The Dos and Don’ts for a Good Night’s Sleep

Following on from last month’s post on the importance of sleep for health, this post is about optimising the quality and quantity of your sleep.

If you are unable to fall asleep or stay asleep when you want to, you are suffering from insomnia. Insomnia can be acute (over just a few days) or chronic (lasting for weeks or months) and it can be primary (of an unknown cause) or secondary (e.g. as a result of medication or lifestyle factors). Perhaps more commonly though, a lack of sleep can be the result of simply not allowing enough hours in the day for sleep. To find out more about how much sleep you need, see my previous blog post on that subject.

If you feel tired, it is important to be aware that there is a difference between sleepiness and fatigue. Excessive daytime sleepiness is caused by a lack of sleep and results in you falling asleep easily in the day during unstimulating tasks like reading, meetings and, most worryingly, driving. Fatigue is physical tiredness due to a lack of rest, not sleep. So if you are feeling tired, but not sleepy, you may just need to rest more. If that doesn’t help, then you may be lacking deep sleep and you will need to work on that.

If you are not sleeping well or getting enough sleep, the first thing to do is to look at your sleep hygiene.

What to Do

Consistency is key to good sleep hygiene, because it keeps your internal rhythm (known as the circadian clock) on track, so try to establish a daily routine that sets you up for a good night’s sleep:

  • Have a regular wake up time every day

  • Exercise outside in the morning if you can to tell the brain and body it is the start of the day

  • Try to eat your meals at the same time every day and try to finish your evening meal three hours before bedtime

  • If you find that thoughts keep you awake, set aside time before bed to review the day and plan ahead, because writing it down can really help get it out of your head, and once the allocated time is up, stop

  • Dim the lighting in the evening to a warm glow similar to candle light and use the night shift option for screens on IT equipment

  • Have a warm bath about an hour before bed, as the drop in body temperature afterwards induces sleep

  • After your bath, do something calming like meditation, a breathing practice (see below) or gentle exercise like yoga, tai chi or qigong

  • Reading before bed may also help you to switch off.

If you wake in the night, it is better to stay in bed resting (if you can bear it) than to get up and do things, as you will at least benefit from the rest. Breathing exercises can be helpful in getting back to sleep. Let go of the fear of not sleeping: control the factors that you can and let go of the rest. Enjoy the peaceful time and remember that rest can be as beneficial as sleep.

What to Avoid

Light, sound and a buildup of carbon dioxide at night can disrupt sleep, so eliminate as much light and sound from the bedroom as possible and ensure adequate ventilation through an open door or window.

If you smoke, be aware that nicotine is a stimulant and so can delay the onset of sleep as well as disrupting the quality of your sleep.

Caffeine is also a stimulant and it makes you pee, which is not a winning combination for a good night’s sleep. It has a half life of about six hours, so it is best to avoid caffeine after midday or at least six hours before bedtime if you want a to sleep well, and remember that there is caffeine in some soft drinks and in chocolate, especially the dark variety.

Although alcohol is a depressant rather than a stimulant, it can still have a detrimental effect on sleep quality. It may help you get to sleep, but it will disturb your slumber later on as the liver gets to work on it overnight.

You may not need to avoid smoking, caffeine or alcohol completely, just be aware of the impact that they can have on sleep and modify your behaviour accordingly, so cut down and/or change the timing of your consumption if you have a sleep problem.

Catching Up on Lost Sleep

If you haven’t slept well and feel that you need to catch up on lost sleep, try to nap before midday. Avoid napping in the afternoon or evening because that can negatively impact sleep. 

If you feel that you need a pick me up in the afternoon, meditating for 10 minutes can be as reviving as sleep without having a negative impact on the quality of your sleep at night, in fact by teaching the body and mind to settle, routine meditation can improve sleep quality. 

A really good way to meditate is to focus on the breath. The box breath exercise is supposed to be particularly good for wakefulness: breathe in for a count of four, hold your breath for a count of four, breathe out for a count of four and hold again for a count of four, repeating for 10 minutes and all the time breathing through your nose. For variety you could try the 3,4,5 breathing exercise breathing in for a count of three, holding for a count of four and breathing out for a count of five. If you feel comfortable with that, you can try extending it to 3,5,7. Making the out breath longer than the inbreath is particularly calming.

