2023 EDITION

Sleep Problems (Insomnia)

Many people have difficulty falling asleep or staying asleep.

Some get to sleep easily but sleep lightly, waking often during
the night. Insomnia is the term used to describe when your
lack of sleep at night affects your ability to perform activities
the next day.
Insomnia affects people of all ages but is more common
in adults and the elderly. More than 45% of all New
Zealanders report insomnia at least once a week.
People are said to have chronic insomnia if they have
poor sleep on at least one night a week for at least three
months.

Why is sleep important?

Causes of insomnia
Sleep is a vital part of our well being and studies have shown • Drinking alcohol or caffeine (coffee)
that being deprived of sleep can adversely affect our health. • Food (eating heavy or spicy meals close to bedtime)
A good night’s sleep can boost our immune system, • Medical conditions (eg, anxiety, arthritis, asthma,
decrease stress, enhance concentration, and improve our depression, reflux, restless legs)
mood. Chronic poor sleep is associated with dementia, • Medicines (eg, for heart or thyroid disease, colds/flu)
depression, heart disease, obesity, type 2 diabetes, and several • Menopause/perimenopause
other medical conditions. • Napping during the day
One night’s sleep is actually made up of several sleep • Pain or sickness
cycles; each lasting around 90 to 120 minutes. During • Shift work or travel through time zones
each sleep cycle, we enter different stages of sleep, termed
• Sleep apnea or snoring
REM (rapid-eye-movement) and non-REM sleep. We all
• Smoking or nicotine replacement therapy
briefly wake up between cycles, although most of us won’t
• Stress, trauma, or recent bereavement
remember waking by the morning.

How much sleep do I need? Improving your sleep

The amount of sleep you need each night depends on your
age and ranges from 14–17 hours for newborns to 7–8 There are many things you can do to improve your sleep.
hours for older adults. For most adults aged less than 65 First, talk to your GP about your insomnia and try to identify
years, 7–9 hours sleep each night is recommended. a cause. Sometimes eliminating or even just knowing the
Of course, some people function on less sleep, while cause can help.
others need more. It is especially important to talk to your GP if you are
To ensure you are getting the right amount of sleep feeling excessively sleepy during the day or falling asleep
for you, ask yourself the following questions: do you at inappropriate times (such as while driving) as this can
feel sluggish or irritable the next day and find it hard to indicate a specific sort of sleep problem (such as obstructive
concentrate on work or other tasks? Are you overweight? sleep apnoea or narcolepsy) which needs treatment (as well
Do you feel sleepy whilst driving? Do you depend on as daytime sleepiness being a safety concern).
caffeine to get you through the day? Your GP will talk to you about your lifestyle and any
If you have answered yes to any of these questions it causes of stress. In a few situations, you may be referred on
is a good idea to look at how much sleep you really are to a sleep clinic for investigation.
getting and what you can do to improve your sleep. The most effective long-term treatments for insomnia
involve changing your sleep habits and behaviours.

Aged 55 or over and Ask your doctor or pharmacist if

Vigisom is right for you
struggling to get a Slow release melatonin to help restore prolonged release melatonin

