- 15 hours ago
How to Sleep Better
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00:07Yet another bad night's sleep.
00:10So many of us are tossing and turning, lying awake, suffering.
00:14But why?
00:15Everyone seems to be talking about how knackered we are.
00:19And yet, when we try to sleep, we can't.
00:21Even though we're absolutely desperate for a decent kib.
00:26One in three UK adults struggle with insomnia.
00:30And sleep anxiety has nearly doubled.
00:32I am literally tired of being tired.
00:35The nation's obsessed with sleep and ironically, it's the one thing keeping us all awake at night.
00:40That and the snoring.
00:43I can only describe the noise as a cross between a train and a drunken pig.
00:52But help is at hand, starting, rather alarmingly, with your wake-up time.
00:57We want you to get up at the same time every day.
01:01And your daily cuppa.
01:03I would keep caffeinated beverages before 12pm.
01:07Before 12?
01:08Before 12pm.
01:09And even your evening tipple.
01:12Red for bed.
01:12Don't judge me.
01:13But fortunately, it's not all about habits.
01:17There's tech, too.
01:18I don't know if I'm going away.
01:20And surprising psychology.
01:23I need you to leave the bedroom and go somewhere else.
01:26It's time to wake up, get some answers, and find out what's really keeping us up at night.
01:3210% we know have chronic insomnia, and you're no longer one of them.
01:37It's amazing.
01:38It's great.
01:44So this is the chill pill, and it is supposed to calm your anxiety.
01:49The sleep industry is worth billions, with new apps and gadgets promising the perfect eight hours sleep.
01:55But still 20 million people in the UK suffer from insomnia.
02:01I'm meeting sleep expert Stephanie Romoshevsky to find out the root of the problem.
02:08Stephanie's worked at Harvard Medical School on NASA-funded sleep studies.
02:12She's treated over 10,000 people, even Premier League footballers.
02:17Stephanie, have we always been obsessed with sleep, or is this a new fixation?
02:22It's definitely a new fixation that has happened through industrialization and this new data age.
02:30Back in the day, we were just governed by the natural things around us, like the light-dark cycle of
02:36the planet, and these sleep mechanisms.
02:38They would just work uninterrupted.
02:44There are two mechanisms to actually drive healthy sleep.
02:49One of them is called your sleep drive, and the other one is called your circadian rhythm.
02:54So what is circadian rhythm?
02:56Sounds fancy.
02:57Yeah.
02:57In Latin, it just means for about a day, essentially.
03:01And it's just talking about all those processes that rely on a 24-hour timeline.
03:06And you have this clock in your brain, which basically dictates when things happen.
03:12The circadian rhythm is your body's internal clock.
03:16It helps us know when it's time to wake up and go to sleep.
03:19We all have one, but some are better than others.
03:22So how do we fix it if it goes a bit wonky?
03:26That's where our sleep drive comes in.
03:31A sleep drive is where we build up the pressure to sleep.
03:36So you can't just sleep.
03:37You need something to be built, a bit like a hunger or a thirst drive.
03:42So what we need to do is we need to spend time, all that time awake during the day.
03:46And what happens at the same time is that your body builds up this pressure.
03:50It's actually a chemical called adenosine, which is built up all the way through the day,
03:54in order for eventually it to dissipate, in order for you to effectively sleep.
04:00OK, time for some fancy science.
04:04Adenosine is a chemical in your brain that builds up while you're awake.
04:08The more energy your body uses, the more adenosine you produce, creating a feeling of sleepiness.
04:14Right, so if I'm thinking, do you know what, it's 9.30pm, I need to be in bed now, but
04:20I'm not tired,
04:21I'd benefit more then from just staying up a little bit longer until I'm naturally tired.
04:25Exactly.
04:26And if you start by consistently getting up at the same time of the day,
04:30you will start to notice that that will become predictably similar times every night.
04:36So you want to start feeling sleepy at 9.30pm?
04:39You've got to start with your get-up time because that helps really sort of dictate
04:43how strong and how consistent that sleep drive is, that pressure, to help you go to sleep.
04:50Well, that sounds simple enough.
04:53Use up your energy during the day to build up your sleep drive.
04:56Don't go to bed until you're genuinely tired and wake up at the same time every morning.
05:01Yeah, I think I can manage that.
05:04More key rules from Stephanie later to help fix your sleep.
05:08But what if you're looking for something more immediate?
05:10Could what you're eating be the answer?
05:18I've tried everything, warm milky drinks, yummy gummies, even fruits that are supposed to help you sleep.
05:24But how much of this actually works?
05:27I've got my massive basket of shopping with me and I'm on my way to meet Dr. Rupi, author of
05:34multiple cookbooks.
05:35If anyone knows how what we put in our bodies affects our sleep, it's him.
05:40Food is essential for your overall well-being and there is a link with sleep.
05:46A healthful diet full of fruits, vegetables, lots of different fibres is definitely associated with better sleep.
05:53Well, this is definitely the right place.
05:57Oh, wow.
05:59Oh, hello.
06:00Hello.
06:01What a great space you've got here.
06:02Thank you, Denise.
06:03Oh, something smells delicious.
06:04Oh, thanks.
06:05Yeah, we're going to have that later.
06:06Right.
06:07Oh, are we?
06:07Yeah.
06:08Look forward to it.
06:09Right, I have got with me a basket full of foods that I've been told are led to believe will
06:15help you sleep.
06:16All right.
06:17So you have a look.
06:18We'll see.
06:18Yeah, we'll see.
