Losing out on ZZZs can leave you facedown in your Cheerios, or cheek-to-cheek with the daily agenda in your morning work conference. Tired of your intense hatred for that 5am sunrise and counting the seconds to your alarm clock? It may not be that late night coffee, that hunk of cheese by your bedside or the Buffy marathon on Netflix that’s tiring you out. Insomnia is real, and it sucks.
When am I sleeping badly, and when is it insomnia?
Many of us trivialise insomnia, a serious sleeping disorder, in the same way we trivialise depression and anxiety with phrases like, ‘The Vampire Diaries season 6 is over and it’s depressed me’ or ‘I’m so OCD’, when you’re really, really not.
‘Insomnia means a chronic difficulty getting to sleep, staying asleep or waking early,’ says Professor Morgan of the Clinical Sleep Research Unit at Loughborough University. ‘Chronic insomnia is defined in terms of three times or more a week where you have difficulty sleeping for three months.’
Rebekah, 21, from Lincoln, says she dismissed her insomnia for too long. ‘I thought everyone had the same sort of thing, and never realised how big a problem it was. It was only after a few mood swings on visits home that my mum asked me how I was sleeping. I would go three days on less than four hours kip.’
Professor Morgan describes it as non-trivial: which means it can affect absolutely everything going on in your life. ‘What it does is that it renders them weary and fatigued all the time, impairs psycho-motive performance, making people clumsier, it affects the ability to regulate our emotions, making you snappy, and brings significant risk factor for major depression.’
Apparently, people with insomnia are four times more likely to develop major depression.
Who’s most prone to it?
Insomnia affects 10 per cent of all adults in the developed world, which Professor Morgan says is a ‘robust figure’ – scary when you think about it, taking into account how many of us are living with it untreated. It also tends to affects women more than men and tends to increase as we get older.
Sophie, 26, from south London, says that both she and her boyfriend suffer from insomnia, but perceive it differently. ‘We’d both been dealing with it for a few years before we met. He was used to self-medicating himself with weed, whereas I was used to going to the doctor to talk about different methods.
‘None of what the doctor has suggested has worked for me, but cannabis just makes my boyfriend lethargic and spacey rather than sleepy,’ she says.
Insomnia is a subjective complaint, and studies have shown that women are more likely to report medical ailments. Women, it seems, are far more comfortable about expressing vulnerability, whereas men adhere to the ‘stoic male’ stereotype.
But forgetting stereotypes, Professor Morgan says there’s still a reason why women would report it more. Our psychology is on a much broader spectrum because of what’s going on inside.
‘Sleep quality is affected by menstrual cycles,’ says Professor Morgan. ‘Men’s internal environment is constant, but women’s varies. Hormonal changes can be disruptive of sleep and pre-menstrual pain; then menopause is a big factor for lack of sleep.’
How does stress impact on how I sleep?
Professor Morgan also points to stress in areas such as employment, school or personal relationships that can cause chronic insomnia, especially if there’s ongoing, unresolved issues. When you lie awake at night, you begin to associate your bed with a place of worry and alertness.
‘Insomnia fundamentally focuses on the mechanism of falling asleep, the point of transition between wakefulness and sleeping stage. The transition is mediated by psychological bridge, a kind of mental state adopted by an individual which allows it to happen.’
We can’t will sleep or force ourselves, because it stresses us out even more – that’s why people suggest counting sheep, because your mind is focused on jumping fluffballs. ‘We have to adopt an internal sleep to allow automatic processes to transmit us into sleeping state.’
Can I be hardwired for insomnia?
Everyone feels some degree of stress, pain or illness in their lives, but it’s still a minority that reports insomnia. ‘Some are hardwired to develop it. They are, in medical terms, pre-disposed to it because of the way they focus attention on work. They’re far more likely to think hard about falling asleep, meaning they won’t.’
If you’re in a high-pressure job, you can be hardwired to thinking rapidly and intrusively.
Lucy, 22, from Belfast, says she feels her personality in her high-pressure environment works against her. ‘I’ve always been a perfectionist, work hard, play hard and all that. I’m in my final year of law and have had plenty of times where I’ve worked through the night on essays. Even when I’m not, or I know I have a day off the next day, I’ll be in bed staring at the ceiling for hours on end. I can’t make my brain slow down.’
How do I treat it?
It’s worth reiterating that you have to take it seriously. Insomnia doesn’t just affect your sleep, but your whole life. And if you don’t get it sorted, it’s more likely to get worse than get better.
Aside from the old, tired non-tricks of drinking warm milk or spraying lavender on your pillow, Professor Morgan says there are pharmaceutical options and psychological options.
‘The psychological option is usually preferred by the patient and has benefits that last longer, making it medically superior,’ says Professor Morgan. ‘Sleeping tablets only work for two or three weeks, after that you have an addiction and the original insomnia which will return.’
He recommends Cognitive Behavioural Therapy, which utilises the evidence-based strategies and procedures of how sleep actually works in the first place.
CBT organizes behaviour in a way that maximises falling asleep and re-organising your mind. It also helps to remove the intrusive thoughts of work the next day or an upcoming exam or life crisis. So basically, you’re getting a full mindful clear out.
How can I establish a healthy sleeping pattern?
The golden rule is not to agonise over it. ‘Let it resolve itself first. Sleep is a self regulating mechanism.’ According to Professor Morgan, an adult can deal with two or three nights bad sleep before they crash (ew).
Regularity is important for sleeping better. It probably won’t make you that popular setting a solid bed time, but it will make you healthier.
Professor Morgan says: ‘Don’t spend lengthy times in bed if you can’t sleep; get up and do something. Chronic insomnia means people don’t fall asleep in bed, and actually spend more time in their bed than people who don’t as they’re waiting to sleep.’
What happens, is that we learn not to fall asleep in bed, but to be wide awake and alert.
If you have a chronic sleep problem and address it by reading a book or watching Netflix, you’re teaching your body this it isn’t a place to sleep. ‘It becomes no more of a place than you sleep than your kitchen,’ says Professor Morgan.
Does coffee affect my sleep?
Unsurprisingly, caffeine keeps your brain from recognising tiredness. Professor Morgan recommends cutting down your intake after midday, and refraining from it after 6pm. It takes four hours for your body to break down half of an Americano.
Alcohol is another factor that can affect your sleeping pattern, as well as sleepy hangover days.
Is it Ok to take a nap when I’ve slept badly?
If you’re having a bout of poor sleep, avoid napping, no matter how good the sofa looks at 4pm on a Saturday. ‘Getting to sleep requires the resource of sleepiness, and getting to sleep if you aren’t is difficult,’ explains Professor Morgan, to my absolute dismay.
Napping means that every nap takes away from the sleepiness you take to bed at night, those ZZZs have to come from somewhere.
When should I see my GP?
If it’s affecting your day time performance, you should go see a GP ASAP. But Professor Morgan says to research and be aware of your options.
‘Many doctors don’t understand insomnia and don’t understand the treatment options available,’ he says. Explain your symptoms and be very clear. ‘Discriminate between staying and getting to sleep, and what it is that’s bothering you. If you have daylight symptoms make that clear. It all points in particular directions.’
He also warns about the temptation of quick fixes, like sleeping tablets. ‘If you rely entirely on your doctor’s treatment, you’ll come away with sleeping tablets. Ask what they’ll do when they run out and you still have symptoms. When a course of treatment ends, you need to be better informed.’
He recommends asking for a psychological therapy referral, which every doctor in the UK has access to.
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Illustration: Assa Ariyoshi
This article originally appeared on The Debrief.