Monday, August 2, 2010

Fatigue Causes

Fatigue Cause No. 1: Not Enough Sleep
Fatigue Cause No. 2: Sleep Apnea
Fatigue Cause No. 3: Not Enough Fuel
Fatigue Cause No. 4: Anemia
Fatigue Cause No. 5: Depression
Fatigue Cause No. 6: Hypothyroidism
Fatigue Cause No. 7: Caffeine Overload
Fatigue Cause No. 8: Hidden UTI
Fatigue Cause No. 9: Diabetes
Fatigue Cause No. 10: Dehydration
Fatigue Cause No. 11: Heart Disease
Fatigue Cause No. 12: Shift Work Sleep Disorder
atigue Cause No. 13: Food Allergies
Fatigue Cause No. 14: CFS and Fibromyalgia

Sleep Disorders and Fibromyalgia

Fibromyalgia syndrome causes symptoms of extreme pain in the muscles throughout the body. Sometimes the pain associated with the illness can be so intense that sufferers cannot continue with their daily tasks. But fibromyalgia isn’t just associated with pain. Fibromyalgia and sleep disorders also go hand in hand. In fact, it is thought that up to 80% of people with fibromyalgia experience some type of disordered sleep. Often, these sleep disorders leave people feeling tired, drained, and physically incapable of dealing with the stresses associated with fibromyalgia.
Alpha EEG Anomaly
An alarming percentage of fibromyalgia sufferers have a sleep disorder called alpha EEG anomaly. This sleep disorder may actually be a cause of fibromyalgia because so many sufferers have it. Alpha EEG anomaly affects deep sleep, preventing sufferers from getting a good night’s rest.
Alpha EEG anomaly occurs when sudden bursts of brain activity occur during a time when the brain should be in deep sleep. These periods of intense activity are measured as alpha waves on an EEG monitor. People with alpha EEG anomaly do not have difficulty falling asleep, but once they reach deep sleep, their brains begin to act like they are awake. This leaves sufferers feeling tired and drained.
Sleep Apnea
80% of people with fibromyalgia suffer from sleep apnea, a disorder that causes momentary stoppages in breathing. Sleep apnea only occurs when a person is sleeping, but it can affect some people so badly that they actually cause themselves to wake up. Many people who suffer from sleep apnea don’t even know that they have it - usually it is a partner that notices the sufferer waking up.
In apnea, there are gaps in breathing that can last for a few seconds or even as long as a minute. These gaps are often caused by a collapse in the airway due to snoring or being overweight. This is referred to as obstructive sleep apnea. However, there is also a much less common form of sleep apnea that appears to be caused by a defect in the central nervous system.
Referred to as central sleep apnea, this type of apnea is caused by a miscommunication from the brain. For some reason, the brain "forgets" to tell the lungs to breathe. People suffering from this type of apnea usually remember waking up.
Sleep apnea symptoms can affect a person’s sleep patterns. Some people with severe sleep apnea actually wake themselves up hundreds of times a night, if only for a few seconds. This prevents the body from benefiting from any restorative sleep. Sleep apnea can leave fibromyalgia sufferers feeling increasingly fatigued and even more subject to pain.
Restless Leg Syndrome (RLS)
Many people with fibromyalgia suffer from restless leg syndrome symptoms. RLS causes unpleasant sensations in the lower limbs, so much so that the limbs have to be moved in order to reduce the pain. RLS occurs mostly at night, between the hours of 10:00 pm and 4:00 am, though it can also occur throughout the day in severe cases. 
In a 2008 study, 64% of participants with FMS also had RLS.

