Is there much worse of a thing than the sound of your weekday morning alarm when you’ve only just managed to drop off to sleep? After hours of tossing and turning, your brain churning with pointless thoughts. It’s a rhetorical question of course. There are many worse things: the Trump presidency, the Tory government, climate change, war, torture. The list could go on. But for those of us plagued by insomnia, that sound marks the start of another exhausting day.
According to medical guidelines, anyone who has interrupted sleep for more than three nights a week, for more than three months, has chronic insomnia. That’s me. I’ve had interrupted sleep for about ten years, since I started waking up at night to pee because my unborn child was pressing on my bladder. After he was born, like all new parents, I woke up with his cries, or when he needed to be fed. I remember that obsession with counting how long your baby slept, both at night and during the day. Because that figure also equalled how long you got to sleep, or catch up with essential chores, such as the endless washing of baby clothes. Or even just managing to drink a full cup of tea while it’s hot.
Eventually, even the most wakeful of babies learns to sleep through the night. But that doesn’t mean the parents do. In the same way that our bodies don’t easily ‘pop’ back into shape post-birth, our sleep can be similar. For years my son has slept soundly for ten to twelve hours a night. I can already see that there will be trouble getting him out of bed in future mornings as puberty approaches and for this, I am green with envy.
Despite this decade of disrupted sleep, it’s only the last couple of years that have been the kicker. Back in the day, if I needed up for the loo, or to feed or comfort my baby, I would get back to sleep again fairly quickly. So even if I didn’t get my eight hours in the one go, I would still get close to it overall. Some people believe that this segmented sleep pattern is normal and healthy, as it’s how humans tended to sleep in the past. Everything changed with the invention of the lightbulb it would seem. However, most of us don’t have the luxury of time for one early evening sleep and another after midnight until the morning.
Nowadays I look back on that imperfect sleep with fondness. For although I tend to fall asleep easily enough, I can almost set my clock by my three am waking. After that it’s a lottery: some days I can get back to sleep within thirty minutes, but on others I am only just drifting off before the dreaded assault of the alarm. On the very worst days, I don’t get back to sleep at all. When that happens, I start the day with dread, feeling physically sick and woozy from the moment I get out of bed. Getting through the day is a massive challenge, with the mid-afternoon as peak exhaustion time.
Every article published about insomnia reminds us of the medical dangers: everything from increased chance of strokes and heart disease to obesity and seizures. Chronic sufferers are more likely to experience depression and anxiety, as well as the increase in risk of accidents due to tiredness, maybe while driving or operating machinery at work. Of course thinking about all of this while tossing and turning in the wee small hours is not gonna do anything positive for anyone’s anxiety. Sometimes my night thoughts are about mundane trivialities, other times it’s more along the lines of ‘I can’t sleep, I feel like shit, and I’m probably going to die early because of it.’ Such joy.
So what is one supposed to do about it? One of the more obvious treatments is sleeping tablets, but doctors are less likely to prescribe them these days because they are highly addictive and may have unpleasant side effects, such as constipation, daytime drowsiness and even breathlessness, which is ironic given that difficulty breathing can be a common outcome of insomnia. When the daytime impact of my insomnia reached malfunctioning level last year, I was given them for a week to make up the sleep deficit. I still woke up in the middle of the night, so stopped using them after a few days. There are over the counter herbal medications, but their efficacy is mixed and they only provide temporary relief, rather than solving the underlying causes of insomnia.
Scratch that. What else can we do? There’s been a fair amount of research of late into using Cognitive Behaviour Therapy (CBT) to resolve long term sleep disorders. Unlike pills, the purpose of this talking treatment is to identify the causes of insomnia and change the associated behaviours. In some trials, this approach has had success rates of 75% and higher, but more importantly, with long term impact. I have no idea if this available on the NHS in the UK, but it’s on my list, if I can find a doctor prepared to discuss the issue in a more sophisticated way. And whose first response to every medical problem isn’t to suggest taking an anti-depressant.
Either that, or to watch your sleep hygiene. Which is a real thing that we need to be mindful of, but not the only answer and sometimes downright impossible. For example, go to sleep at the same time every night and get up at the same time every morning. Really? Apart from grannies, who does that? One of the things I love the most about weekends (apart from staying up late) is the opportunity on one of the mornings to make a cup of coffee, go back to bed, read my book and catch up on snooze time. Bliss. But according to sleep hygiene, your bedroom should be for sleeping and sex only. Not reading. Conveniently forgetting about the fact that some books are a lot better than some sex.
Avoiding screens before bed is a good piece of advice. It’s clear that the light from our smartphones is doing a whole heap of damage and messing with our circadian rhythms, which have already been messed up since that pesky lightbulb came into being. I try not to look at my smartphone after ten PM and I’ve changed its light settings to something allegedly less cancerous. However, I regularly fail to meet this and know that many of us are the same. Television isn’t particularly concerning. Unless I’m watching the most nail-bitingly exciting binge-set, I’m more likely to fall asleep in front of it than stay awake after eleven at night.
Our modern life is killing us. Of this I have little doubt. During the summer, I stayed on a tiny island for over a week, off-grid and with no towns or street lighting. I wouldn’t go as far as to say I slept brilliantly, but better than I had in a long time. If I had the luxury of being there for longer, with no alarm clock, then I reckon I could crack this brutal cycle. Live more like our ancestors, hard though it was, in many ways they were much healthier than us. In many ways, I yearn for that life.
In the meantime, I must accept my reality. My flawed, unnatural-for-humans, urban reality, which I love and loathe with equal fervour. Sleep-wise, I suspect that for this phase of my life I must accept it’s not going to be ideal. The current phase of extreme insomnia is probably circumstantial. Everyone says that moving home is in the top three of most stressful things, and I have a lot on my mind. I am hoping that my sleep will go back to crap, rather than ultra-shite in a few weeks’ time once I’ve moved.
But there are other things I need to do once out of this stress-fest. Exercise properly and drink less. Yeah, that old chestnut. Alcohol is known to have a negative impact on sleep, although I find little difference between the days I drink or don’t. I assume I would probably have to stop drinking for a long period of time to see the benefit in my sleep and in peri-menopause. And although I planned to give up drinking for period of the move, it hasn’t quite worked out that way. I’m still ploughing through my house-move workplan but finding alcohol a useful evening stress reliever in these times, even though I know I’m praying to a false god. Sorting all that shit out is also on my list.
In the meantime, it’s whatever gets you through the night. Or at least part of it.
Until next time,