Medical Help for Insomnia

If you don’t see an improvement in your sleep after implementing the lifestyle factors suggested above for a month or so, it is advisable to see a doctor about it. Your GP should be able to diagnose if you have a particular sleep disorder such as sleep apnea, narcolepsy, restless leg syndrome or circadian rhythm disorder which requires treatment. Your GP may also be able to refer you for cognitive behavioural therapy for sleep if he or she feels that is appropriate. Sleeping pills should be avoided for daily, long-term use as they are addictive and have been linked to dementia, but they can serve a purpose for insomnia caused by acute stress, among other things.

If you are blessed with being able to sleep well, don’t short change yourself, give yourself at least eight hours of sleep opportunity every night. And if you don’t sleep well, please seek help. Your life really does depend on it. 

If you would like to read more about sleep, I can highly recommend these three books:

  • Matthew Walker's Why We Sleep (the new science of sleep and dreams)
  • Chris Winter's The Sleep Solution (why your sleep is broken and how to fix it)
  • Satchin Panda's The Circadian Code (lose weight, supercharge your energy and sleep well every night)

Sleep as a Pillar of Health

Although still not fully understood, sleep is vital to health. We have all experienced the effect of just one poor night’s sleep on our mood, making us feel low, negative and irritable. It also affects concentration, memory and energy levels. A chronic lack of sleep can lead to other health problems that we are not even aware of in the short term, but that can have serious, even fatal, consequences in the longer term.

It can be helpful to understand why sleep is so important in order to find the motivation to prioritise optimising sleep quality and quantity, which is why I am focusing on the why we sleep here before moving onto how to optimise sleep in the next post. As sleep affects the whole body, I will break it down by system: nervous, circulatory, endocrine and immune.

Nervous System

Given how we feel after one bad night, it is no surprise then that chronic poor sleep can lead to mental health problems such as depression and anxiety. It also adversely affects reaction times to the point that even moderate sleep deprivation can impair mental performance just like alcohol consumption can, which means that there are a lot of tired people driving around as dangerously as if they were drink driving without even realising it. Worse still, if you fall asleep at the wheel, albeit momentarily, you don't react at all. At least someone under the influence of alcohol reacts, albeit slowly, which can make driving when sleep deprived even more dangerous than drink driving, and, sadly, it frequently is.

The lymphatic system drains waste from the whole body except the brain. The brain has its own waste disposal system: the glymphatic system. The main waste product in the glymphatic system is amyloid beta, high levels of which are found in the brains of people with dementia. Studies have found that the glymphatic system is 60% more productive when we are asleep. Even people genetically at risk of developing dementia can delay onset and/or reduce the risk by improving their sleep quality. Parkinson’s disease has also been linked to poor sleep quality.

Circulatory System

Sleep apnoea is a condition in which the airway closes during sleep causing frequent waking. It has been found to increase the risk of high blood pressure, heart attack, heart failure and stroke. Studies have shown that poor quality sleep of any form can increase the risk of raised blood pressure.

Endocrine System

A chronic lack of sleep can lead to obesity for several reasons: it affects the hormones that govern hunger, it reduces impulse control, and the feeling of a lack of energy after a poor night’s sleep can prompt us to eat to compensate. Chronic sleep problems interfere with sugar regulation in the body and so can increase the risk of diabetes.

Immune System

Without sufficient sleep, the immune is unable to function properly leading to increased vulnerability to infections, inflammation and even cancer.

Don’t panic! The odd night of poor sleep won’t do you any long-term harm. If you do have a chronic problem with your sleep, there is action that you can take to improve it and to reduce your risk of developing disease, which I will cover in the next post. Sleep supports relaxation, healthy food choices and an active lifestyle, and relaxation, a good diet and exercise promote sleep, which is why sleep can be seen as the foundation of the other pillars of health. If you want to read more about the four pillars of health, I can recommend Dr Rangan Chatterjee's book The 4 Pillar Plan.

Movement as a Pillar of Health

This month I will be exploring movement as one of the four pillars of health. In the previous two posts I have covered relaxation and nutrition, as detailed in Dr Rangan Chatterjee’s book ‘The 4 Pillar Plan.’ The final post in this series will be on sleep.