RLS is exacerbated by long periods of rest, particularly nighttime sleeping, long car rides, or airplane travel. People with RLS describe crawling, itching, burning, or aching sensations beneath the skin in their legs. These sensations are so uncomfortable that they must move their legs, either by getting out of bed, or by exercising orstretching. Many find that if they do not move around, their legs will twitch involuntarily. Typically, RLS affects the calves and lower legs, though it can also affect the thighs, feet, and arms.
RLS causes major disturbances to sleep patterns. Because you are constantly being woken up or forced out of bed, many FM sufferers find that they just cannot get adequate rest. Many feel drained and sleepy during the day.
RLS is a neurological condition, but we don't yet know what causes it. Some cases may have a genetic cause, while others are believed to be related to:

Diagnostic criteria for RLS include:
  • A desire to move limbs, often linked to odd sensations
  • Symptoms that are present (or worse) when you rest; movement provides some temporary relief
  • Motor restlessness
  • Worsening symptoms at night

Symptoms of Restless Legs Syndrome and Fibromyalgia

Fibromyalgia and RLS share these symptoms:
  • Excessive daytime sleepiness
  • Problems with concentration
The primary symptom of RLS is odd sensations (parethesias) or unpleasant sensations (dysesthesias) in the legs and an uncontrollable urge to move to relieve these sensations. This phenomenon is not associated with FMS and requires different treatment.

Restless Legs Syndrome Treatment

RLS treatments can include medications and lifestyle changes.
For mild-to-moderate symptoms, your doctor may suggest you cut down or eliminate use of caffeine, alcohol and tobacco. If you have nutritional deficiencies, especially iron, folate or magnesium, your doctor may suggest supplements.
Other lifestyle management techniques include:
  • Maintaining a regular sleep schedule
  • Regular, moderate exercise
  • Avoiding excessive exercise
  • Hot baths
  • Leg massages
  • Applying heat or ice
These measures, however, don't generally provide complete symptom relief.
Your doctor may suggest medication to treat RLS. The more common types include:
  • Dopaminergics: (Examples are RequipMirapex) These drugs act like dopamine, which is a neurotransmitter that regulates muscle movement.
  • Benzodiazepines: (Examples are ValiumXanax) These are central nervous system depressants, generally used as anti-anxiety medicines, that also suppress muscle contractions.
  • Opiates: (Examples are DarvonPercodan) These pain killers also relax you and can suppress RLS in some people.
  • Anticonvulsants: (Examples are NeurontinTegretol) These are normally for preventing seizures but sometimes help relieve muscle contractions.
Some medications may make RLS symptoms worse, including antinausea, anticonvulsant and antipsychotic drugs and some cold or allergy medicines. If you're taking any of these, you may want to talk with your doctor about changing to drugs that are less likely to worsen your symptoms.

Restless Legs Syndrome Treatment vs. Fibromyalgia Treatment

RLS treatments don't generally conflict with FMS treatments, and in many cases, treatment may help both conditions. Many people with FMS find relief from benzodiazepines, opiates or anticonvulsants. (While they're widely used, benzodiazapines and opiates aren't part of official recommendations for FMS.) Also, many RLS lifestyle management techniques (regular sleep schedule, moderate exercise, hot baths) can be useful in managing FMS symptoms.
If you're taking or considering medications for both fibromyalgia and restless legs syndrome, be sure to talk with your doctor and pharmacist about any possible drug interactions.

Periodic Limb Movement Disorder (PLMD)
Periodic limb movement disorder often occurs alongside RLS. In fact, 80% of those fibromyalgia sufferers who have RLS also have PLMD. PLMD is very similar to RLS, however it only occurs during nighttime sleep. It can also become quite exacerbated and even violent, unlike RLS.
PLMD causes intermittent movement of a person’s limbs while they are in deep sleep. A person with PLMD may move their feet, knees, or thighs rhythmically without even realizing it. Most movements occur at intervals of between 5 and 60 seconds. For example, a person with PLMD might suddenly flex their knee, and then 60 seconds later, flex it again. These flexes tend to last for 10 seconds or more. The most common movements seen in this sleep disorder are flexes of the big toe, fanning of the toes, and flexion of the knees.
PLMD can be quite annoying when you are already suffering from widespread pain and other fibromyalgia symptoms. Sometimes people with PLMD can become quite violent, kicking and flailing while they are in bed. People with PLMD often report bouts of insomnia or daytime sleepiness, which can exacerbate their symptoms.
Bruxism
Bruxism (teeth grinding), frequently affects people with fibromyalgia. Bruxism is thought to be a part of a disease that is closely related to fibromyalgia, calledTemporomandibular Joint Disorder (TMJD). This disorder causes muscle pain in the face, neck, shoulders, and back, and often leads to grinding of the teeth. 75% of people with fibromyalgia also have TMJD.
Nocturnal bruxism occurs when you are sleeping. For some reason, sufferers begin to clench the muscles in their face causing their teeth to grind together. Many are unaware of this as they are sleeping, but in the morning they can be left feeling achy and sore in the jaw area. Bruxism can lead to a variety of dental problems, including loosened and broken teeth.


