Insomnia – How did you sleep last night?

Most of us who do or have suffered from anxiety or panic, or who are a prone to higher than average periods of stress and worry tend to suffer from difficulty sleeping. Insomnia, to give it its grander title, seems to be one of those conditions that gets worse the more you worry about it. Many herbs have been said to help, namely lavender and chamomile, likewise their are chemical medications both available on prescription but they tend to cause side effects or be habit forming, or plain ineffective.

 

Meditation, yoga, exercise and diet have all been suggested, in fact there are as many cures as there are sufferers. And most people do find a solution. I found that routine is my best weapon. If I get up at the same time I tend to sleep at the same time. Obviously avoiding caffeine helps enormously, especially after 4pm.

 

This article from the Guardian was rather interesting:

 

From the moment a baby arrives, sleep becomes an obsession. But, as John Crace discovers, the broken nights that so many parents experience may have little to do with the kids. Sleeplessness – like wrinkles and grey hair – is simply part of the process of ageing

Saturday December 30, 2006
The Guardian

 

If you’re getting enough, you barely give it a moment’s thought. But once you’re not, it dominates your waking life. Almost to the point of obsession.

 

A third of all adults have sleeping problems and, more often than not, we blame having children. Not that people necessarily sleep that brilliantly before they have children. It’s just that sleep rarely becomes a big issue. You have a good night, you have a bad night. No problem.

 

 

All that changes when a baby comes along. Spend more than 20 seconds with any new parent and you will be treated to a lengthy discourse on exactly how many hours both they and the baby are sleeping. Every moment of unconsciousness is logged and documented. And yearned for.

 

Leah Jewett, mother of Copey, five, and one-year-old Dare, knows just how this feels. “I’ve always had unusual sleeping patterns, but it was easier to cope before the children were born. If I woke up in the night, it was just my problem and I could catch up with my sleep later.

 

“Now there is the added anxiety both of being woken up by the children and having to be on hand for them in the daytime. I worry about my sleep constantly.

 

“With the baby monitor on, I come to with a start when I hear Copey or Dare cry out. When it’s not on, I’m yanked from sleep, heart thudding, imagining I can hear Dare’s syncopated, prolonged cry – an auditory mirage. Then I lie there, listening in to the silence.”

 

Most parents eventually recover their sleeping patterns. But some don’t. Terry Everett, 50, has had few decent nights’ sleep since her early 20s, when her son was born. “My son was born premature and he seemed to spend most of the nights awake.

 

“Then my husband and I split up when my son was very young and he seemed to become even more restless at night. I became more and more worried about him and I got into a vicious circle. I’ve no trouble getting off to sleep but the slightest noise wakes me up and I just can’t get back off again.”

 

So what is a normal night’s sleep? Seven hours is often quoted as a good night’s sleep for an adult, but in reality there is no such thing as a standard night’s sleep. “People tend to have a fixed idea of how much sleep they need that stays with them throughout their lives,” says Kevin Morgan, professor of gerontology at the Sleep Research Centre at Loughborough University. “But sleep changes over time. The ageing process is just as evident in the unconscious as it is in the physical manifestations of wrinkles and grey hair.”

 

As virtually no one thinks they need less sleep than they are actually getting, and most adults claim to experience life past the age of 30 as one long battle against fatigue, you might also assume sleep deprivation was part of the human condition. But you’d be wrong.

 

“We can all sleep more than we need,” says Jim Horne, professor of psychophysiology and, for the past 25 years, director of the Sleep Research Centre. “Ask someone about their holiday and they will often talk in terms of ‘catching up’ with their sleep. This doesn’t square with the facts. We sleep more on holiday simply because the brain’s got less to do. Sleep is just a way of passing the time. Only a quarter of those with sleeping difficulties can be described as sleep-deprived.”

 

Not that this is of much comfort to anyone who is having trouble sleeping. “You can try telling a young mother that she’s actually getting enough sleep each night,” says Morgan. “It’s just that she’s getting it in interrupted packets rather than in a single stretch, but she’ll still feel frazzled and may worry that she’s not coping.”