I think we all know that movement is good for us, but it can be confusing as to what form that should take and how much to do. Exercise doesn’t need to be extreme to be beneficial, it very much depends on the individual and their current life situation. For one person a run may make them feel good and for another person a yoga session or tai chi may be more beneficial for them.

Be aware that you can have too much of a good thing and that too much exercise can be harmful to health and wellbeing, to the point that some healthcare and fitness professionals advise against extreme endurance activities like marathons. Listen to your body and be guided by it. As a general rule, exercise should make you feel good, if not immediately after, then later that day and over the longer term. If you feel exhausted, not just tired, after a workout, then you have probably overdone it.

In my view, the greater the variety of movements that you engage in, the better, in order to develop and maintain a healthy level of fitness and function in the body. So doing different types of exercise or sport over a week can be healthier than doing the same thing every day. A mix of cardiovascular, resistance and stretching work is ideal, whether in the same workout session or on different days. Cardiovascular exercise is any form of exercise that increases the heart rate and breathing rate to a moderate or intense level for at least 10 minutes. Resistance training involves challenging the muscles by lifting or pulling more weight or resistance than they are used to in order to make, maintain or develop strength and endurance. Stretching the soft tissues helps with the range of motion and flexibility of joints.


Give Your Heart a Workout

You don’t need to take out a gym membership to keep fit. The best way to ensure that you exercise regularly is to make it part of your daily routine. One way of doing that is to walk more, perhaps walking to the shops instead of driving, or leaving your car a mile or so from your office or getting off the bus or train one stop earlier so that you have to walk the rest of the way. Or perhaps schedule a daily walk into each day, ideally in the morning if you can. Walking is a low impact, low intensity form of exercise that is accessible to most people. For more inspiration, I can recommend listening to the podcast interview with Professor Shane O’Mara ‘Why walking is the super power you didn’t know you had.’

If you want to give your heart more of a workout, high intensity interval training (HIT) is an efficient way of doing it. Just 10 minutes of HIT can be as beneficial as an hour of sustained activity. Basically, HIT involves a short period of high-intensity activity (around 40 seconds) followed by a longer period of low-intensity activity (around 80 seconds). That could be walking, running, cycling, swimming or any type of activity you choose. For the high intensity bit, go as fast as you can for 40 seconds, and for the low intensity bit slow down to a moderate pace for 80 seconds, then keep repeating that high/low cycle for 10-15 minutes. Ideally you want to be doing at least two HIT sessions a week. I have noticed that I feel at my best after a HIT session, which is what motivates me to do it even if I find it hard to do at the time.

Become Stronger

As Rangan Chatterjee explains in his book, ‘Sarcopaenia is age-related loss of muscle. It's a major public health problem. Once we pass the age of thirty, we begin naturally losing muscle mass. As we get older, the rate of this loss begins to accelerate. This can be significantly detrimental to health. Loss of muscle mass independently predicts mortality. The best way of reversing sarcopaenia is regular strength training.’

Ideally, we should all be doing some form of strength training at least twice a week. That doesn’t need to involve pumping iron at the gym. Although yoga is often thought of as stretching, some yoga positions are strengthening. And slow and gentle as tai chi and qigong are, the shifting of weight from one leg to the other is strengthening, as is balancing all of the body weight through one leg. If you do not already incorporate strength training in your weekly routine, you may find this five-minute kitchen workout practicable. Back pain can be linked to weak gluteal muscles, so exercises like these to strengthen the glutes can help to prevent or treat back pain.

Stretch Yourself

Yoga, tai chi and qigong are excellent traditional forms of exercise that involve stretching and would be a good introduction to that type of movement if you don’t already incorporate some form of stretching activity into your weekly routine. I plan to talk more about stretching in a future blog post, so I won’t go into any more detail about it here.

To end, I just wanted to flag up that movement is not just about the body, it is about engaging the mind as well. When you are exercising try to focus in on how your body is moving and how it feels. Tai chi and qigong are known as internal martial arts, because they involve paying mindful attention whilst moving in order to connect fully with the body. In comparison, external martial arts like judo involve fast powerful moves.

You can practise any physical activity mindfully. I really enjoy concentrating on my technique when I am running, swimming or cycling, focusing on one point at a time for a few seconds or minutes. And sometimes it is good just to let the movement flow naturally without thinking about it at all and to just notice how that feels.