Wednesday, July 14, 2010

10 STEPS TO PEACEFUL BEDTIME By Claire Marketos

10 STEPS TO PEACEFUL BEDTIME
By Claire Marketos

“Sweet dreams, my darling, sleep well, is every parent’s wish for their child. Yet, bedtime can sometimes be a nightmare with youngsters throwing tantrums. If sleep is vital for all of us, why are there so many children who don’t want to go to bed and struggle to fall asleep?

Physical, emotional, and environmental factors all play a part in how easily your child goes to bed and how well she sleeps. You know your child better than anyone else and so it is important to tune into her needs not only at bedtime but during the day as well. Here are some simple guidelines based on what children need to help you make bedtime a pleasure.

DAY TIME AND NIGHT-TIME
In order for your child to develop good sleeping habits, “You must follow the biological forces of sleep. Sleep should happen during night- time hours (the circadian rhythm) and children need to be awake for long enough to be sleepy (homeostatic force),” says Dr. Alison Bentley of The Wits Dial-a- Bed Research Laboratory.

 “It is not fair to insist on a specific bedtime unless your child has been awake long enough for her to get sleepy, emphasizes Dr. Bentley, “You have to take daytime sleep into account.” If your child needs a nap, it should happen early in the afternoon. Toddlers, who fall asleep in the car after 3pm in the afternoon, will not be able to sleep easily at night.

ROUTINE 
 
“The key to getting your child to sleep is consistency, consistency, consistency,” stresses Dr.Irshaad Ebrahim of The Constantia Sleep Centre in Cape Town. “Children of all ages respond to rules and routine, as this provides them with an element of predictability in their life and hence security, and they need this especially when they are tired,” explains Ebrahim. “Bedtime should happen in the same way, at the same time every night, as long as day time naps finish early enough,” Bentley points out.

Children can go to bed later on the weekend and during the holidays, once a bedtime routine has been established, and “both parents clearly and consistently explain that this is a variation from the routine,” stresses Ebrahim. The bedtime ritual you use may vary to the one outlined below. Nevertheless, it should get them to bed calmly and quickly, so that they can sleep for at least 8-12 hours a night.  

When the child begins slowing down and is tired, it is time to start the bedtime routine. Don’t wait too long, otherwise she may get a second wind and then it becomes difficult to get her to sleep. Announce in a firm matter of fact tone, that it’s bedtime. “Time to say goodnight to everyone, brush your teeth, and go to the toilet.” This should take 5-10 minutes. You can make bedtime more fun by telling your child that her favourite teddy is waiting for them to cuddle, or by describing how snug her bed is going to be. A positive tone from you will reassure her that bedtime can be enjoyable.

For the next 10 minutes you can read a story, and your child can have a drink of warm milk. Give her a favourite soft toy or blanket. The bed and its surroundings should be free of any stimulating toys or pictures. Then, sit with your little one and gently stroke her if necessary to help her relax. Do not engage in conversation, say, “We’ll chat tomorrow.” If she keeps chatting say, “Go to sleep now, I’m going to pack things away in the kitchen.” “Make a slight noise,” Ebrahim advises, “to let your child know that you are still there.” Leaving a bathroom light on also makes children feel safe.

If your child comes out of her bedroom, calmly return her to bed. Be firm and reassuring but don’t resort to hitting or shouting, as “this can arouse the child and make them excitable and alert – the exact opposite of what you are trying to achieve,” explains Ebrahim. Sit with her until she is asleep. If you are implementing this routine for the first time, you may have to return your child to bed several times in the first week. Be tenacious, especially if you have to undo bad habits.

