel springs or ridges beneath the surface?
• When moving in bed do you hear creaks, crunches or other suspicious noises?
• Do you and your partner roll towards each other unintentionally?
• Is the bed too small to give an undisturbed night's sleep?
• Is the divan or base uneven or sagging?
• Are the legs and castors worn out?
• Would it be embarrassing if the neighbours saw the bed without its covers?

Keeping your sleep centre ship-shape.

Proper care will keep your bed in better condition during its lifetime. Always read and retain manufacturers care instructions and ask your retailer for advice too. Otherwise, the following tips will help you to get the best out of your bed during its natural life:

1. Use a washable, protective cover to protect the mattress (and pillows) from stains. Barrier fabrics for allergy sufferers are also available.
2. In the mornings, throw back the bed clothes and leave the bed to air for 20 minutes to allow body moisture to evaporate.
3. Unless otherwise advised by the manufacturer, turning your mattress over from side and side and end to end every few months (every week for the first three months) helps upholstery fillings to settle down more evenly. Some more luxurious mattresses, with much thicker layers of fillings designed to mould themselves to the contours of your body, may retain signs of these impressions, despite turning.
4. Don't make a habit of sitting on the edge of the bed and don't let the kids bounce on it.
5. Don't roll up or squash a mattress to store or transport it - this can cause permanent damage.
6. Handles are designed to help you position a mattress on its base - do not use them to support the full weight of the mattress on their own - they may pull out.
7. Don't leave any polythene wrappings on a new mattress - dampness, mildew and rotting could all result from a build-up of condensation.
8. Vacuum your mattress and base from time to time to remove fluff and dust. This should be carefully done so as not to dislodge fillings or damage tufts. Open windows while vacuuming - especially if there is an asthma sufferer in the house.
9. When tackling stains, use mild detergent and warm or cold water. Never over soak a mattress or base.
10. Putting a new mattress on a base for which it was not intended, a new mattress on an old base or a board between the mattress and base can impede comfort and reduce the useful life of the mattress - as well as affecting any guarantees or warranties.

Out with the old.

Once you've bought yourself a new bed, make arrangements to have the old one disposed of. Don't give it to the children, relatives, guests or neighbours. If it wasn't good enough for you, it's not good enough for anyone else, either. In fact, it's a veritable health hazard - get rid of it.