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Ever find yourself awake, staring into space at four in the morning? Is it just a bad habit, or is there something more sinister going on? And why does it always seem to happen at 4am? “We start to experience less deep sleep after around four to five hours,” says Lisa Artis, deputy CEO of The Sleep Charity, who have partnered with Simba mattresses. And once we’re in that lighter sleep faze, we wake much more easily. If you generally fall asleep around 11pm – which is a very common bedtime, 4am wake-ups are more likely. And there are many factors leading to these inconvenient stirrings. Hormones “Sleep is guided by our internal clock or circadian rhythm. One of the most significant and well-known circadian rhythms is the sleep-wake cycle,” Artis continues. “Sleep is regulated by the levels of two hormones: melatonin and cortisol, which follow a regular 24-hour pattern. Melatonin assists you in dozing off, while cortisol helps get you up, and keeps you awake,” she explains. Keeping an eye on your hormones is important in preventing those late-night wake-ups. “Engage in calming activities before bedtime, such as reading, listening to soothing music, or practising relaxation techniques, like deep breathing or meditation,” says Dr Mariyam H. Malik, GP at Pall Mall Medical. Equally, pop your phone down for a bit. “Blue light from electronic devices can suppress melatonin production. Try to avoid screens for at least two hours before bedtime, or use blue light filters. It is best to charge them in a separate room overnight,” Malik adds. Diet Caffeine, heavy meals, alcohol, sugar, and a lack of magnesium or B vitamins could lead you to have a more disturbed night’s sleep, according to Malik. Sugar and carbohydrates may have a particular impact. “A diet high in sugar and refined carbohydrates can cause blood sugar fluctuations, leading to wakefulness during the night,” she says. “It’s unlikely you’ll feel hungry in the middle of the night if your blood sugar dips,” notes Artis, “but to reduce ungodly hour awakenings, trial alternatives for your last meal or snack of the evening. Instead of carb or sweet-based snacks, opt for protein-packed and magnesium-rich foods, like hard boiled eggs, cottage cheese, pumpkin seeds, spinach, dark chocolate, cashews, chicken thighs or turkey.” Protein can take the edge off your night-time hunger, she says, while magnesium is known to support sleep. Needing a wee Do you wake up needing to wee at the same time every night? “Try not to drink excessive amounts of fluids before bedtime,” advises Malik. “It’s important to stay hydrated, but try not to drink anything for around two hours before your usual bedtime. Go to the toilet before you go to bed to empty your bladder. ” Age and life stage “Sleep tends to become more disrupted as people get older,” Malik explains. “Sleep patterns change with age, and various factors can contribute to sleep disturbances in older adults. Some common reasons for sleep disruption in the elderly include changes in your circadian rhythm, decreased melatonin production, medical conditions or medications, and potential sleep disorders.” It can also affect women during the perimenopause. “The reproductive hormones – oestrogen and progesterone – are entwined with the sleep and relaxation hormones, melatonin and serotonin,” says Artis. “When oestrogen begins to fall before and during menopause, it can create a disturbance in the sleep-promoting hormone melatonin, meaning it can’t properly balance out cortisol. When this happens, the ability to fall and stay asleep is affected.” Recurring hot flushes, night sweats, dry skin, and low libido can signal waning oestrogen. Artis advises incorporating foods with high levels of phytoestrogens into your diet throughout the day to help with this. “Phytoestrogens imitate the natural estrogens found in your body. As a consequence, they can bind to your body’s oestrogen receptors and produce similar effects.” Try lentils, kidney beans, chickpeas, tofu, edamame, spinach, cauliflower and broccoli. Worrying Stress is not good for sleep. One study by Bupa even found that 32 million Brits wake up worrying about their health at precisely 4:05 am. The report, which surveyed 4,000 British adults, revealed that more than three-fifths of us wake up in the middle of the night. If you are finding yourself awake at all hours worrying, or waking up with stressful dreams, there are a few things that may help. “Keep a journal by your bedside and write down your worries before going to bed. This practice can help get your concerns out of your mind and onto paper, making it easier to let go of them temporarily,” says Malik. You may also want to “engage in mindfulness or meditation exercises before bedtime. Mindfulness can help you focus on the present moment, reducing anxiety about the past or the future.”

People living with hepatitis B (HBV) and hepatitis C (HCV) could be just as likely or more likely to develop cancer than someone smoking a pack of cigarettes a day, new research suggests. According to the Center for Disease Analysis (CDA) Foundation, people infected with hepatitis B and C viruses “have a similar or significantly higher risk of developing cancer than someone who actively smokes one pack of cigarettes per day”, and therefore HBC and HBC should be “considered as cancer causing infections and international guidelines should be reconsidered accordingly”. Hepatitis is the term used to describe inflammation of the liver, according to the NHS. Hepatitis B is spread in the blood of an infected person – it can be spread from infected women to their babies, or through unprotected sex and injecting drugs – and hepatitis C is usually spread through blood-to-blood contact with an infected person. The NHS says HCV is most commonly spread in the UK through sharing needles used to inject drugs. The foundation found that HBV and HCV viruses are highly oncogenic. Oncogenes are mutated genes which can lead to cancers in multiple organs and sites. Homie Razavi, managing director at CDA Foundation said: “Hepatitis B and C infections are silent epidemics. These viral infections are cancer causing but since infected individuals don’t show any symptoms until it is too late, most infections go unnoticed. “It is important for all of us to recognise the high risk of cancer associated with hepatitis B and C infections and get patients linked to care. Treatment can reduce the risk of cancer by 85% or more.” As part of a call on World Hepatitis Day 2023 (July 28), the World Hepatitis Alliance (WHA) has launched a campaign called ‘We’re not waiting’ with its global network of 323 members in over 100 countries, in order speed up the fight against the disease, which claims a life every 30 seconds. In a new survey, the WHA found that 42% of people around the world are unaware that viral hepatitis is one of the leading causes of liver cancer. Nearly three-quarters (74%) of those surveyed said knowing that hepatitis causes liver cancer means they are more likely to get tested, whilst 82% would get vaccinated. In total, over 350 million people have been diagnosed with either hepatitis B or C around the world, which results in more than 1.1 million deaths every year. And by 2024, deaths caused by this disease could surpass mortality from malaria, HIV, and tuberculosis combined, according to the WHA. “Every year, more than a million lives are lost to hepatitis,” said Danjuma Adda, president of the WHA. “The theme of World Hepatitis Day 2023 is ‘We’re not waiting’. It’s a call to accelerate elimination efforts of viral hepatitis now and the urgent need for testing and treatment for the real people who need it. “Individuals and communities around the world are making change happen in their own lives and in [the] world around them. We celebrate them, while demanding more action. We’re not waiting for change – we’re fighting to make it happen.” Read More Charity boss speaks out over ‘traumatic’ encounter with royal aide Ukraine war’s heaviest fight rages in east - follow live

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