06:19Okay, let's start with this.
06:21Uh-huh.
06:22Okay, yeah.
06:23Traveled on the bus with this lot.
06:26So chicken and turkey, as well as other tryptophan-rich foods, these are touted as sleepy foods, right?
06:36So tryptophan is an amino acid that you find in lots of different foods and it's involved in the production
06:42of something called melatonin.
06:43I know melatonin.
06:44You know melatonin.
06:45Melatonin is known as the sleepy hormone and it's got a really important role in initiating sleep.
06:52There is a suggestion that having these tryptophan-rich foods can increase melatonin, which is true.
06:58But what isn't proven is the fact that this kind of stuff actually helps with your sleep quality.
07:05Tryptophan from food is needed to make melatonin, but it struggles without help.
07:10Our body's clock and the light-dark cycle control melatonin production and if any food helps, it's carbs, which act
07:17like a green light, letting tryptophan into the brain.
07:21Oh, don't you just love when the science is good news?
07:23Get me a dollop of mashed potato.
07:26There were some small studies looking at high glycemic index foods.
07:31These are rich carbohydrates that quickly turn into sugar in your body.
07:35And if you eat a high-carb meal four hours before bedtime, there is some evidence that it helps you
07:41get to sleep quicker.
07:43So it's really to do with the timing that you eat, isn't it?
07:45I would say that's a lot more important.
07:47Melatonin is a hormone that is released from the pineal gland in your brain and it is associated with sleepiness.
07:55So when you eat, your melatonin is inhibited, i.e. it goes down.
08:00So you want to make sure that you're having an earlier dinner time such that your melatonin naturally gets a
08:06lot higher in terms of dose and you get that sleepiness around bedtime.
08:11Right, next, drinks.
08:13Uh-huh.
08:13Herbal teas. I love a herbal tea.
08:16Yeah. Herbal teas, things like chamomile, valerian roots, licorice.
08:22They might be related to improvement in sleep.
08:25I think it's more the habit.
08:27So when you go to sleep and you essentially give your body a signal, a reminder, oh, this is sleepy
08:33time.
08:34This is when I have my chamomile tea.
08:36That might actually help.
08:37And you do have to check, don't you, if there's caffeine because quite a lot of herbal teas do have
08:41caffeine in them, don't they?
08:42Absolutely, including green tea.
08:44So a lot of people think it has a calming effect.
08:46Green tea has a lot of caffeine in.
08:48I would keep caffeinated beverages before 12 p.m.
08:52Before 12?
08:53Before 12 p.m.
08:55Caffeine has a half-life of anywhere between six and eight hours.
08:59So if I have a double espresso at 12 p.m., I've still got an espresso in my system at
09:06as late as 8 p.m.
09:08Okay, something that's always guaranteed to help me get to sleep, don't judge me, is a lovely glass of red
09:16wine.
09:16I knew you were going to say that.
09:17I knew you were going to say that.
09:18Because honestly, I think it works.
09:20I do, I'll have a nice little glass of red.
09:22Yeah.
09:22Red for bed, that's what they say.
09:24Red for bed, yeah, yeah.
09:25So, red wine, 100%, or any alcohol, will help you get to sleep quicker.
09:32The quality of your sleep, however, is going to be massively impact.
09:37Hang on, massively?
09:39Massively impacted.
09:40You're basically trading off good quality sleep for just getting to sleep quicker.
09:43So what food should we be eating to help us prepare for a really good night's sleep?
09:47I would say you want to be having carb-rich foods, things like sweet potato, parsnips, your starchy vegetables.
09:55I think that's a perfect meal to have at the end of the day, as long as it's three to
09:59four hours before bed.
10:01And lucky for me, Dr. Rupi has made a comforting evening meal.
10:05This looks very colourful.
10:07What have we got in here?
10:07We've got sweet potato with the skins on for more fibre, spinach, eggs, and we've got some red peppers.
10:14This looks good.
10:15There you go.
10:16Sweet potatoes provide slow-release carbohydrates that stabilise blood sugar and may support the body's natural wind-down process.
10:25Eggs apply protein and tryptophan, while spinach contributes micronutrients, including magnesium,
10:32which plays a role in muscle and nervous system relaxation.
10:36See, I love sweet potato.
10:39Oh, that's good.
10:40Mmm.
10:40No, it's really good.
10:42I'd take this over a midnight pizza any day.
10:46So now we know how to help ourselves get to sleep, but what about the age-old problem waking us
10:51back up once we manage to drop off?
11:00Are you putting up with a snoring partner?
11:02The irony.
11:03They're the ones snoring, but we're the ones paying the price.
11:07Shush!
11:10Over 50 million of us are regular snorers.
11:14This damages not just our health, but our relationships too.
11:19I'm here to meet Dr David Garley, who is an expert in sleep disorders, to find out what snoring is
11:24really about and how we can help silence it.
11:29Hi, Denise.
11:30Hi, Denise.
11:30How are you doing?
11:31Nice to meet you.
11:32Come on in.
11:33As well as being a GP, he teaches sleep medicine to healthcare workers across the UK.
11:39Right.
11:40I need to understand more about snoring, because it is the bane of people's lives, isn't it?
11:45So can you explain it to me?
11:46Why do we snore?
11:48So the upper airway is made of either hard structures or soft structures.
11:52So hard structures are like the roof of your mouth, the bony bit there.
11:55You can feel there.
11:56And then soft structures are the back of the throat and the base of the tongue.
11:59Hard structures stay in place by themselves, but soft structures are held in place by muscles.
