STEP THREE

You’ve tightened up your sleep hygiene and implemented some exercise or de-stressing activities to deal with tension and anxiety. For most people, these first two steps are all that is needed to begin sleeping well.

If you still see no real improvement, there’s usually just one more thing that needs looking at — your thinking about sleep.

Fear, low expectation of sleeping, and obsessive or anxious thoughts, particularly about sleep, can keep you awake through almost anything. So is this the time to reach for the sleeping pills, just to calm that anxious thinking?

In short, no. I am resolutely opposed to the prescribing of sleeping pills, particularly for long-term insomnia. This is because beside the side effects, I believe pills often make insomnia worse, not better.

To understand this, consider the message implicit in the prescribing of a sleeping pill — this pill will make you sleep because, let’s face it, you aren’t capable of it on your own. This means every night that you fall asleep on medication your trust in yourself is diminished. Keep taking the pills and your expectation of ever being able to sleep on your own eventually disappears. The self-belief you need to sleep naturally is robbed by sleeping pills. When the pills stop working (as is usually the case), you are then cast adrift and alone with no expectation of being able to sleep at all, with or without medication. This is an extremely frightening place to find yourself.

(Be warned: If you currently are taking sleep meds, you should never, ever stop taking them without consulting with your doctor. Sudden withdrawal can be positively dangerous, even fatal.)

But if pills aren’t the answer, how on earth do we go about changing negative thinking and poor expectation about sleep?

It was as a result of my 15 sleepless years that I became a bit of an expert in the psychology of insomnia — how it’s made worse by certain ways of thinking and speaking, and improved by expectation, routine and habit. I am delighted that finally, the scientific community is coming around to a similar way of thinking and is beginning to acknowledge the problems with sleep meds. In 2016 the American College of Physicians suggested that Cognitive Behavioural Therapy for Insomnia (CBTI) must be used as the first line of treatment for chronic insomnia, not sleeping pills.

A good Cognitive Behavioural Therapy therapist will work wonders but as most of us don’t have access to that, here are a few things you can try yourself.

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If you are plagued by a busy mind or anxious thoughts at night, keep a notepad and pen next to the bed. If a thought won’t leave you alone, get up, turn on the light and write a note to yourself to deal with the issue in the morning. Then let go of the thought and go back to sleep.

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Stop all complaining about sleep. Don’t ever refer to yourself as an ‘insomniac’ and banish the word ‘insomnia’ from your life. One of my favourite little mottos is: ‘The story you tell about your sleep will come true.’ Remember that. If you’re telling a constant story of poor sleep, that story is going to keep coming true. So start talking up the good nights and downplaying the bad ones. And try and tell yourself it’s no big deal if you don’t sleep well. Because, paradoxically, the less you care about missing sleep, the easier it often is to achieve.

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Finally, get on with your life as normal. This is essential. Don’t ever allow a sleep problem to dictate the way you run your life, cancelling appointments or hiding away from the world. The more compromises you make for the sake of sleep, the more you draw attention to the problem, and the worse it gets. The more things you do to try and ‘fix’ your sleep, the worse it often becomes. This is because insomnia is an affliction made worse with attention. Feed it with fear and attention and it just grows bigger. So, one of the very best things you can do after a bad night is totally ignore it.

Whether you’re new to insomnia, you’ve got a long termproblem, or whether you’re slap-bang in the middle of a really bad patch of sleep and are desperate to get things back to normal, my advice is always the same: Keep the sleep hygiene good. Get some exercise or de-stressing done. Get on with your life, avoiding complaining about sleep and paying as little attention to the problem as possible.

By following this three-part plan, you reduce the chances of sleepless nights. It’s just not possible to have night after night of no sleep when these circumstances remain so right for so long. Sleep eventually becomes irresistible.