During lockdown I am running my qigong classes online, so do get in touch on 07528 708650 or email if you are interested in trying this form of movement.

Nutrition as a Pillar of Health

Following on from my previous post about relaxation as one of the four pillars of health, and based on Dr Rangan Chatterjee’s book ‘The 4 Pillar Plan’, this month’s post is about nutrition. Maintaining our health, fitness and wellbeing is particularly important during the current coronavirus crisis to provide us with the physical and psychological resilience that we need at this time.


There is so much conflicting (and often vehemently so) nutritional advice out there that it can be bewildering: high fat, low fat, high carb, low carb, high protein, low protein, paleo, ketogenic, vegetarian, vegan, raw, etc. etc. But what works for one person, may not work another, depending on biological make up, health, age and lifestyle. Some basic principles seem to apply across the board, however:

  • Reduce sugar consumption
  • Eat a rainbow of fresh fruit and vegetables each day
  • Fast for at least 12 hours a day, ideally overnight
  • Drink more water
  • Avoid processed food.


Sugar Reduction

The human brain seems to be hard wired to like sugar, most likely because it served an evolutionary purpose in encouraging us to gorge on sweet fruit in the summer and autumn to store up enough fat to see us through the leaner winter months. With no leaner months now, the fat just accumulates year on year if we consume excess sugars. Added to this, our taste buds become desensitised to sweetness by sugary foods to the point that naturally and more subtly sweet foods such as fruit don’t taste sweet compared with sweets, chocolates and ice cream.


Just as the taste buds can become desensitised to sugar, so too can the body to the insulin produced to control sugar levels in the blood, which can lead to poorly controlled blood sugar levels and type 2 diabetes. Chronically raised insulin levels have also been associated with obesity, high blood pressure, breast cancer and polycystic ovaries.


The trick to countering all that is to retrain your taste buds by cutting down on sugar in food and drink. To help achieve that, some of the actions that Rangan recommends are:

  • Including protein in every meal to keep you feeling fuller for longer
  • Planning ahead and keeping healthy snacks readily available to avoid turning to sugary foods as a quick fix to hunger, even when travelling
  • Avoiding artificial sweeteners.


Sugary foods should be no more than an occasional treat, like having a dessert at the end of a meal out or a piece of cake at a birthday party or wedding, so no not a daily treat!


Eating the Rainbow

So how many portions of fresh fruit and vegetables should we be eating a day: five, seven, ten, more? The advice seems to change with the year. Confusing isn’t it? A simpler way to approach it, and one that I now enjoy using, is to focus instead on what colours those fruit and veg are and trying to eat a rainbow a day: red, orange, yellow, green and blue/purple. The reasoning behind that is that different coloured plant foods have different nutrients, so if you eat a variety of colours you are ensuring a varied intake of nutrients, so all your bases should be covered. For the reasons given above in the section on sugar, it is best to focus on veg rather than fruit.


A variety of plant foods is also important for maintaining a healthy gut microbiome, which you can read more about it in my blog post ‘The Microbiome of the Gut’.


I can recommend downloading the rainbow foods chart from Rangan’s website as a guide and to help you track your colour consumption.




It is not just what you eat that matters, but when you eat. Humans evolved to cope with periods of fasting when food was scarce. Hunter gatherer tribes to this day tend to fast for at least 12 hours overnight between eating at dusk and after dawn. Like with all the other nutritional advice, opinions vary on just how long to fast, but generally speaking most people can benefit from fasting for at least 12 hours a day. The main benefits of this are:

  • The digestive system has a chance to cleanse itself
  • The body goes into rest and repair mode
  • It restricts calorific intake and so can help with weight reduction or the maintenance of a naturally healthy weight
  • It helps set the circadian clock and so optimises the efficiency of all bodily functions, which I talk more about in my blog post ‘Why You Feel Like Hibernating in Winter’.


If you would like to try fasting, work out a 12-hour fasting window that works for you (e.g. finishing your evening meal at 7pm and not having breakfast until 7am). Within that fasting window have only water, or hot drinks without milk or sugar (e.g. herbal teas or black tea or coffee). Once you are comfortable with a 12-hour fast, you can experiment with a longer fasting window, perhaps increasing by an hour at a time. I find that 14 hours works well for me and my lifestyle.