12:04And as you fall asleep, these muscles run out.
12:07And with that narrow airway, the airflow becomes turbulent.
12:10And this causes the soft structures to vibrate, which is what we hear of snoring.
12:14There are three main types of snoring.
12:17Nose, mouth and throat.
12:20But before you can stop snoring, you need to work out which one you have.
12:25A way to tell if you're a nasal snorer is actually if you go and just sharply inhale.
12:30If you find that your nostrils collapse and that the cartilage in your nostrils is perhaps just a little bit
12:35weaker.
12:35To tell if you are a mouth snorer, what you can do is try and recreate your snoring noise.
12:39So if it, for example, sounded like this.
12:44What you can do is close your mouth and try and recreate it.
12:47And if you can't, it's a good sign that you're probably a mouth snorer.
12:51Now for throat snoring, which is more like this.
12:55What you can do is stick your tongue forwards, grip it with your teeth.
12:59And then if you try and recreate your snoring, but you can't, it's a sign that it might be throat
13:04snoring.
13:04Or alternatively, you could get your friend to film you when you're asleep.
13:07You could do that, yeah.
13:08You could employ a friend to follow you around.
13:11I hadn't even considered different types of snoring.
13:14Fortunately, for whichever one you have or the person you share your bed with has, there's a range of gadgets
13:19to help.
13:21So what's this?
13:22So this rucksack-like device is designed to try and stop you sleeping on your back.
13:28You tend to snore louder when you're on your back.
13:30So I feel like a ninja turtle.
13:31Yeah.
13:32Right, where am I going then?
13:33Yeah, please.
13:35So it's just to keep you on your side?
13:36That's right.
13:37So you're sleeping now and then if you try to go on your side.
13:38Oh, you actually can't move.
13:39Exactly.
13:39Yeah.
13:40So certainly with things like snoring, a lot of that is just due to your anatomy that actually you can
13:45get by by keeping people on their side.
13:46If you want to try a positional backpack like this, you're looking at a price of around £60.
13:52What else have we got?
13:54So if you are a nasal snorer, what you can do is just try and bolster the cartilage that's in
14:00your nose.
14:01These are strips, is that right?
14:03It's got an adhesive thing so you just bend it over your nose and it just helps, it springs back
14:07into shape as best as it can.
14:09And it just helps kind of keep your nostrils just slightly more open.
14:12So not everybody finds that this is actually the problem.
14:15It's not sticking very well but I think that's because I've got quite a lot of makeup.
14:19Which I wouldn't wear in bed.
14:21The nasal strips are £9.99.
14:23Not too bad if they work for you.
14:26So this is called the Zeus device and the way it works is you charge it and then you stick
14:31the device just under your chin.
14:33It's a bit like, you know like in 90s catalogues you always saw photos of people with six packs who
14:38basically had these kind of electrical things stuck on their abdomen and it was kind of bolstering the muscles.
14:41It delivers a very small charge to the muscles just underneath here in the throat and the tongue.
14:47Causes it to just regain some of the tone that you get when you're awake which means that you don't
14:52get that same collapsibility of the airway so it reduces snoring.
14:55The Zeus device is meant to help mouth and throat snoring and it's the priciest gadget we've got.
15:00It comes in a whopping 250 quid.
15:04These are gum shield like devices but what makes them different is that they've got a lower section and they
15:11just bring your lower jaw forwards just to create a bit more space at the back of the tongue.
15:16And these boil and bite dental devices start at £20 with this model at £24.99.
15:23This is really weird.
15:25Really not very much short at all.
15:27You would mould it so it would hopefully feel a little bit better than that.
15:30It doesn't look like your thing.
15:32What an array of solutions and later some serious snorers will be putting the tech to the test.
15:46We're a nation of bad sleepers and surveys suggest a staggering one in three of us say we've experienced insomnia.
15:54But how do you know when sleepless nights have become a more serious condition?
15:59When you look in a textbook chronic insomnia has to have a few things ticked off for us to say
16:04you've got it.
16:05So the first thing is you either struggle to get to sleep or you struggle to maintain your sleep or
16:10your sleep just feels very unrefreshing.
16:13Secondly this needs to be happening three times or more in a week and this needs to be happening for
16:19three months or longer.
16:20And it needs to be significantly impacting your day, your work, your relationships.
16:28Jenny is a 47-year-old former nurse from Margate and she has chronic insomnia.
16:34She'd like to be enjoying her life with husband Chris, teenage son and five cute doggies.
16:40Instead she's awake at night and stressed by day.
16:43It's been a lifetime thing. I don't think I've ever really had a good sleep.
16:47Going to bed at night, it fills me with dread and anxiety.
16:51I have tried everything there is going.
16:54Warm hot milk, wine, Epsom salt baths, lavender oil, neuromatherapy.
17:00You name it, I've tried it.
17:02What she hasn't tried is my favourite sleep whisperer, Stephanie's golden rules.
17:07So it's off to the consultation couch to see if years of insomnia can be put to bed.
17:13What's the hardest part about having this problem? How does it make you feel?
17:18My husband and I don't actually sleep in the same bed anymore.
17:21And then I'm conscious that he's got to go to work.
17:23So if I'm up and down all night long, I'm going to wake him up and disturb him.
17:26So he actually sleeps in his office.
17:29I feel extremely tired to the point where I sometimes just can't think straight and I just need to sit
17:34down.
17:35My mind is, just can't seem to switch off.
17:39It's a really common story.
