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healthadvice
lifecoach
7874767
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# LifeCoach: Why can't I get to sleep?
## Our panel of experts answers your questions on everything from insomnia
and cheese in the diet to Peyronie's disease.
![LifeCoach panel: Dr Dan Rutherford, health, Sarah Stanner, nutrition, and
Tony Gallagher, fitness][1]
LifeCoach panel: Dr Dan Rutherford, health, Sarah Stanner, nutrition, and Tony
Gallagher, fitness
12:47PM BST 06 Jul 2010
[Comments][2]
**Q_ _**_I am a 35-year-old woman. For some reason I can't get to sleep any
more. I've never had this problem and I can't think why it is happening. The
only thing that has changed recently is that I've changed my brand of
contraceptive pill. I think I'm getting maybe four hours' sleep a night, but
it feels like less. I'm walking around in a state of exhaustion. I've had to
take a couple of days off work because I simply can't function. I don't drink
a lot of caffeine -maybe one cup of coffee or two cups of tea a day. What can
I do?_ **Sarah Thomas, Clapham **
**DR DAN RUTHERFORD WRITES: **
**A** The **[oral contraceptive pill][3]** has been around such a long time
and has been taken by so many millions of women that its accumulated list of
possible side effects is very large. Although unlikely, it is therefore
possible it's your pill that's causing your** [insomnia][4] **and the only way
to find out is to swap it for another type, or have a break from it if
possible.
Anxiety, depression and worry are the commonest reasons for sleep disturbance,
but if none of these reasons applies to you then the range of further
possibilities is pretty wide.
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I'd suggest some blood tests to check that your thyroid gland is not over or
underactive, that you are not anaemic or short of iron (which can be
associated with "restless legs" at night) and that you don't have any signs of
ill-health that are not immediately obvious. If all that investigation draws a
blank, then it can come down to trying to get back into the "habit" of sleep.
That means avoiding late-night television, getting the room dark with thick
curtains and generally creating a sleep-friendly environment. If that still
doesn't work then a short course of sleeping pills from your GP is safe and
might tip you back into the rhythm again.
**TONY GALLAGHER WRITES**:
**A** Since it is probably more accurate to think of insomnia as a symptom of
another problem, you will need to take on board both medical and nutritional
advice. In the meantime it may help to try the following four exercises. The
first one is based on a deep-breathing technique that you can do in bed which
should help you to go to sleep. Your mind will feel more at ease and it is
often this inability to switch off that causes poor sleep. If you do have to
bring any work home put a stop to it at least one hour prior to bed.
While lying in bed, slow down your breaths. Try to produce a pattern where you
are exhaling for twice as long as inhaling. Aim to keep the breaths smooth.
Once established, do 10 such breaths while lying on your back, 15 lying on one
side and 20 while lying on the other side. The aim is to help send you off to
sleep and provide a better quality of rest.
Alternatively, slow down your breathing, but this time mentally count to 12.
If your mind wanders, and you lose count, start again. If you reach 12,
without interruption, count backwards to zero.
Or try progressive muscle relaxation starting at the toes and working up to
the top of the head. Contract and release each body part twice before moving
onto the next part. Keep breathing freely throughout. Don't forget that
regular exercise generally improves sleep. ** **
The timing of when you actually exercise will depend on each person.
A lot of people with insomnia possess an increased level of stress hormones in
their blood, making them overaroused. Exercise will initially increase the
stress hormones but later on they decrease. Different people will take
different amounts of time, so you will need to experiment to find out when is
the best time for you.
**SARA STANNER WRITES**:
**A** Sleep plays a vital role in restoring and revitalising the body and
mind. It also seems to be important in maintaining a healthy body weight as
lack of sleep has been linked with increased appetite and higher risk of
obesity.
Sleep deprivation is awful - it will make you drowsy, more accident prone,
less productive and can cause health problems in the long term.
Although diet is important, the effect of different diets on sleep has not
been well researched. There are anecdotal reports that certain diets or foods
help, but there isn't good evidence on which to base advice, for example
showing people sleep any better on a high protein diet than a high
carbohydrate diet.
