DR MARTIN SCURR answers your health questions: I have tried everything and still can’t sleep! 

I sleep only two to three hours a night and often wake up in between. I have tried relaxation exercises, reading, walking and even sleeping pills, but nothing works. 

Can you recommend anything to help? I am 47.

Clare Sutton, by email.

For any doctor, one of the most common and most difficult questions to answer is how to restore patients with insomnia to a healthy sleep pattern.

Sleep is a process every bit as vital as good nutrition and, in most cases, it takes a long time to arrive at the point where you realise that lack of sleep has become a defined problem.

There are occasions of acute crisis in life which cause sleeplessness, such as broken relationships, bereavement and unemployment.

Such events often coexist with disrupted sleep as they lead to a surge in stress hormones, which interrupt the normal processes that lead to a good night’s rest.

But more commonly, insomnia is caused by the long-term accumulation of life events, including the combined strains of work and running a home, or perhaps parenting teenagers or caring for elderly parents.

The fact that it has taken you years to get to this point suggests it will take some time to train yourself out of this state — and training is what it will take.

As you have already found, sedation drugs are either ineffective or only useful for a few days — the artificiality of sleep obtained in this way is an unhealthy option and can be a pathway to drug dependency.

I suggest you try cognitive behavioural therapy for insomnia (CBTi), which involves a combination of practical steps and talking therapy to help reprogramme your brain to adopt good sleeping habits.

Research confirms that this treatment is effective, though it will take at least three months for you to feel any effects.

There are occasions of acute crisis in life which cause sleeplessness, such as broken relationships, bereavement and unemployment [File photo]

Part of the training will involve a degree of sleep deprivation, in which you will not be allowed to go to bed until 11pm and then not allowed to spend more than five hours in bed, working up to a point when you will be permitted, eventually, seven hours.

It is possible to follow CBTi courses online. But the severity of your current sleep pattern suggests it might be better to obtain a referral to a sleep clinic from your GP, where a specialist can take you through the steps.

I have one further thought, given that you are 47. One of my colleagues has fallen out of her usual, contented sleep pattern into severe insomnia. 

She asked me if I thought it might be related to the emerging menopause. I reminded her that oestrogen is a vital component of brain chemistry in women, so fluctuating levels can have an impact on sleep.

My colleague started on hormone replacement therapy and, within a month, her previous sleep pattern was restored.

Something to consider and maybe ask your GP about, if it’s relevant. 

In my view…  

Covid mustn’t distract from other risks

The pandemic has too easily distracted us from other health threats that are no less important, including whooping cough (pertussis). 

There was an outbreak in 2012, with more than 9,000 cases in England alone. Fourteen babies died.

The causes aren’t clear, and while there has been a fall in cases since then (to around 4,000 in 2017), numbers are still high (until 2011, there were less than 1,000 cases per year).

A baby must be at least eight weeks old to be vaccinated, so those first few weeks of life are when they’re at greatest risk.

Write to Dr Scurr at Good Health, Daily Mail, 2 Derry Street, London W8 5TT or email: drmartin@dailymail.co.uk — include contact details

Pregnant women can protect their babies by having a booster jab between 16 and 32 weeks. 

The antibodies triggered by the injection pass across the placenta and protect the baby so that, once born, the infant is safe from infection. This should last for around a year.

Covid-19 has focused our attention on the threat of infectious diseases. Effective protection from many of these threats already exists, and ensuring you’re up to date with vaccinations is every bit as important as social distancing.

Write to Dr Scurr 

Write to Dr Scurr at Good Health, Daily Mail, 2 Derry Street, London W8 5TT or email: drmartin@dailymail.co.uk — include contact details. Dr Scurr cannot enter into personal correspondence.

Replies should be taken in a general context. Consult your own GP with any health worries.