good night’s sleep? your natural sleep cycle. So you can

sleep the way you’re supposed to.
Patient information – Insomnia

Sleep hygiene/good sleep habits Medications for chronic insomnia

Sleeping pills
Sleep hygiene is the rituals and behaviors you follow before
you go to bed and while you are in bed. They are also called Sleeping pills can help, but they should only be used for
sleep habits. Many sleeping problems are due to bad habits short periods (eg, five to 10 days, ideally not daily), or on an
built up over a lifetime. occasional basis. They do not address the underlying causes
Everybody, regardless of the cause of their insomnia, of insomnia.
should try to improve their sleep hygiene/sleep habits. Sleeping pills do carry some risks. Some people can
become dependent on medication to help them sleep. If
taken for longer periods, the medication may not work unless
Tips for improving sleep habits a larger dose is taken. Some people can also get ‘rebound
• Get at least 30 minutes of natural light outdoors first thing insomnia’ when coming off sleeping pills. Combining sleeping
in the morning pills with alcohol or some other medicines can be dangerous.
• Exercise daily for at least 30–60 minutes Sleeping pills also have some side effects: confusion,
• Reduce or avoid caffeine (eg, coffee, tea, cola, energy sedation, amnesia and impaired coordination. These do not
drinks), cigarettes and alcohol, during the day but occur in everyone but they can lead to falls or being unsafe
especially at night while driving or performing other tasks, especially if their
• Avoid large meals late in the evening effects are still felt in the morning.
• Avoid TV, computer screens, mobile phones for an hour If you are taking sleeping pills it is important to take
or two before bed – the artificial light interferes with them as prescribed by your GP and not to combine sleeping
your natural cues to sleep – and keep them out of the pills or increase the dose unless you have spoken to your GP.
bedroom (use the bed for sleep only)! Melatonin
• Create your own bedtime ‘ritual’ eg, unwind before bed
by reading or listening to music, write down the things to Melatonin is a natural hormone that helps regulate your
do tomorrow, make a hot, milky drink or take body clock – it provides a cue for feeling sleepy. The natural
a warm bath – begin at the same time each night production of melatonin in the body varies over 24 hours
• Make sure your bedroom is cool, dimly lit or dark, quiet and is suppressed by daylight. Melatonin production declines
and as comfortable for sleep as possible. Make sure with age.
your feet are at a good temperature – not too cold and Prolonged-release melatonin tablets are a prescription
not too hot. Turn around any bedroom clocks treatment for insomnia disorder in people who meet
• Go to bed only when you are drowsy and do not nap for certain criteria and are aged over 18. Melatonin may cause
longer than 20 minutes during the day drowsiness but is not thought to cause dependency, tolerance
(where an increased dose is required for the same effect), or
have any serious adverse effects. It should not be taken with
Some techniques to help you sleep alcohol or other sleeping pills.

Additional information
Progressive relaxation: Involves slowly tensing and
relaxing all the muscles in your body starting from your toes
The National Sleep Foundation
and working upwards towards your face. Hold each tension for
www.sleepfoundation.org
about five seconds then relax for 10 seconds.
Visualisation: Close your eyes and imagine a place that
makes you feel calm and happy; it may be a mountain stream,
the beach on a summer’s day, or a grassy meadow. Concentrate
on how relaxed this place makes you feel. Original material provided by The Health Media
This information is intended solely for New Zealand residents and is of
Focus on your breathing: Place the tip of your tongue just
a general nature only. No person should act in reliance on any statement
behind your front teeth and keep it there. Exhale completely contained in the information provided, but at all times should obtain
through your mouth with a whooshing sound. Close your specific advice from a health professional. All rights reserved. © Copyright
mouth and inhale through your nose for four seconds. Hold 2023 The Health Media Ltd. No part of this publication may be reproduced
your breath for seven seconds. Exhale completely through your without the written permission of the publisher, Phone +64 9 488 4286.
mouth for a count of eight seconds. Repeat up to four times.

Vigisom improves sleep onset, quality of sleep and morning alertness. Ask your doctor or pharmacist if Vigisom is right for you.
Vigisom® (melatonin) Prolonged Release Tablets 2mg is used for short term treatment of insomnia characterised by poor quality of sleep in patients aged 55 or over.
Ask your doctor or pharmacist if Vigisom is right for you. Vigisom has risks and benefits. Use strictly as directed. If symptoms persist or you have side effects please see your
doctor or pharmacist. Vigisom is an unfunded medicine. Prescription Medicine except when supplied by a Registered Pharmacist. Normal Doctors
fees and Pharmacy Charges apply. Consumer Medicine Information available at www.medsafe.govt.nz. Vigisom® is a registered trademark of Neurim
Pharmaceuticals Limited used under licence by Aspen New Zealand C/O Pharmacy Retailing (NZ) Ltd, Auckland. TAPS BG1743-OCT21. INSIGHT 11173