Caffeine alcohol and nicotine are all substances

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Caffeine, alcohol and nicotine are all substances which can impair sleep quality. Caffeine makes it harder to sleep because it stimulates the central nervous system, increasing your heart rate and adrenaline production, and also supressing melatonin production. It takes a long time for the body to break down caffeine, so drinking coffee during the day can affect sleep at night. Alcohol can help people fall asleep, but it also impairs sleep quality during the second half of the night, and it is a diuretic which means that we may need to wake in the night to go to the toilet, disrupting the sleep pattern. However, a rapid reduction in alcohol intake for someone who is a heavy drinker can lead to alcohol withdrawal syndrome, which itself can lead to insomnia. Alcohol can also contribute to depressive mood, which in turn can contribute to insomnia. Nicotine may impair sleep, smokers take longer to enter sleep and have less total sleep time (approximately 14 minutes less per night) compared to those who have never smoked 66 . Reducing nicotine intake is unlikely to lead to immediate improvements in sleep, but the long term health benefits are likely to have implications for sleep quality. Eating habits have the potential to affect sleeping. It is important not to go to sleep whilst feeling hungry, so eating a light snack before bedtime may be helpful. However, eating large meals shortly before bedtime should be avoided, because the body will spend time digesting before it can sleep. Some foods may have sleep inducing properties; for example, rice and oats may contain small amounts of melatonin, which increases the desire to sleep. Some foods, such as dairy products, contain the amino acid tryptophan which is useful in manufacturing melatonin. Other foods, such as those that contain caffeine or large amounts of refined sugar, make sleeping more difficult. A study in the Isle of Wight examining the effects of food additives on health, found that preschool children who received additive-laden drinks were more hyperactive than when they did not have drinks containing colours and preservatives 67 . Sleep hygiene Many people can benefit from improving the quality of their sleep. The phrase sleep hygiene is often used to describe how lifestyle and environmental factors can affect our sleep. Positive sleep hygiene may help to improve sleep quality, but is not enough to treat chronic insomnia.
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53 52 Regular exercise may also help us sleep. One study in older adults showed improved sleep quality with regular aerobic exercise 68 , such as jogging or cycling. It may be that physical fitness with increased metabolism is associated with better sleep patterns. Also, exercise can help to improve mood and to reduce anxiety, which can in turn improve sleep in people with chronic insomnia 69 . Exercise can also help to reduce the symptoms of obstructive sleep apnoea 70 .
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