REASON
“Why do I have to go to bed now?”
Giving children an explanation of why they need to go to bed helps them to understand the importance of caring for themselves and being healthy. Tell your child: “You are tired. Your body needs to rest so you can grow big and strong, and so you can have lots of energy to play with your friends tomorrow.” Even very young children will listen to your explanation although they may not understand everything you are saying.

Acknowledge their feelings of not wanting to go to bed. “I know you don’t want to go to bed. I know you want to play with your toys. Tomorrow you will have play time again. It is bed time now.” Doing this initially, will relax and reassure your child, and you won’t have to say it every night.

PEACE AND QUIET

In order to sleep well, children need a peaceful environment with positive, calm parents who are in control. Stick to the bedtime routine, and support the parent, who is carrying it out. If you have ideas to make bedtime easier, discuss them with your partner once the children are sleeping. Be creative, and devise a plan together that makes bedtime a joy, rather than a chore.

Stop all stimulating activity including TV, an hour before bedtime, to help your kids calm down. They cannot sleep if they are not calm.

PHYSICAL NEEDS
In order to sleep well, children’s physical needs have to be met. A warm bath and a healthy, sit down dinner, (not in front of the TV), should take place in the hour before bedtime. Avoid sugary and salty foods, or foods which may have colourants and caffeine in them. After dinner, chat, read, or listen to classical music. Rough-and-tumble games with Mom or Dad should take place earlier in the evening.

On the other hand, physical activity during the day is imperative for good rest at night. If your children are sitting in front of the TV all afternoon, they will have more problems falling asleep than if they’ve had a fun day outdoors.
Always check for symptoms of illness which may be preventing your child from resting peacefully. If your child has persistent nightmares and anxiety at bedtime, consult your family doctor, or a child psychologist as there may be underlying issues of which you are not aware.

SECURITY AND SAFETY
You play a significant role in making your child feel safe and secure, which is important if she is to rest peacefully. Be aware of what you say in front of your children, especially when talking about violence. Keep arguments and fights with your partner private where the children can’t hear you. Kids usually blame themselves if there is conflict in the home and may spend many hours at night worrying about how to fix the problem, rather than sleeping.
Talk to your children about concerns they may have, such as the birth of a new sibling, the beginning of a new school year, disputes with friends and exams. Sometimes you may have to initiate chats and bring up topics, even if your child doesn’t tell you what’s bothering her. These conversations should always make the child feel secure. It is counterproductive to create more issues for them to worry about at bedtime.
Take your child’s fears of monsters hiding in her room seriously. Pretend to fight them off “or give them a torch to make them feel a little in control,” recommends Dr. Bentley.

Children should feel comfortable going to bed, so let them help you make their room and bed an inviting sanctuary.

YOUR FEELINGS IMPACT YOUR CHILD’S ABILITY TO SLEEP
“Children are extremely sensitive to their parent’s feelings. They will know from the way you hug them, look at them, and the tone of your voice, how you are feeling.” Ebrahim explains. “If they sense you are anxious, they may cry at bedtime for reassurance. If you allow them to stay up when they cry, they could interpret you actions as caring for them, or that they are not safe in bed. It depends slightly on the emotional situation in which this happens as to how various messages will be interpreted. Not all of the signals from your children relate to how your child is feeling, but how they think you might be feeling as well,”clarifies Ebrahim. 

Give yourself enough time to de-stress before bedtime, and to sit with your child in their bedroom.

MOTIVATION
Having a goal to work towards gives children a sense of accomplishment when they achieve it and it also enhances their self esteem. Find positive ways to motivate your children. Having incentives such as a sticker chart to get them started may help. However, they should learn that sometimes we do things because it is the right thing to do and because it’s good for us. Never reward youngsters with food.

If a child throws a tantrum and resists having to go to bed, understand that she is trying to express her frustration and anger at having to make the change from playtime to bedtime. Acknowledge her feelings with the same exuberance she is expressing them- “You’re cross! You don’t want to go to bed. I understand. Tomorrow you can play again,” while calmly continuing with the bedtime routine.
Praise your children by telling them how proud you are of them when they are successful at bedtime.

