Can you recommend any natural sleep remedies? I keep waking in the middle of the night and cannot get back to sleep for at least two hours. I am a healthy, fit 52-year-old man.
The unfortunate truth about sleep problems is that there is often no easy fix. It can take time and patience to arrive at a long-term solution that works.
If a patient is waking up in the middle of the night, doctors will first consider obvious factors that disrupt sleep. This includes too much caffeine in the daytime, needing to go to the toilet at night, and exercising in the evening. Physical activity can aid sleep, but it can be over-stimulating if you do it just before bed.
Sleep environment is also really important. Doctors call this sleep hygiene – although it has nothing to do with cleanliness. It’s about considering factors such as how dark the bedroom is, if it’s a comfortable temperature and if it is sufficiently quiet.
Most people don’t realise we tend to sleep better in a slightly cooler room. An eye mask and ear plugs can also help, or have a relaxing bath before bed.
Make sure you’re not staring at screens (phones or televisions) just before you want to drift off, as this can be stimulating.
‘I keep waking in the middle of the night and cannot get back to sleep for at least two hours’ (picture posed by model)
Anxiety and stress are also common causes of insomnia. If this is the case, sleep troubles are unlikely to resolve unless the underlying problem is sorted.
There is a specific type of psychological therapy recommended for sleep problems. It’s called CBT-I and aims to reduce anxiety about not being able to fall asleep, which makes the problem worse.
A therapist will also help patients to identify the thoughts, feelings, and behaviours that are contributing to insomnia and manage them. Such advice should be available via local psychological NHS services, called IAPT.
As for natural remedies, it might be worth trying an over-the-counter medicine – such as valerian – or an antihistamine. These are not normally recommended for sleep problems but some people find them helpful. Massage and relaxation treatments can also help.
Can you help with a very embarrassing problem? I am a fit and active 76-year-old woman with no health problems. But recently, I’ve noticed an unpleasant smell when I empty my bladder. There’s no pain. I’m afraid to go to the toilet in a public place.
‘I am a fit and active 76-year-old woman with no health problems. But recently, I’ve noticed an unpleasant smell when I empty my bladder’ (picture posed by model)
A smell after passing water is usually a telltale sign of a urinary tract infection.
However, these normally cause other symptoms, including pain and needing to empty the bladder very often.
The simplest way to find out if it is an infection is to ask the GP surgery for a urine test.
More from Dr Ellie Cannon for The Mail on Sunday…
This could involve two tests. First, a dipstick test, done in the surgery, which looks for blood cells and changes in the urine that suggest bacteria is present.
Then, a secondary test in which the sample is sent to the laboratory to look specifically for bacteria.
Older women can have asymptomatic bacteriuria: lots of bacteria start to grow in the urinary tract but do not cause an infection. This would be confirmed with the second test.
Changes to the smell of urine may also come from vaginal discharge. This is more likely to happen after the menopause, due to changes to the vulval tissues.
Certain medications, such as vitamin supplements or penicillin, can also alter the smell of urine – ask your pharmacist about this.
Being dehydrated can be a factor, as can eating certain foods including asparagus.
It is worth drinking more water and seeing whether that solves the issue.
I had Covid recently and ever since, I’ve had excruciating pain in my bottom and upper thighs. The pain and spasms have got better, but I still need to take painkillers daily to cope. Is there anything that will speed up my recovery? I am 77.
Viruses are well known to trigger a range of problems, including those that affect the muscles. This sounds like reactive myositis – inflammation in the muscles that develops after an infection such as Covid.
Typical symptoms include weak, painful muscles that feel tender. The thigh muscles are often affected, as are the shoulders or the hips.
Muscle aches and pains are one of the more commonly recognised symptoms of long Covid.
Experts recommend activities like stretching and yoga to improve flexibility, as well as strength work to build up the muscle.
Pacing yourself is an important part of recovery. Begin at a low level of activity, before building up gradually.
Myositis happens as a result of the immune system’s effort to fight the virus as the body’s fighter cells trigger inflammation within the muscles.
It can also develop as a chronic autoimmune condition. It could be a coincidence that it happened at the same time as Covid, or the virus may have triggered it.
If the symptoms have continued for months, it may be worth asking your GP for blood tests to confirm the diagnosis and look for muscle damage.
Steroid tablets are often used for the chronic type of myositis, to reduce inflammation within the body.
Are you one of the growing army of booster refuseniks?
Have you had your latest Covid booster yet? Everyone aged over 65 has been eligible for an extra dose since early September to protect them from the inevitable winter wave.
Healthcare workers, pregnant women and people who are very vulnerable to Covid can also have one. But apparently a lot of people in this group are yet to have theirs.
I’ve heard from some say they don’t want another jab, having had four or five by now, and others haven’t even been invited.
Have you had your latest Covid booster yet?
It doesn’t bode well, given that we have the rest of the over-50s to get through, who will be called up in the coming weeks.
The extra boost of protection is crucial, with a double whammy of Covid and flu expected to floor the NHS this winter. I’m officially boosted – and all it cost me was a slightly sore arm for a couple of days.
I want to know if you’ve had your booster yet. And if not, why not? Write and tell me.
Cheap drugs miss the target
Are you familiar with the drug Humira? Or adalimumab, to use its generic name.
It’s one of the most commonly prescribed medications and is used to treat conditions involving the immune system, such as rheumatoid arthritis and bowel disease.
But Humira is branded, making it eye-wateringly expensive, so since 2018 the health service has been offering patients generic, cheaper versions of the medicine, called biosimilars.
But I have heard that some patients have been finding that the cheaper versions are less effective. One friend, a man in his 50s who has severe arthritis, has been told that he can’t switch back to Humira because it’s too pricey, which has left him in terrible pain.
I want to know how you’ve got on with the switch. Please write and tell me.