Dreaming of sleep
Trying to break the iron grip of insomnia’s vicious cycle,
As I write this, it is turning noon. I am exhausted. My mind runs through the verbal alternatives — done in, beat, dead, shattered, jiggered, drained, wiped, consumed, finished, spent — and settles on what Oxford informs me is its British vulgar slang option: buggered. My skin is stretched taut over my cheeks, charcoal smudged under each eye. I am shivery, a tightly wound neurotic; yet vague, mentally clouded, doomy with apprehension and jittery with caffeine. I am not a great weeper but do not feel far from it.
I am no less hypersomniac, subject to daytime sluggishness and a desire to slumber a lot. I once slept for 48 hours, waking disorientated having lost two days. I could sleep at any hour of the day. Day sleep is becalmed, indulgent, medicinal. But I do not allow myself to since — like all creatures of the night — I endeavour to observe rigorous “sleep hygiene.”
This method — in which the insomniac disciplines herself to a regular waking pattern with a view to establishing a corresponding sleeping routine — will be one of a catalogue of solutions the sufferer will have deployed.
I have also tried hot baths, warm milk, caffeine bans, lavender, camomile, valerian, magnesium, calcium, cherry capsules, alcohol, Nytol, melatonin, antidepressants, massage, intercourse, foot patches ... and a small chunk of amethyst clutched in the palm. Psychotherapy, cognitive behavioural therapy, yoga, exercise, nutritional approaches, hypnosis, nature noises, sound-wave technology and sleep hypnogram apps have also featured.
It has become one of western culture’s most cherished neuroses that we exist in a constant state of sleep deprivation. Hours are notched up where once we might have totted up calories. Friends compete to determine who has passed the more fitful night. Magazine covers that were wont to holler “hot sex” now lure us in with promises of “deep sleep.”
And oh, how we love a spot of breaking sleep tragedy or hypno-machismo. In December 2011, Antonio Horta-Osorio, chief executive of Lloyds Banking Group, was famously forced to take several weeks’ leave after a bout of particularly torturous insomnia. This summer, Bank of America Merrill Lynch intern Moritz Erhardt, 21, died after working until 6 a.m. three days in a row, having slogged throughout the night eight times in two weeks.
Burberry’s chief, Angela Ahrendts ($1.7 million in pay, plus benefits and bonus), clearly sees herself in the four-hours-anight Thatcher mode, boasting that if she scores more than six hours’ rest she gets a headache. And media mogul Arianna Huffington, who once shattered her cheekbone by falling asleep at her desk, is forever encouraging women to “sleep their way to the top.”
As a culture, we are fixated with sleep and, correspondingly, beset with sleeplessness. Almost 40 per cent of people endure at least one symptom, with a quarter of these experiencing chronic traits at any one time.
Insomnia is widely considered an epidemic, with scientists increasingly unearthing dire implications for sufferers’ physical and mental health, weight and life expectancy. Popular culture blames our 24/7 lifestyles, technology and our inability to switch off.
Colin Espie, a professor at Oxford’s Nuffield Department of Clinical Neuroscience, looks deeper: “We put ourselves under a huge amount of pressure and fail to take full advantage of having more free time to live a full and healthy life. … No aspect of daily functioning is unaffected by sleep — from concentration and energy, to mood, productivity and social interactions. … Long-term poor sleepers are seven times more likely to feel helpless, five times more likely to feel alone and twice as likely to have relationship problems as good ones.”
Dr. Guy Meadows, founder of London’s Sleep School, agrees: “I see clients who have completely stopped living their lives in the hope of controlling their sleep. They have given up working to avoid stress, stopped socializing to avoid being out late, stopped going away on holiday … and even chosen not to have children for fear of being bad parents.”
This will not sound extreme to insomniacs. At the most banal level, you wonder what you would look like with sleep (younger, surely?), you fantasize that you would eat and drink more wisely sans lag, function better, be less of a bitch. At a less banal level, there are moments when sleeplessness feels akin to madness or mental illness.
Huw Morgan, a 41-year-old prospect researcher, is a lifelong insomniac. “I think it is a bit like anorexia in that it’s an inability to do something quite simple, vital and instinctive that most people take for granted. You can feel as if you are going genuinely mad, something tied into the loneliness, depression and anxiety inherent in the condition — as if your mind is broken and leaking all over the place at 4:30 a.m. on a Tuesday morning in your living room.”
Science is forever looking for solutions. For a time, Meadows used to deploy traditional methods such as advising patients to get up when wakeful and resist negative thoughts. But he realized that fighting insomnia merely created a tug of war situation stimulating the amygdala, the region of the brain that governed the fight-or-flight mechanism, ensuring the situation became self-perpetuating.
He is now advocating an “acceptance technique.” He is the first to apply the lessons of acceptance and commitment therapy (ACT) to sleep. His work centres on a mindful approach, with clients sitting — or rather lying — with and even “befriending” the mind’s demons.
His axiom is that while sleeplessness is outside our control, you can control your reaction to it — which can, in turn, break insomnia’s vicious cycle. His success rate is impressive: 87 per cent of his 2010-11 patients reported significant improvement (with 10 per cent not responding).
Espie is a co-founder of the online sleep-improvement program Sleepio, which costs from $11.48 a week. He says: “The most effective treatment for poor sleep, by far, is cognitive behavioural therapy” (CBT) — a psychotherapeutic approach that addresses behaviours and thought processes through goal-oriented, systematic procedures).
“CBT has been shown to help around 70 per cent of sufferers and is what we call an ‘evidence-based therapy,’ meaning that it has been shown to be effective in controlled clinical studies. … So, yes, I do think insomnia can be fixed, but CBT is the only proven means.”
“I’ve accepted it — which you have to otherwise it gets worse,” says Morgan. “I treat it like a minor illness.” He found attending a CBT session helped, even revealing that all the things he did were recognized CBT strategies, like not having a clock in the bedroom and having a bedtime routine.
In my own case, I try to sit with my insomnia, learn its lessons, if any, and pile on the under-eye concealer. In the end, I find I come back to Prospero’s closing acceptance of Caliban in The Tempest: “This thing of darkness I acknowledge mine.”