We all seem to know how important it is to keep well hydrated, but putting that into practice can be tricky. Again, the advice on just how much that should be varies and there is as yet no conclusive scientific evidence to tell us. Undoubtedly it varies from individual to individual, so be guided by how you feel. Drowsiness, chronic low-grade headaches and constipation can all be signs of dehydration, so if you experience those symptoms, try drinking more water and see if it helps.


To help the body regulate hydration, it is best to drink little and often, so sipping throughout the day is better than glugging down half a litre at a time in. And it is best to avoid drinking anything more than a few sips for at least half an hour before, during or after a meal to avoid diluting the digestive enzymes.


It is also important to avoid drinking calories because they don’t give the body the cues of fullness that food does, and so you can end up consuming too many. Calorific drinks tend to be sugary too, so I refer you to my earlier comments on that.



Unprocess Your Diet

Rather than worrying about the dietary extremes mentioned above, Rangan recommends an unprocessed wholefood diet to regulate appetite, promote a healthy microbiome, support the immune system, avoid chronic inflammation and optimize health and wellbeing. As a guide, any food product that contains more than five ingredients is likely to be highly processed, unless of course you made it yourself from scratch.


You can learn more about these topics and the science behind them in The 4 Pillar Plan. In my next post I will talk about movement as one of the pillars of health. In the meantime, I do hope that you and yours stay safe and well.

Relaxation as a Pillar of Health

Having recently read The 4 Pillar Plan: how to relax, eat, move, sleep your way to a longer, healthier life by Dr Rangan Chatterjee (of ‘Doctor in the House’ fame on TV and presenter of the ‘Feel Better, Live More’ podcast as well as being a practising GP), I can highly recommend it and will give you a taste of what it contains here and in subsequent posts.


The key pillars of health are usually considered to be nutrition, exercise and sleep, but Rangan Chatterjee adds relaxation to make it four. In fact, he puts relaxation before the other three because he has seen that stress is the root cause of many of his patients’ health problems, so I will cover relaxation here, but first I will touch on stress.



Stress is any factor that affects physical or mental wellbeing. The response to a stressor depends on the individual: what stresses one person may not stress another. Acute stress can be beneficial and it wouldn’t exist if it hadn’t improved our chances of survival in some way, but chronic stress can be detrimental to health. You can learn more about stress in my blog post ‘How Aware of Stress Are You?



Relaxation is the antidote to stress and the key recommendations that Rangan Chatterjee makes are:

·       Me time every day

·       A screen-free Sabbath

·       Gratitude

·       Stillness.


Me Time

‘You cannot serve from an empty cup’ and what better way to refill your cup than making time for your own selfcare, doing whatever you find relaxing, whether that is reading, handicraft, gardening, walking, sport, etc. I talk more about this in one of my blog posts on ‘Mindfulness’.


Screen-free Sabbath

Try treating yourself to one day a week without technology, or at least social media, and see whether you feel better for it. Instead focus on face-to-face interactions with others or over the phone, or just enjoy some me time or connect with nature.



For reasons of survival, the human brain has evolved to recall negative events more than positive, but in the modern world that is having a detrimental impact on our health and wellbeing.  Practising daily gratitude, however you choose to do that, can help shift the balance by tuning the brain into noticing and recalling good things more than it would otherwise. I tend to review the day in my head at bedtime thinking of all the things I was grateful for that day and then picking the top three to hold in my mind as I drift off to sleep. You could try writing it down if you prefer. Another way to do it that I heard recently is to ask yourself three questions: ‘How has someone helped me today?’, ‘How have I helped someone today?’ and ‘What have I learned today?’ That could even make for a daily dinner table conversation with family or friends.



I love stillness and peace and quiet, but I know that some find it difficult. It is worth persevering with though because of the health benefits of stillness. You can find your own preferred or most convenient way of being still, but here are some mindful practices that focus on the senses to help get you started:


Author and presenter, Claudia Hammond discusses the importance of rest with Rangan Chatterjee in a recent podcast 'Why You Need More Rest’ , which is well worth a listen. 

If you would like to book a treatment or to attend a qigong class to help you to rest or relax, do get in touch on 07528 708650 or