LOVE AND COMPASSION
Children need to feel love and acceptance to sleep calmly. Show them patience and compassion when they are tired, and especially if they have been through a life changing experience, such as the birth of a sibling, divorce or death.

During these times, children may need more assurance and attention from you during the day, to help them feel secure at night. In severe cases they may also need play therapy from a professional child psychologist, especially if anxiety persists.  

A child often regresses during difficult times, especially if there is a newborn in the parent’s room, and then it may be necessary for a mattress to be placed in the parent’s room for your older child to sleep on. Give her what she needs and then after several weeks, slowly help her to make the transition back to her own bedroom.

Attention from you is essential for peaceful sleep. If you are away from your child all day, she will want to attach to you from the moment she sees you, and therefore may act out at bedtime to be close to you.
Feelings of guilt should not prevent you from being firm and doing what is best for your child.

FOLLOW YOUR INSTINCTS
Most children who wake at night can be soothed back to sleep quickly. However, Dr Bentley explains “Children who have a very disruptive sleep disorder can wake up to seven times a night and demand either milk or rocking to go back to sleep. This is usually not due to any physical need but rather a behavioural disorder for which you may need professional help.” (See essential signs of seep disorders.)

ESSENTIAL SIGNS OF SLEEP DISORDERS IN CHILDREN:
1. Snoring and associated hyperactivity or sleepiness in the daytime
2. Interrupted breathing while asleep
3. Excessive limb movements in sleep
4. Sleepwalking
5. Sleep/night terrors (not the same as nightmares)
6. Inability to fall asleep, despite adequate parenting

If you feel your child may have a sleep disorder, talk to your general practitioner or paediatrician. 

Chat to your partner and come up with a plan for the middle of the night you both agree on. If junior can climb into your bed without waking you or your partner, it will provide an excellent opportunity for you to all bond and cuddle, especially if you are separated during the day. If you are unable to sleep with junior in your bed, a mattress next to it may be an alternative, or follow the same routine you used at bedtime. Ensure your little one’s room is warm enough. You may want to use a sleeping bag if she kicks her blankets off. Letting her have one of your T-shirts that smells like you to cuddle with can provide solace.

If she has a nightmare or wakes up afraid during the night, gently reassure her that she is safe and that you are there for her. If the nightmares continue speak to your family doctor or a child psychologist. When you say goodnight to your child, remember to always tell her you love her and say: “With a butterfly kiss and a ladybug hug, sleep tight little one like a bug in a rug." A good night to you all.

Useful Contacts: Dr Yacoob Omar Carrim http://zasleep.blogspot.com

Thursday, July 8, 2010

Obstructive Sleep Apnoea (OSA) - SNORING can KILL you

Obstructive Sleep Apnoea (OSA)
Obstructive Sleep Apnoea (OSA) refers to any disorder in which there are breaks or pauses in a person's breathing during sleep. Most people who have OSA also snore, but not all snorers have OSA.. Diagnosing OSA needs to be done in a sleep centre and requires at least one Nocturnal Polysomnogram (PSG), which measures various physiological functions during the stages of sleep. A trained sleep technician monitors the patient continuously during the test. Then, the results are evaluated by a sleep disorder specialist, a diagnosis is made and a treatment plan is proposed.

The most effective means of treating OSA is by Continuous Positive Airway Pressure (CPAP). In this highly effective therapy, a mask is worn over the nose during sleep. Nasal CPAP provides a pressure splint to the upper airway, allowing the person to sleep and breathe normally. The airflow required must be determined through testing during sleep which is done during an overnight PSG.

OSA left untreated is associated with a much poorer long term outcome and increases the risk of cardiovascular, pulmonary and other diseases.