 

In this respect, sleep is like pain. It exists on its own continuum; if anyone thinks they have a problem, then they have a problem and what’s tolerable for one person may be intolerable to another. Even so, as the graph of average sleeping patterns shows, there is typically a steady decline in the number of hours we sleep each night the older we get.

 

Sleep begins in the womb and changes both in character and length throughout our lives. Babies can spend up to 80% of their sleep in rapid eye movement (REM) mode – the state most associated with dreaming – while REM will only account for about 10% of a 70-year-old’s sleep. The four stages of non-REM sleep follow a similar pattern with the transition to stages three and four, the deeper stages of sleep, becoming less common the older we get.

 

This does not, however, answer the basic question: why do some people seem to need more sleep than others? In any random sample of 24 babies there will be one that sleeps for 18 or more hours each day and another that sleeps for just nine or 10. And the patterns of sleep we adopt in childhood will most likely carry on into adulthood.

 

Teenagers are a special case, however. Many spend hour upon hour in bed – but for a good reason. The neural networks of the cortex are going through a process of intense reconfiguration and the brain needs some time out. As their teens slumber, parents in turn lose further sleep worrying that something untoward is causing their children to sleep so much. Periods of extended sleep can be associated with depression or excessive dope smoking. On the other hand it might just be down to normal adolescent boredom.

 

Jane Hall has three sons: Danny, 18, John, 16, and Richard, 13. “They’ve all had very different sleeping patterns throughout their lives,” she says, “but it’s been noticeable how much more they’ve started to sleep since they became teenagers.

 

“We were never that concerned about Danny as he was always able to get himself up. But John would regularly sleep 12 hours a night if he got the chance. He doesn’t seem to be as motivated as his elder brother and we have to keep on his case during term time.”

 

And what’s been the effect on Hall’s own sleep? “After years of living with three boys, you get used to not sleeping,” she laughs. “I’ve got used to going to bed before Danny, but, if they are out at a party, you don’t switch off until they get home.”

 

Sadly, our sleep is unlikely to improve once the kids finally leave home. The older we get, the shallower and more fractured our sleep tends to become. “I wake up at least once almost every night,” says Penny Butler, 70. “There’s no real pattern. It could be at midnight or 2am. And I could wake up a second time. I wake up sad, I wake up happy, I wake up hot, I wake up cold. It’s just the way my life is. I try not to let it bother me.”

 

Tempting as it is to measure our sleep record by life-defining events, Morgan argues it’s more to do with thought patterns than life changes. “Sleeping problems aren’t merely a function of external events. Most people with insomnia, regardless of their age or what’s happened to them, share a circular style of thinking. It’s not about being prone to anxiety, but about getting trapped in a pattern of thought.”

 

Daniel Newnham is proof of this. He’s 31 and has no kids, yet when his insomnia is at its worst he gets just four hours’ sleep a week. “It started about three years ago when I went to California. I did a lot of travelling and my body clock just never returned to normal.

 

“I would lie in bed, feeling more and more exhausted, but my brain would be racing. I became very depressed. I try to avoid becoming fixated on going to sleep, but it’s still a struggle.”

 

While no one rules out the use of medication as a quick fix, few argue for it as a long-term solution. “We can exercise some control by establishing good routines,” says Jim Horne. “Parents should let their babies settle themselves, providing they are clean and fed. Comforting them just because they are awake and crying merely encourages them to continue that behaviour.

 

“We can also create routines in our own lives. Rather than lying in bed thinking, you should get up and do something quiet, such as reading, and go back to bed once you’re tired. If the same thing happens again, get up again. And don’t try to catch up with your sleep; start your day at a set time each day. You may feel tired for a bit, but eventually your sleeping patterns should return to normal.

 

“Older people should try to keep mentally and physically active. It’s the people who do less that tend to doze off in the day – which makes sleeping at night that much more difficult.”

 

Most sleep problems, says Morgan, can be sorted out with cognitive behavioural therapy – the only drawback being that, assuming you can find a doctor who takes your problem seriously, there can be a two-year waiting list to get referred to a therapist on the NHS. And time can be critical. “The only guarantee with sleep,” says Morgan, “is that problems will only get worse if left untreated.”

 

 

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