17:41I know that we can treat you and that there is a way to retrain you to sleep, even though
17:48this has been going on for so long and it feels like you've tried absolutely everything.
17:59Stephanie's first piece of advice for Jenny, and for many of us suffering sleeplessness, is to get up at the
18:05same time every day.
18:06If I said to you 6, so it's not going to be 6.15, if we just lie in bed,
18:12even if we're not sleeping, it sends mixed signals to your brain and your brain doesn't know that it can
18:18start building up pressure for you to sleep at night time.
18:21So the irony of all this is that your morning routine is really going to help you with feeling properly
18:27sleepy tired at night time and actually getting you to fall asleep when you want to fall asleep.
18:33Yeah.
18:33Okay.
18:34The second one is to go to bed when you're actually sleepy tired, so this isn't about fatigue or exhaustion,
18:42this is, oh gosh, I actually feel like I'm going to fall asleep.
18:45The third of Stephanie's rules is for what to do when you wake up in the middle of the night,
18:50and this one's a bit of a toughie.
18:52I need you to leave the bedroom. Pretend like you're still in your evening time, so if you're watching a
18:58bit of TV, if you're having a read, if you've got a podcast in, I just want you to do
19:02those things.
19:02And if you start nodding again and you feel you could go back to sleep, absolutely go back to the
19:07bedroom.
19:08Okay. Yeah, I do tend to put a load of washing on at 3 o'clock in the morning.
19:12So the problem with doing stuff like that is teaching your brain, oh, these are the things that she does
19:16during the day, so let's help her by giving her lots of weight chemicals.
19:19Let's give her some cortisol, which isn't just a stress hormone, it's a weight hormone.
19:23Reduce that melatonin, get rid of that sleepy hormone, we don't need that right now.
19:27All the while you're thinking, wow, I'm buzzing.
19:30So restful activities, but stay out of the bedroom until you're nodding off.
19:35And the final golden rule, no napping during the day. Yikes!
19:40The problem with napping during the day is that it kind of takes away from that sleep pressure that you're
19:45trying to build.
19:46Your body sees it as, oh, we need to restart the drive again.
19:50We need to build up all that pressure again.
19:52And before you know it, you're going to sleep at 3am instead of 11pm, for example.
19:58Stephanie also wants Jenny to get as much exposure to natural light as she can after her daily wake-up
20:03call.
20:04And much more movement in her morning routine.
20:07What we've got to do is create signals for the brain to help you wake up, especially when you've had
20:14a bad night's sleep.
20:15So as a bit of a foundation, how does that sound for something for you to do as consistently as
20:21possible?
20:21I just want to try it.
20:24Can't wait to go to bed.
20:25Good.
20:26That's really good.
20:29As well as following Stephanie's golden rules, Jenny will be undergoing cognitive behavioural therapy for insomnia.
20:36This eight-week program aims to change her habits, thoughts and physical patterns to reduce anxiety around sleep.
20:44And gradually retrain her over-alert nervous system so sleep can happen on its own.
20:56If you haven't heard about magnesium, melatonin or herbal teas, you've probably been sleeping under a rock.
21:03With the sleep supplements market worth around £300 million a year in the UK alone,
21:09I'm desperate to get to the bottom of what we should or shouldn't be taking.
21:17I feel like we're a nation who are a sucker for supplements.
21:21Oh, yeah.
21:21So let's go through these because ashwagandha, any good for helping you sleep?
21:27Ashwagandha is a traditional herbal remedy that's used quite a lot in India in ayurvedic practices.
21:33There might be some benefits for sleep.
21:35However, ashwagandha is one of those supplements that might be toxic to your liver health.
21:41And I would recommend if you have been taking ashwagandha for a long period of time to get your liver
21:45checked.
21:46Oh, wow.
21:47Yeah, yeah.
21:47So supplements in general are not innocuous.
21:51Just because we can go and buy them doesn't mean that they are harmless.
21:55In fact, a lot of these can be harmful.
21:57It depends on the dose that you take them on and also the quality that you're having as well.
22:02So these are all the things that I would think about before you even reach for spending money on any
22:07of them.
22:07Okay. Next, we have got magnesium.
22:12Magnesium.
22:12Magnesium is something that all my friends are like, you need to take magnesium.
22:16It'll help you sleep.
22:18Magnesium is something that a lot of people are deficient in.
22:21It's generally because we have quite poor quality diets.
22:24We rely a lot on processed foods.
22:27We don't eat enough of the magnesium rich foods.
22:29Things like nuts and seeds, dark green leafy vegetables.
22:33Magnesium has been shown to improve sleep quality, 200 to 400 milligrams per day.
22:39The ones that might be beneficial for sleep are magnesium therionate and magnesium biglycinate.
22:45So it might be one to try, but I would improve the magnesium in your diet before you start relying
22:49on something else.
22:50Okay.
22:50So correct everything with the foods first.
22:52Absolutely.
22:53Okay.
22:53Next, we have melatonin gummies.
22:56I can tell you got this from America.
22:57When you buy this in America, you tend to get whoppingly big doses.
23:01So if we're looking at this dose, this is 10 milligrams per serving.
23:04And we release melatonin in our brain in picograms, which is an order of magnitude much smaller than what you're
23:12taking in these supplements.
23:13So this is overdosing?
23:14This is a lot of melatonin.
23:17Now, I don't think you would come into harm by taking a big dose like this, but it's not going
23:23to do you any good.
23:24If you are thinking about taking melatonin, A, speak to your medical practitioner.