Disruption of sleep caused by frequent interruption of breathing, leading to excessive daytime sleepiness, irritability, memory lapses, inattention, personality changes, poor work performance, increased likelihood of driving and industrial accidents. Dangerously low levels of oxygen can lead to potential heart problems and other health disorders, including: depression, mood changes, memory loss, weight gain, impotency and headaches. Pressure changes in the throat can lead to an irregular heart beat. There is an increased risk of high blood pressure, premature heart disease and stroke.

The Sleep Medicine group of sleep centres provides a fully comprehensive diagnostic and treatment service for patients with OSA including Sleep Studies, Titration, Patient Education and Compliance Monitoring.

Seven-day sleep makeover Written by Hannah Ebelthite, Zest magazine

Getty - Main
We all know what makes for a good night's sleep - sticking to a routine, avoiding stimulants, learning to relax.
But a warm bath, a cup of camomile tea and a sniff of lavender often aren't enough to help us nod off. And unfortunately, next-day grogginess and irritability aren't the only consequences.
Bad quality sleep can suppress your immunity and make you more prone to illness. It may increase your risk of serious illness, too, such as diabetes and cardiovascular disease.
Plus, regularly sleeping fewer than seven hours a night may increase the risk of high blood pressure in women, says a study in the journal Hypertension. And research by the University Of Bristol links sleeplessness with weight gain - the less you slumber, the more appetite-stimulating hormone is released.
But even if you're not troubled by sleeplessness, you may still not be getting the quality of shut-eye you need.
So remedy that now, with our seven-day sleep makeover.

SUNDAY

Do this: keep a sleep diary

Getty - Diary
This will highlight your individual sleep patterns, says clinical hypnotherapist Glenn Harrold, author of Sleep Well Every Night (Orion, £9.99).
'Note the time you went to bed, to sleep, the total time slept, if you woke, what you did, any remedies you took, the last time you ate or drank, and your moods on going to bed and waking. After a week or so, you'll spot the factors that help or hinder your sleep.'

Did you know?

'Research shows that people in the UK get seven and a quarter hours' sleep per night on average,' says sleep expert Dr Neil Stanley of Norfolk And Norwich Hospital.
'But sleep need is like height or shoe size - it's different for everyone. So stop watching the clock and listen to your body instead. If you're alert and happy after six hours, that's fine; if you need nine, that's normal, too.'

Sleep clinic

If you're physically shattered but can't switch off, try spritzing Bach Rescue Night Spray (£8.05, from pharmacies) on your tongue - it's a variation on the classic Rescue Remedy formula, which quietens active minds.
Sunday-night sleeplessness is common, says Dr Stanley. 'It's a combination of not actually needing to go to sleep early, as you've probably had a lie-in and not been particularly active that day, and mental stress caused by thinking ahead to another week of work.'
Harrold suggests the following mindemptying technique: 'Breathe very slowly and deeply in through your nose and out through your mouth for about ten minutes.
'Allow your mind to go blank. Thoughts will still drift into your mind, but don't fight them. Just imagine a computer screen full of data that becomes blank by hitting a keypad. Imagine pressing that keypad, and you'll clear your mind.'

MONDAY

Do this: buy new curtains

Getty - Curtains
'Like most animals, humans are biologically hard-wired to sleep at the onset of darkness,' says Harrold.
'Only when it's dark does your pineal gland release the hormone melatonin, which promotes deep sleep. Even an LED light on an alarm clock or chinks of light under the door are best avoided as you must aim to sleep in complete darkness,' says Harrold.
If you can't eliminate all light, buy an eye mask.

Did you know?

If you haven't exerted yourself during the day, physically and mentally, sleep may elude you at night.
'You lie down and your body says, "what's the point of this? I don't need it",’ says Dr Stanley.
'Research indicates that exercise during the day will help you sleep.' But don’t leave it too late. 'An evening gym session may mean you're too stimulated and hot to sleep well,' he says.
'If you hit the sack at 11pm, say, finish your workout by at least 8pm.'

Sleep clinic

If you fall asleep easily, but wake in the small hours and find it difficult to get back to sleep, then stop trying and do something different. 'Don't just lie there watching the clock,' says Dr Stanley.
'Sometimes just getting up to go to the loo is enough to break the cycle. Or maybe you need to switch on the light and read for ten minutes, or make a drink.'
Just try not to do anything stimulating, such as watching TV. 'The key is to accept you're awake and not to stress out - you'll soon wind down again.'