However, studies show that too many caffeine-containing foods and drinks can
disturb sleep among susceptible individuals, so these shouldn't be consumed
late in the day.
Avoid eating late at night, especially high fat or high calorie meals, as this
can cause intestinal discomfort and indigestion which will disrupt sleep.
Try to eat a modest-sized dinner at least two to three hours before bedtime.
If you are hungry later on, opt for a light snack such as cheese and crackers,
yogurt or warm milk. Some studies have shown malted milk and foods rich in the
amino acid tryptophan (found in protein-rich foods such as dairy, soy
products, meat, fish) help to promote sleep, so there is some truth in the
benefit of a milky drink before you got to bed.
Don't be tempted to use alcohol as a sleeping aid. A "nightcap" might make you
sleepy, but will disrupt your normal sleep pattern - you are more likely to
wake up and experience difficulties getting back to sleep. It can also
dehydrate you, leaving you tired the next day. People who drink significant
amounts of alcohol between dinner and bedtime often experience the worst sleep
problems. Also, alcohol causes the muscles in the throat and upper airway to
relax, and interferes with breathing, which is why people who rarely snore can
do so after night-time drinking. Even small amounts can worsen sleep-related
breathing problems (sleep apnoea).
Many herbs are said to be useful for inducing sleep (but should not be used
during pregnancy or breastfeeding). One of the most popular is valerian,
available in a tea or as a supplement. Although some insomnia sufferers have
reported it to be of benefit, more trials are needed to prove its efficacy.
Other remedies include teas made of camomile, hops, lemon balm and peppermint,
but there is not much evidence that these work. Try keeping a food diary to
record what you are eating and drinking each day to see if there is any
pattern with your sleeping habits.
**Q **_Are there any healthy cheeses? _**J Butler, Harrogate**
**SARA STANNER WRITES**:
**A** **[Cheese][11]** is a good source of several nutrients - in particular
protein, calcium, phosphorus, B vitamins and zinc. But many cheeses are high
in calories, fat, saturates and salt.
Those with the highest calorie and fat content include Stilton, Parmesan,
full-fat cheddar and other standard hard cheeses, Roquefort and full-fat soft
cheese.
Lower calorie/low-fat options include quark, cottage cheese, "light" soft
cheeses, ricotta cheese and reduced-fat hard cheeses such as half-fat cheddar.
Feta cheese and some cheese products (spreads, for instance) contain the most
salt, while ricotta, cottage cheese, Emmental and mozzarella tend to contain
the least salt.
Always check the labels as the amount of salt found in cheeses of the same
type can vary widely.
Also consider the amount you will use - if you are adding flavour to a dish,
you will need less of a strong-tasting cheese such as stilton, mature cheddar
or feta.
**Q_ _**_I am in desperate need of an answer to my problem. I have suffered
from "Peyronie's disease" for the past two years. Although the pain is only
very slight and uncomfortable I cannot seem to find out from anyone as to
whether or not the problem will eventually go or if I will remain as I am._
**Anon, by email**
**DR DAN RUTHERFORD WRITES**:
**A** Peyronie's disease is caused by a zone of thickened tissue that develops
within the shaft of the penis.
The reasons why it happens are unclear but perhaps involve a combination of
local injury as well as overreaction of the body's immune system.
The condition varies in severity from being a minor nuisance to one causing
significant discomfort and deformity of the erect penis, and associated
problems with sexual function. Peyronie's is not rare - perhaps one in 30 men
have it, but this is far more than the number who report it to their doctor.
Treatments are available, although experts tend to suggest no action until at
least a year has gone by as it can spontaneously improve.
You have had the problem long enough now to make it worthwhile seeing a
urologist, who can advise on the appropriate treatment for you, so do ask your
GP for a referral.
See a summary of the condition and what can be done about it at
[www.tiny.cc/7hiwe][12].
* Send your questions and comments to The Sunday Telegraph, Life Coach, 111
Buckingham Palace Road, London SW1W 0DT; or email
[lifecoach@telegraph.co.uk][13]
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