Insomnia (An amended version of an article I wrote for The Times in December)
It’s four in the morning and I am staring into the darkness, aware that in just three hours, it will be time to get up. It’s going to be hard to cope with the day ahead, which makes me fret and worry. I am overwrought and exhausted, but too alert to sleep. I turn the light on, sit up, read, turn the light off, lie down, turn to one side and then the other, get up, tiptoe downstairs and warm a pan of milk in the cold kitchen,(more to relieve the monotony than anything else). My husband remains oblivious to my nocturnal wanderings and slumbers on snoring beside me. Although I am quite adept at going through the motions of work and childcare on four hours sleep, at worst I am snappy, intolerant and unproductive. At the very worst (perhaps after two or three days of not sleeping) I feel demonized, low, plagued with headaches and debilitated with exhaustion.
Hours pass slowly in the early hours and the night feels interminable. In the early hours of the morning, my life seems bleak. On the rare occasions that I sleep well however, I feel invincible and optimistic. There are insomniacs who are only on good form for part of the day, Jim Cooper, a digital producer and consultant, says that if he’s had a bad night he will be “fine all morning, but after lunch is often a dead zone. Not a good time to drive or give a presentation as I just want to sleep. If I’m in my office I often lie on the floor and close my eyes.”
Night-time has never been great for me. I was prescribed valium when I was too nervous to sleep during the summer of A levels and was very scared of the dark, as a young child. Bedtime was something I rallied against. I remember being sent for afternoon rests in the dark when I wasn’t tired and going to bed early. Dr Chris Idzikowski, director of the Sleep Centre in Edinburgh, says, “if children are sent to bed too early and lie in bed awhile before they fall asleep, it can possibly lead to an association with remaining awake in bed, ie insomnia. The same is true for adolescent’s who’s biological clocks run slightly slow so they don’t fall asleep as early as most parents would like. They go to bed and remain awake, with the same potential problem of an association of remaining awake.”
Repercussions of insomnia can be severe. When our son was one, my husband and I separated for three months, both worn down with the broken nights and exhaustion, he despairing at the fact that I was permanently tired. Things are better now, but I have to take precautions to increase my chances of a good night. No caffeine or chocolate after 2pm. Alcohol, particularly champagne, keeps me awake. Eating too late or rowing can stop me sleeping. If my adrenaline gets going (most recently when my husband was away and I thought I heard someone slamming the back door) I won’t sleep. If a room is too light, or too noisy it will wake me, and I may not get back to sleep. I remember a holiday in a hot room in Greece when I didn’t sleep more than four hours a night the whole week. There are so many rules to follow and things to factor, that sometimes something slips.
Dr Idzikowski agrees that for an insomniac everything has to be just right. “Sleep is controlled both by the brain and the mind. In the area called the hypothalamus, in the brain, there are three important control mechanisms, one controls sleep, another wakefulness and another is the 24 h biological clock, which permits sleep to occur during the night. The sleep controller needs to be turned fully on and wakefulness fully switched off for good night’s sleep. Psychological mechanisms such as conditioned wakefulness and over-active mind also contribute. Everything has to be right for sleep to occur and perhaps this complexity is what causes sleep to go wrong.”
Jim Cooper thinks his reason for not sleeping is medical. “I was diagnosed with over-productive adrenal glands. My body naturally produces an excess of adrenalin. I take pills to bring this under control. When I can’t sleep I am completely wired., thinking of ten things at once. It’s like having 10 screens in your head all showing different things. I’ve decided that if I can’t get to sleep or wake up early I should just get up and read or work.”
Dr Idzikowfski supports alternative therapies that are scientifically backed up to help insomniacs, like acupressure, yoga and Thai Chi. He treats insomniacs with cognitive behavioural therapy and if someone needs help regulating their sleep patterns in the short term, he would prescribe sleeping pills but as he points out every case is different.
In an attempt to combat insomnia, I have tried homeopathy, acupuncture, reflexology, massage, over the counter drugs, yoga, hypnotherapy, regular exercise, lavender spray, Jin Shin Jyutsu, the therapist places hands on your body “to determine energy flows”. (This seemed to help, though costly, and the therapist left) I once even tried a meditative walk around a labyrinth in Arizona, which was wacky but rather wonderful. The most recent attempt to induce sleep, involved listening to a CD of ambient music for insomniacs– it didn’t make me sleep.
My husband once insisted that I try sleeping pills. When my GP finally agreed to prescribe them it was a miracle to drop off instantly to sleep, but after a while the pills made me feel hung-over, as though I had permanent jet lag. I never take them now.
There was a breakthrough when a fellow insomniac, recommended Acem Mediation. If I practice this simple mediation daily, my sleep patterns are better, but I need a good chunk of time to do it properly. I sometimes use it as method to fall asleep for a ten-minute nap, which always leaves me refreshed. At the moment I am taking supplements that contain serotonin, magnesium and valerian, but they are not guaranteed to work particularly at key hormonal periods of the month. They haven’t worked tonight for example. I have turned on the light and write this at 1.41 am.