23:29There are some instances where it might be useful for people with circadian rhythm disruption, for people who are jet
23:36lagged, night shift workers, certain children with ADHD or autism or neurodevelopmental issues.
23:44But for the majority of people, I wouldn't recommend that.
23:47So what about over-the-counter sleep aids like these?
23:50Over-the-counter medications like antihistamines, they definitely can cause a sedative effect, but they do have potential interactions with
24:01other medications.
24:01They can cause grogginess, hangover effects the day after.
24:06So from what you're saying, we shouldn't really be going to the supplements first.
24:09We should be changing our diets, spending the money on good food.
24:13That's vital, isn't it?
24:15Absolutely.
24:16Yeah, I would say you want to spend your money on great food.
24:19Make sure you're optimising all the other lifestyle elements that are free before you start reaching for supplements.
24:25So there we have it.
24:28Save the cash, unless you've been advised by a doctor, most supplements probably aren't worth the money.
24:34Did you know about 40% of us snore with men being louder than women?
24:40And some people snoring is so loud, it's noisier than a lawnmower.
24:44I want to help four snorers on a journey to a peaceful night.
24:49They are Brian.
24:53Brian just snores like a dead cow all the time.
24:58Andy.
24:59At the minute, it's got another bed.
25:02If it gets too bad, I can just quickly wheel it out into a different room and find somewhere to
25:06a pitch camp for the night.
25:08Angela.
25:10I make awful grunting noises, apparently.
25:13It goes a little like this.
25:18And Kathy, who lives in Guildford with her wife, Maz.
25:22We've been married for nine years, don't forget.
25:25Why are you asking me?
25:26I'm just working out the maths.
25:28I can only describe the noise as a cross between a train and a drunken pig.
25:38It's not conducive to a good night's sleep.
25:45The first step to curing snoring is figuring out the cause.
25:49To find out exactly what's going on with these snorers, Dr Garley has given each of them a sleep test
25:55kit to wear overnight.
25:57It's a watch-like device on your wrist, a sensor on your finger and a wire on your chest.
26:04OK, I'm all ready for bed.
26:05In just one night, it tracks how you snore, how loud, your body position, your heart rate and oxygen levels
26:13and, most importantly, whether it's simple snoring or something more sinister.
26:21Stick that on there.
26:23Feels nice.
26:25Fingers crossed it works for the night and we'll report back in the morning.
26:28Dr Garley will analyse the results in order to determine the best gadget or treatment for each of our snorers.
26:35Night.
26:36Oh, night then.
26:37Night.
26:38See you in the morning.
26:43It went well.
26:44It didn't fall off or anything, which is good.
26:45I think I slept six hours and he said that I snored 39% of the time.
26:54Coming up, the results are in and there's more to the snoring than meets the eye.
26:59You have significantly increased risk of cardiovascular complications such as heart attack, stroke, diabetes, but also depression.
27:08I get to the bottom of whether we even need eight hours sleep.
27:11You're thinking the duration is the most important thing, when actually it's the quality.
27:17And is it teenagers' faults that their sleep is all over the place?
27:21I can go to sleep half ten, eleven, twelve, one.
27:32Earlier on, Dr Garley sent our snorers some sleep test watches to monitor their symptoms.
27:38The results are back and, alarmingly, all four of our snorers have sleep apnoea.
27:46I need to find out more.
27:48So this is a sleep disorder usually associated with snoring, where your upper airway repeatedly closes as you sleep,
27:54which gives you these pauses in breathing, which means that your body then has to wake you up,
27:58either completely awake or just to a shallower state of sleep.
28:01But it means that you never get into these really deep states of sleep that you need to get in
28:05order to feel properly refreshed in the morning,
28:06because whenever you do, your airway closes, you stop breathing and your body wakes you up again.
28:10Can sleep apnoea be dangerous?
28:13Sleep apnoea can be dangerous.
28:14So you're excessively sleepy during the day, so you fall asleep in meetings,
28:17but the real risk is falling asleep thriving.
28:20And the other one is that when you're in this kind of more stressed cardiovascular state as a result of
28:24sleep apnoea,
28:24that you have significantly increased risk of cardiovascular complications,
28:28such as heart attack, stroke, diabetes, but also depression.
28:32So, to apnoea, or to stop breathing, up to five times an hour is considered normal,
28:39and if this is you, you don't have sleep apnoea.
28:42Between five and 15 times an hour is mild sleep apnoea.
28:4715 to 30 is moderate, and above 30 is severe.
28:51But the really challenging statistic is that 85% of people with obstructive sleep apnoea are undiagnosed.
28:59That means as many as 10 million people in the UK could have sleep apnoea and not even know it.
29:06One of them is Cathy.
29:09And Dr Garley needs to give her the results.
29:13When we did the test, what they will give us is something called your sleep apnoea score,
29:18known as your AHR, your apnoea hypopnoea index.
29:21Yours came out as 18.6.
29:25So, these are the number of times per hour that you stop breathing.
29:28So, this would be moderate obstructive sleep apnoea.
29:31Okay.
29:32I'm not surprised.
29:34My partner has videoed me, so I have seen how I behave when I'm asleep.
29:39Now, there are treatments for obstructive sleep apnoea,
29:41but the gold standard treatment is called CPAP,
29:44which stands for Continuous Positive Airway Pressure.
29:47Is this something you've heard about before?
29:49I have heard about it, actually, yes, because my partner uses one.
29:53So, yes, I'm quite familiar with them.
29:57Dr Garley will now send a CPAP machine to Cathy to try,
30:00similar to the one her partner, Maz, uses.
