Advice from a real sleep scientist
‘I’ve had so many people come to see me who never thought of themselves as having a sleep disorder, yet they tell me, “My sleep tracker tells me I’m not sleeping enough!”’ says Dr Rae, who has a special interest in the relationship between sleep, the body clock and physical performance.
She says the rise in orthosomnia can be attributed to three factors. ‘First, in recent years there’s been increasing awareness of the health benefits of sleep, and how a deficit can affect you. This makes sense as new scientific research comes to light that helps us understand just how important sleep is over the long term.
‘Second, as this new information has come to light, people have been writing books about sleep, doing PR to sell their books, and generally making a lot of noise in the media that in some instances amounts to fear mongering. At times, the information isn’t even that accurate, and the message – get good sleep, or else – is certainly not one that scientists want to promote.
‘Third, the proliferation of devices that offer to monitor your sleep are also causing us to focus on sleep excessively and – usually – unnecessarily.’
So, how can you tell if you have a legitimate sleep disorder? Put down your smartwatch and listen to your body. Excessive exhaustion and brain fog that impact your ability to function during the day, inexplicable weight gain and feeling overly emotional are all red flags.
Generally speaking, says Dr Rae, in the absence of any identifiable physical disorder such as sleep apnoea, a mental health diagnosis or environmental factors (loud noise, for example), anxiety and stress are the number-one blockers of sleep for most people who don’t sleep soundly. Anxiety can cause acute insomnia, which is usually fleeting and may be related to a temporary situation. This diagnosis is made when you have considerable difficulty sleeping at least three nights a week but for under a month. Longer than that and it’s considered chronic, and this is where things get tricky, because your body and mind can become acclimated to a broken sleeping pattern, and carry this pattern forward even if the cause has been removed. ‘For example,’ she says, ‘many new mothers or fathers experience hypervigilance at night as a natural side-effect of wanting to be attentive to the baby’s needs – but have a hard time ridding themselves of this ingrained pattern once the child has fallen into a more stable sleeping pattern.
‘It’s so important to address the root causes of sleep loss. Because once it becomes entrenched, it becomes complicated to remedy.
‘Waking up in the middle of the night and feeling a flood of anxiety as soon as you do, regardless of what is going on in your life, is a classic example.’
It is to this already-present angst that the ‘sleepconomy’ caters, cultivating concern about how our lack of sleep may be affecting us in the long term. Now, not only are you lying awake worrying about making ends meet, but you’re also stressing about how you’re not currently asleep.
No matter how bad the problem seems, Dr Rae says, it is almost always possible to recover from debilitating chronic insomnia with a range of interventions. But first, she says, ‘Stop measuring and over-investigating your sleep!’
She might recommend cognitive behavioural therapy for insomnia to help remove negative associations with your bed and bedtime. ‘Once your bed or sleep is linked with stress or worry in your mind, it’s going to make it that much harder to sleep.’
She might also recommend a therapist to work through any underlying psychological issues, along with creating ‘sleep pressure’: reducing opportunities for sleep and reducing your sleep time so that you become tired enough to sleep all the way through, breaking the habit of lying awake at night.
Are there any sleep products on the market Dr Rae would recommend? ‘No,’ she says flatly. ‘Commercial sleep monitors can measure habitual sleep duration and patterns, but they’re not yet good enough at measuring stages of sleep such as REM for us to “self-diagnose” sleep problems. If you are that concerned about your sleep, see a sleep specialist. If you really want to use a sleep tracker, rather choose one you wear somewhere on your body. Ones that sit next to your bed are far less accurate.’
From Dr Rae’s advice I can see that I have probably had mild chronic insomnia since my turbulent teenage years.
Yet I don’t experience any concerning symptoms. Overall, I feel healthy, even though I could probably do with more energy, but then, who couldn’t? In fact, I’ve come to value the wee hours when I lie awake in the dark with my thoughts, without distraction. Often, I come up with new ideas. Sometimes, I meditate and observe my thoughts. Almost always, I drift back to sleep eventually.
The bottom line? ‘If you can still exercise, your weight is manageable, you don’t feel overly emotional for no reason, and you’re otherwise healthy, don’t worry about it!’ ❖