TUESDAY

Do this: try supplements

Getty - supplements
'B vitamins are essential for sleep and stress relief,' says nutritionist Alice Bradshaw. 'Take a good B complex formula, as the vitamins work best in synergy.'
And if stress and anxiety is the route to your insomnia - or vice versa - try the amino acid L-theanine. 'Studies show it promotes good quality sleep,' says Bradshaw, 'as it's involved in the production of neurotransmitters that have a calming effect akin to meditation.
'Research shows 5-HTP also improves sleep quality.' Try Solgar L-Theanine, £25.85, and 5-HTP, £9.95 (www.solgar-vitamins.co.uk).

Did you know?

Researchers at the University Of Geneva found that people who get a decent quota of sleep perform better in brain and memory function tests.
It's thought sleep helps your brain consolidate experiences and learning, and boosts memory, as connections between nerve cells are strengthened during slumber, which means sleep is vital before an exam or interview.

Sleep clinic

If you're one of the UK’s 15 million snorers, before you reach for the nasal strips and throat sprays, check what type you are.
The British Snoring & Sleep Apnoea Association has a test at www.britishsnoring.co.uk that identifies whether your snoring is caused by an allergy, nose-breathing, mouthbreathing, or is related to your tongue or soft palate. It then recommends appropriate solutions.
In all cases though, avoid alcohol, caffeine and smoking, and lose weight if you need to.
Also, see your doctor - snoring may indicate another, treatable problem, such as nasal polyps.

WEDNESDAY

Do this: de-electrify

Getty - de-electrify
A recent survey by the Sleep Council found that one in three of us makes phone calls or sends texts in bed, while one in five of us goes online, plays computer games or listens to their iPod. But it's definitely not a good idea, says Harrold.
'Studies show that electromagnetic fields (EMFs) from wi-fi, TVs, clock-radios and mobile phones affect sleep patterns in a negative way, stimulating your brain and body as you attempt to rest.'
He advises removing all electrical items from your bedroom with the exception of a daylight-simulating alarm clock (such as the Bodyclock at www.lumie.com).

Did you know?

A study at the University Of Zurich found that using a mobile phone for an hour before sleep increases brain activity, adversely affecting sleep.
'Keep your chats to earlier in the evening, and if you must have your mobile in the room with you, keep it at a distance - not on your bedside table next to your head. Or use a landline phone with a cord,' says Harrold.

Sleep clinic

If you sleep OK but wake up shattered, it may just be sleep inertia - the inability to come round fully after waking.
'For some people, the grogginess lasts minutes,' says Dr Stanley, 'but for others it's up to two hours. Natural daylight and using your body and brain will soon wake you up.'
What about that feeling when you've been dreaming all night and you wake up exhausted? 'The fact is you only remember dreams if you wake during them,' says Dr Stanley.
'So feeling that you have dreamed a lot actually means you've woken several times during the night.'
Dr Stanley also points out that dreams are very real. So if you dreamed you ran a triathlon or were being pursued, for example, your heart rate and breathing would have increased for real - another reason you may feel tired.
'Daytime tiredness may also indicate insomnia - the term refers to sleep quality as well as quantity,' says Dr Irshaad Ebrahim, who is the medical director of the London Sleep Centre.
'You may not always be aware if the sleep you're getting is poor quality. Look to your sleep environment, and ask your partner if you seem restless or noisy during the night.'
Identifying why you feel exhausted is the first step towards solving it.

THURSDAY

Do this: try hypnosis

Getty - try hypnosis
'Hypnosis has a very similar effect on brainwave cycles as sleep,' says Harrold.
'The transition from full consciousness into a hypnotic trance will steadily slow your brainwaves and naturally guide you into a state that's ideal for sleep.' Harrold's book comes with self-hypnosis tips and a hypnosis CD to use before bed or if you wake during the night. Or to find a local practitioner, visit the British Society of Clinical Hypnosis at www.bsch.org.uk.