30:03So, what we have here is a CPAP device.
30:05So, this blows air at a low pressure through a tube through to a mask,
30:10which you can get to fit either over your nose
30:13or over your mouth and nose like this one.
30:15And what this does is it blows air at a very low pressure
30:18and that low pressure holds your airway open from the inside
30:21so you don't get these pauses in your breathing.
30:24So, for Cathy, best-case scenario,
30:25we would hope that there'd be a very brisk restoration of quality sleep
30:28and an impact on improving her symptoms of daytime sleepiness,
30:32improving concentration memory and also often an uplifting mood.
30:35And now it's arrived, Cathy is getting to grips with the kit.
30:40Look, it's got a glass of wine in it.
30:43Has it? And it's raining.
30:46It's not a bad fit, though, isn't it?
30:48And the rest of our snorers will also receive their devices.
30:52For Brian, it's a bedtime rucksack.
30:54I'll just put it on.
30:56His sleep apnea is positional,
30:58so the hope he's lying on his side could improve his condition.
31:01For Andrew, it's the Zeus device.
31:04It stimulates throat and tongue muscles,
31:06so hopefully this will keep his airway clear.
31:09And it should stop my muscles from acting too much
31:12and hopefully cut down my snorring.
31:14And finally, Angela is getting a dental device.
31:17Hopefully she'll get on with it better than I did.
31:23Back in Margate, chronic insomnia sufferer Jenny
31:26is putting out expert Stephanie's first golden rule into action.
31:30She's still struggling with her sleep,
31:32but at least she's getting her daily dose of daylight and fresh air.
31:36Managed to pull myself together and get out with the dogs.
31:41Bella, Daisy. Daisy, get off there.
31:44Teddy.
31:45Bingo.
31:46And Chris.
31:47Hi.
31:48Get some fresh air.
31:50Trying to stay awake.
31:56Stephanie, I feel like we're obsessed with sleep, aren't we?
32:00It's the biggest topic of conversation for most people.
32:02I know I am.
32:03And I'm such a terrible sleeper.
32:06How do we solve the problem?
32:08You're right.
32:08We are obsessed with sleep.
32:10But now I'm seeing in clinic a lot more people coming to me,
32:13not with a chronic sleep disorder,
32:15but with chronic sleep anxiety.
32:17And what does that do to your sleep?
32:19It makes it worse.
32:20Right.
32:20I think I've got sleep anxiety then
32:22because I literally get into bed at night
32:24and I clock watch
32:26and I think I need to get a full eight hours sleep
32:28because that's what's drummed into us.
32:30To have a good night's sleep,
32:31to feel great during the day,
32:33you need eight hours.
32:34Is it true?
32:34No, you do not need the perfect eight hours
32:37in order for sleep to be working for you.
32:40In fact, you're thinking the duration is the most important thing
32:43when actually it's the quality.
32:46And if that quality of sleep has been poor for whatever reason,
32:49there's so many different reasons,
32:50from external reasons like your environment, like stress,
32:54to internal reasons like going through the menopause or illness,
32:58that your sleep can be entirely different.
33:02So you can have 20 minutes of amazing sleep and feel great
33:06and you can have eight hours of terrible quality sleep and feel awful.
33:11So why are we being told
33:13that it has to be eight hours sleep in the first place?
33:16Well, strangely enough, it might be nothing to do with science.
33:21One of the earliest references to eight hours sleep was in 1817
33:25when Welshman Robert Owen, a social reformer,
33:29campaigned for an eight-hour workday.
33:31He famously coined the phrase,
33:33eight hours labour, eight hours recreation, eight hours rest,
33:37which would go on to launch a global rights movement.
33:40Not much of a basis for a better night's sleep, though.
33:45So what should a good night's sleep look like?
33:48The cycle of sleep starts with stage one and stage two,
33:53which is very light.
33:54And then you go into something that we do call deep sleep,
33:57and that is where you have cell restoration, tissue repair,
34:02things like growth hormones,
34:03all of that's happening in your deep sleep.
34:06And then we go into something called REM sleep,
34:09which actually is quite light compared to deep sleep.
34:12But it's more important for things like emotional processing
34:15and memory consolidation.
34:17So at the beginning of the night,
34:18you're going to have more physical restoration sleep,
34:21so more deep sleep.
34:22In the second half of the night,
34:24you're going to have more REM sleep,
34:26which is where you do that emotional processing.
34:28It's also where we mostly dream,
34:31and often when we remember our dreams quite a lot of the time,
34:33it's because that REM sleep has been a bit interrupted,
34:37so it can be a sign that sleep needs to be improved.
34:40But sleep does change throughout our lives,
34:43and hormones play a big part.
34:52Yes, that's right, those pesky hormones.
34:55And if you're a teenager, you'll know all about them.
34:59Teenagers have a very different sleep cycle and duration than adults.
35:05They tend to need more sleep,
35:07and they need to sleep at slightly different times,
35:09so they tend to want to go to bed later and get up later.
35:13I'm going back to school to ask a few teenagers about their sleep habits.
35:17I'll get to sleep around midnight or 1 o'clock.
35:21I get to bed, and then I realise I don't feel tired at all,
35:24and then I just stay awake for, like, hours.
35:27I get into bed the same time every night.
35:29I'm usually in bed about 10,
35:31but sleep, it varies a lot.
35:33I can go to sleep half 10, 11, 12, 1.
35:37I aim to go to bed for about 9,
35:39end up falling asleep about half 10, 11.
35:41Do you feel different when you have a longer sleep at the weekends?
35:44I feel more tired.
35:45I sleep through, like, a whole day
35:47to make up for, like, all the activities I've done the day before.
35:51Because you love your sleep.
35:52Yeah, I get burnt out really quickly
35:54from, like, too much socialising and stuff.
35:56I'm just up all night on my phone.
35:59And do you feel like you have a good sleep routine?
36:02Absolutely not.
36:03Oh. No.
36:04I thought he was going to say yes.
36:05It's entirely my fault. No, entirely my fault.
36:06I'm more sluggish throughout the day
36:08because I've had extra time in bed.
36:12Wow. Well, that blew my mind a bit.
36:15I wasn't expecting that.
36:16So it appears that the youth have very different sleep patterns.
36:20Some will sleep for hours
36:21and others are not getting much sleep at all.
36:26And here's the science of why.
36:28During puberty, hormonal changes delay the release of melatonin,
36:32meaning teenagers are naturally programmed to fall asleep later.
36:36But biology is only part of the picture.
36:39Excessive screen use, academic pressure, social and work anxiety
36:44all play a role, further disrupting sleep.
36:47The result is that no two teenagers experience sleep in the same way.
36:51The best advice for teens is to keep a regular routine,
36:55avoid sleeping in too late, limit screens and social media in the evening
36:59and make the bedroom a space for rest.
37:03And our teenage years aren't the only time our sleep patterns change.
37:08When we get to our 50s, for example,
37:10what happens is we tend to become a bit more phase-advanced.
37:14You tend to get a bit tired a bit earlier
37:16and you tend to want to wake up a bit earlier.
37:19But if your mindset is,
37:21I used to be that night hour,
37:23what's happening?
37:23There's something wrong.
37:24Actually, no, it's just a normal, natural shift.
37:26We've been around for a long time now
37:28and sleep is still here.
37:30No-one's actually lost the ability to sleep.
37:32That's not happened.
37:33So, actually, we just need to be looking at sleep differently.
37:37Coming up, will the devices cure our snorers?
37:41Every time I moved,
37:43I was getting, like, far too noisy.
37:46What's causing us to wake up at 3am?
37:48If I did a sleep study on the average good sleeper,
37:51there would be loads of wake-ups in the night.
37:53And has Stephanie managed to cure Jenny of her insomnia?
37:57So, how are you?
38:06Can't sleep?
38:08I've had many of those nights.
38:10Heart racing, you can't switch your brain off.
38:13But what is happening when we get that stress spike?
38:15And how do we manage it?
38:21So, I keep waking up at 3.30 in the morning
38:24and now I've got the fear
38:25that this is going to be like this for the rest of my life.
38:28So, this is the million-dollar question.
38:30Why are we waking up in the night at a specific time?
38:32And some people will say it was, like, 3am.
38:35Mine's sort of around 3.30.
38:38Funny, interesting.
38:39So, first of all, it's totally normal to wake up in the night.
38:44In fact, if I did a sleep study on the average good sleeper,
38:47there would be loads of wake-ups in the night.
38:49It's just that we don't necessarily remember them all.
38:52When it becomes a pattern,
38:55you're going to start getting some weight hormones
38:58and weight chemicals.
38:59So, let's give her a load of cortisol
39:01and you're thinking, what the hell's going on?
39:03Why am I waking up feeling stressed?
39:04So, we've got this sort of association
39:06between sort of waking up
39:07and then suddenly this sort of anxiety response
39:10will start to happen
39:11and this over, sort of, hyper-arousal.
39:14Now, if that starts to become a pattern,
39:18then your body's starting to learn it
39:20and it thinks it's normal.
39:23Cortisol is a hormone that's meant to wake us up.
39:26Production starts around 2 to 3am
39:28and is meant to slowly build up over time.
39:31But if we're under extended periods of stress during the day,
39:36our baseline for cortisol
39:37can automatically adjust to a higher level.
39:40This means at 3am you can get a much bigger hit of cortisol
39:43that wakes you up feeling wired.
39:46To keep it under control,
39:48you need to identify the stress factors during the day
39:51and address them as best you can.
39:53Exercise and relaxing wind-down time before bed can help.
39:57And even what we eat can affect our stress levels.
40:00There are lots of studies that demonstrate
40:02a better diet can help
40:05within the many different things that we can do
40:08in terms of stress management,
40:10but food is definitely a pillar
40:12that's getting a lot more attention
40:13within the psychiatry community
40:16that a lot more people are becoming aware of
40:18within the field.
40:19But there are so many fads and theories out there,
40:23so it's time to bust some food myths.
40:25So I've got a quick fire round of some questions.
40:29I've always wanted to host a game show,
40:31so I'm in my element here.
40:33Fingers at the ready for the buzzers.
40:34Here we go.
40:35Sugar before bed will stop me from sleeping.
40:38I'd say that's probably true.
40:41I would recommend people limit their sugar intake anyway,
40:44have it earlier rather than right before bed.
40:46Dark chocolate contains caffeine,
40:48which means it's not a good bedtime snack.
40:52I would say that's false.
40:54Whilst there is some caffeine in dark chocolate,
40:57we're talking, you know,
40:58a fifth to a tenth of an espresso.
41:01It's full of flavanols,
41:03it's great for your brain,
41:04and it is packed full of fibre as well.
41:07Hot stroke warm milk will help me sleep.
41:10I'm going to go false on that.