Did you know?

In a survey by the British Chiropractic Association, about 25 per cent of people blamed their bed for their back pain, and 40 per cent of back pain sufferers said that pain affected their sleep.
Memory foam neck pillows and mattresses such as Tempur (www.tempur.co.uk) relieve pressure on your joints and support the natural curvature of your spine.
In an independent survey, 86 per cent of Tempur customers with back pain said their mattress relieved the pain and gave them a better night's sleep.

Sleep clinic

If you have restless leg syndrome (RLS), you'll experience symptoms such as an itchy, 'crawling' feeling in your legs as bedtime approaches, and involuntary jerking of your legs during sleep that may be enough to disturb your sleep or that of your partner.
'We don't really know what causes this uncomfortable night-time twitching,' says Dr Stanley, 'but if it disrupts your sleep as well as your bedfellow's (who may sustain the odd bruise!), your doctor may be able to prescribe medication for it.'
'Caffeine consumption has been associated with RLS, so avoid it from late afternoon,' says Bradshaw.
Try soporific herbal teas, such as camomile and valerian, instead.
'Magnesium is needed for good muscle function, so supplements may ease symptoms,' she adds.

FRIDAY

Do this: eat right

Getty - eat right
Whether a nightcap or a mug of cocoa is more your style, neither is likely to improve your slumber, says nutrition consultant Ian Marber, founder of The Food Doctor.
'Alcohol may help you get to sleep, but it ultimately disturbs it,' he says.
'Herbal tea or water is better, but remember not to drink too close to bedtime - a full bladder will wake you up later.'
When it comes to food, he suggests similar abstinence.
'You hear about sleep-inducing foods such as turkey, lettuce and carbs, but really the best thing to go to bed on is an empty stomach. You don't need fuel for sleeping and an active digestive system delays deep sleep.
'Try to allow three to four hours between your evening meal and bed.'

Did you know?

In a Sleep Council survey, 41 per cent of us cited lack of sleep as the cause of morning grumpiness. And women feel it more than men - only 14 per cent of us never wake up in a bad mood, compared with 24 per cent of men.
Could that be because 28 per cent of us squeeze in housework between rising and going to work, compared with 5 per cent of men?
'Sleep problems statistically affect both sexes in roughly equal numbers,' says Dr Stanley.
'But in my experience women are more sensitive to and vocal about feeling sleep deprived.'

Sleep clinic

If your sleep is often disturbed by noisy neighbours or traffic, what can you do to lessen your exposure?
'It sounds obvious,' says Dr Stanley, 'but many people "train" themselves to sleep through such disruptions, when it might be more helpful to find ways to eliminate the disruptions.'
So talk to neighbours, fit secondary glazing, wear ear plugs, buy blackout blinds - whatever it takes.

SATURDAY

Do this: stick to your routine

Getty - stick to your
    routine
'Get into the habit of going to bed and rising at the same time, even at weekends,' says Harrold.
'This will help regulate your sleep patterns so you’ll soon become sleepy and wake up naturally at the same time each day.'

Did you know?

A Greek study found that afternoon naps reduce stress levels and your risk of heart attack.
In fact, sleep researcher Dr Sara Mednick, author of Take A Nap! Change Your Life (Workman, £8.99), says a 20 to 90-minute nap before 4pm will increase mental performance and reduce your chance of weight gain by positively affecting your metabolism.

Sleep clinic

If you've tried it all and still can’t sleep, remember that hormones affect body temperature.
'This can result in disturbed sleep at certain times of your cycle, during pregnancy or the menopause. Adjust your environment to remain cool,' says Dr Ebrahim.
'Also, some medication, particularly antidepressants, may affect your sleep, so consult your doctor.'
If you think the cause is medical, ask your GP for help and don't be palmed off with sleeping pills. 
'You can self-refer to a private sleep clinic,' says Dr Ebrahim. 'There, you'll see sleep experts and may spend nights at the clinic for observation.' 
Last updated 15.01.2009
You can contact Dr Yacoob Omar Carrim on zasleep@gmail.com for a direct appointment.