41:12Warm milk has got tryptophan in,
41:14which is why it's got this reputation
41:15that's going to help rise melatonin levels,
41:17it's going to help you get to sleep quicker.
41:19There isn't any evidence for that.
41:20I think it's more likely the routine
41:22of having something like a warm milk or a warm tea
41:25to signal to your brain,
41:27ah, it's my one-down routine,
41:29it's time to go to bed.
41:30An energy drink in the day won't affect my sleep.
41:33Oh, muscles.
41:35Energy drinks are really high in caffeine.
41:39You want to be making sure
41:40that you're having your energy drinks earlier in the day,
41:43and ideally not at all,
41:44because they're also packed full of sugar,
41:46bad for your teeth, bad for your brain,
41:48bad for your heart, bad for everything.
41:49Now, just asking for a friend.
41:52My friend always wakes up in the night
41:54to have a wee.
41:56OK.
41:57Should she limit her water intake before bed?
41:59I would say it's a pragmatic strategy
42:01that could work for your friend.
42:04OK.
42:04It's something I do, actually, myself,
42:06because I have a similar issue as your friend.
42:09Yeah.
42:09As long as you're having enough water and hydration
42:13during the day,
42:14I think it's a good idea.
42:16Now, I take my role of game show host very seriously,
42:18and I wouldn't want you to leave empty-handed,
42:20so here's a potato.
42:21Oh, great.
42:22I'm going to have this four hours before bed
42:24and make sure that I'm having it
42:26with some Trifton-rich foods as well.
42:28Perfect.
42:29Sweet dreams.
42:32Earlier on,
42:32we set out to cure four snorers
42:34who all turned out to have sleep apnea.
42:39And they've each received an anti-snoring device
42:42based on their symptoms.
42:44But have they worked?
42:46I've been using their sleeping backpack now
42:49for about a week.
42:51Mm-hm.
42:52But it hasn't really helped.
42:54I think they still snore as much as they can.
42:57Mm.
42:58As Brian's backpack hasn't worked,
43:00he'll now get a dental device to try
43:02and follow up with his GP.
43:04I am sleeping right the way through.
43:06And I'm not feeling sleepy in the day.
43:08We're both getting a peaceful night's sleep now.
43:11CPAP has worked for Kathy.
43:14That's two snorers down and two to go.
43:16I think I slept really good.
43:19You didn't snore as much as you usually do.
43:21The dental device has made a difference for Angela.
43:24Not bad for under 30 quid.
43:27Andy's already seen some improvements
43:29using the Zeus device.
43:30Unfortunately, I'm still snoring with it.
43:33But I do think it's getting better.
43:35And I think it's just going to take time
43:36for it to get the muscles working
43:39to help me hopefully get back in my own bed.
43:41So there it is.
43:43Three out of four snorers have noticed an improvement.
43:46It just goes to show it's worth giving the devices a go.
43:49And who knows?
43:50If you do, you might just be able to improve yours
43:54and your partner's sleep.
43:57Back in Margate, Jenny has spent the last eight weeks
44:01trying to fix her insomnia.
44:03Beautiful.
44:04Wednesday morning, I've managed to get out with the doggies
44:07and it's so nice.
44:10Along with rigidly following Stephanie's four golden rules,
44:13she's been undergoing cognitive behavioural therapy for insomnia.
44:17Love it here.
44:19Feel really good today.
44:20Have a good sleep.
44:21That's the light that I need, I think, every morning.
44:24It's beautiful.
44:25Now she's meeting Stephanie one last time
44:28to find out if her insomnia is finally cured.
44:31So how are you?
44:33Thrilled, to be honest.
44:34Let's start right from the beginning
44:35because it's been several weeks since we started.
44:38Talk to me about how long it takes you to fall asleep.
44:42Five minutes.
44:43Wow.
44:44Wow.
44:44That's incredible.
44:45The quality of sleep I'm getting is better.
44:49I'm sleeping solidly sometimes for six hours.
44:52And we know now that that is because
44:54you have a much more strengthened sleep drive
44:56and that you did that with your morning routine
44:59rather than the evening routine.
45:01But most importantly to me is
45:04how are you feeling about your sleep?
45:07Oh, it's not a worry now.
45:09And if I do have a bad night, I don't worry about it.
45:13It's so great to hear how well you're doing.
45:16And you know it's about a third of the global population
45:19that really struggle with chronic sleep problems.
45:22And about 10% we know have chronic insomnia.
45:26And you're no longer one of them.
45:28It's amazing.
45:29It's great.
45:31It feels amazing.
45:32It feels liberating.
45:33I can make plans.
45:35I feel happier.
45:36I feel like myself.
45:37I just feel more confident.
45:40So there it is.
45:41So many things are in our control when it comes to sleep.
45:45From working on our stress levels during the day
45:48so we can avoid those nighttime cortisol spikes
45:50to avoiding naps so you can build up adenosine
45:54and strengthen your sleep drive for more consistent tidiness.
45:58And even when it comes to things we can't control,
46:01like our changing hormones,
46:02the most important part is to try and relax.
46:06After all...
46:07Sleep isn't something you win at.
46:09It's a natural phenomenon.
46:11And you will sleep eventually.
46:12So fix your wake-up time,
46:14get some morning light and move your body.
46:16And just...
46:17Just stop worrying about it.
46:19Because the more we chase the perfect sleep,
46:22the harder it becomes to rest.
46:24Good night.
46:24Good night.
46:25Good night.
46:28Good night.
46:37Good night.
46:41Good night.
46:43Good night.
46:45Good night.
46:45Good night.
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