My dream cure for insomnia!
Dr Michael Mosley reveals all in Good Health
Does this sound familiar? You go to bed at 11pm and fall asleep. Around 3am, you find yourself wide awake. You lie there fretting and, after what seems like hours, you drift off — only to be woken immediately by your alarm clock.
This is what I used to do almost every night ever since I hit middle age. I would wake tired and irritable and began to dread going to sleep. It was like being trapped inside my own personal groundhog day.
And I was convinced this disrupted sleep was rotting my brain and ageing my body.
I tried everything to stop it. I bought a new mattress, replaced my pillows, got a dimmer bedside light. I sweated away on my exercise bike in the early evening, hoping to exhaust myself, and even sniffed lavender.
I tried every different kind of overthe-counter sleeping remedy and even brought melatonin capsules (a supplement containing a version of the ‘sleep’ hormone we produce naturally) back with me from the U.s., where it’s available without a prescription.
But nothing made any difference. As far as I was concerned, I had developed chronic insomnia, which I put down to getting older. Lots of people who find themselves in similar circumstances badger their GP for sleeping pills.
Last year, more than nine million NHs prescriptions were issued for these and, according to Professor Kevin Morgan, director of the Clinical sleep Research Unit at Loughborough University, this number will be matched in sales of over-the-counter medications.
The trouble is that sleeping pills can be addictive and they are not a long-term solution.
Sleep just like our ancestors did
BUT what if we are on the wrong track? Thanks to fascinating research I’ve recently come across, I’ve realised that what I’m doing is entirely natural.
It turns out I’m not an insomniac with a medical problem, but someone whose sleeping pattern harks back to an earlier time.
I am sleeping less like a 21st-century man and much more like our ancestors did. And knowing that has helped me conquer my anxiety so that I am sleeping better than I have in years.
The eureka moment for me was when I discovered my pattern of falling asleep, waking for a prolonged period, then falling asleep again, has a name: biphasic, or segmented, sleep. surprisingly, the person who has done the most to highlight its importance is not a doctor, but a historian, Roger ekirch, a professor of history at Virginia Tech in the U.s.
Professor ekirch has found evidence that biphasic sleeping used to be common. By exploring diaries, novels and medical textbooks, he discovered that, in pre-industrial times, this was how most people slept.
After sunset, they would go to bed, sleep for four or five hours, and then get up. This was known as ‘the first sleep’.
They would then stay awake for an hour or so, before going back to bed for a ‘second sleep’.
Between the two sleeps, they would do household chores, visit friends, or remain quietly at home. They might even enjoy a bit of intimacy.
Indeed, a doctor’s manual from the 16th century, which Professor ekirch unearthed, recommends that the best time for sex is after the first sleep, when you are likely to ‘have more enjoyment’ and ‘do it better’. Professor ekirch published his findings 15 years ago, but I first came across his ideas recently while doing research for the TV programme The Victorian slum.
I soon realised that, not only was he describing what I do, but this was once seen as entirely natural. It was such a relief.
so why isn’t sleeping like this still seen as the norm?
Professor ekirch thinks that the pressures of the industrial age and the arrival of electric lights in the early 20th century meant people no longer went to bed soon after dark.
That meant they had no time for socialising in the middle of the night (though some huntergatherer societies still do this).
Instead, the idea of a ‘first’ and ‘second’ sleep faded from public consciousness and sleeping continuously became the standard practice.
Two sleeps may be better than one
FURTHER evidence that this form of biphasic sleeping might be more ‘natural’ comes from earlier studies by Thomas Wehr, a sleep researcher at the National Institute of Mental Health in the U.s.
In one study, he put eight healthy young men into rooms where they were exposed to light for ten hours a day and left in the dark for 14 hours each night.
This was to mimic the pattern of light and dark you might experience in early winter without artificial light.
The men fell into a pattern where they would get four hours’ sleep, followed by a couple of hours of quiet wakefulness, followed by another four or five hours of sleep. While asleep, the men wore electrodes so that the scientists could examine their brain activity.
The volunteers’ ‘first sleep’ consisted largely of deep sleep, when your brain is busy doing such things as moving memories from short-term into long-term storage. This creates more shortterm memory space for the following day.
If you don’t get adequate deep sleep, this will have a significant impact on your memory. (Interestingly, studies show that students who cut down on sleep and try to do lots of last-minute cramming do worse in exams.)
When the volunteers went into their second sleep, it was usually lighter than the first, with less deep sleep and much more REM, or rapid eye movement, sleep. This is the phase in your sleep cycle when most of your muscles — apart from the eye muscles — are paralysed.
REM sleep is important as it’s the only time that a stressrelated chemical in your brain, noradrenaline, is switched off. It allows us to remain calm while our brain processes the experiences of the day, helping us to come to terms with emotional events that have occurred.
If you don’t get enough REM sleep, your brain won’t have had time to process your emotions — which could explain why being sleep-deprived leaves us feeling stressed and anxious. What was
striking about this particular study was not just that the volunteers slept in a biphasic pattern, but that they slept much longer than normal — nearly nine hours a night.
This could be because they had little else to do, or it could be a sign they were chronically sleepdeprived. I suspect the latter. Though research suggests that adults should be getting at least seven to eight hours of sleep a night, most people aren’t getting anything like this.
A study by the Sleep Council found 70 per cent of British adults reported getting seven or fewer hours of sleep a night. Getting enough sleep matters because, as well as memory and emotions, sleep deprivation has a devastating effect on blood sugar control. Studies have shown that people who consistently sleep for less than seven hours a night double their risk of developing type 2 diabetes and, if they sleep less than five hours a night, the risk goes up five-fold.
Give the spoon test a go
So how can you tell if you’re getting enough sleep? I recommend trying the Sleep onset Latency Test. The version I’m about to describe sounds absurd, but it was developed by a famous sleep researcher called Nathaniel Kleitman, from the University of Chicago, and is based on solid science. You lie down in a quiet, darkened room in the early afternoon (note, this is a daytime test) clutching a spoon, which you hold over the edge of the bed. You put a metal tray on the floor by your bed, check the time, then close your eyes. The question is: do you fall asleep and, if so, how soon after you lie down? The idea is that, when you fall asleep, the spoon will drop from your senseless fingers and hit the tray with a clang, waking you up. You immediately check your watch to see how much time has passed. According to Professor Kleitman, if you fall asleep within five minutes of closing your eyes, then you are severely sleep-deprived. If it’s within ten minutes, this is ‘troublesome’; anything longer than 15 minutes is fine. You may find it surprising that falling asleep rapidly is such a bad sign. Yet it correlates with self-reported daytime sleepiness. In lab studies where people are severely sleep-deprived, researchers find that they often fall asleep in less than a minute when given the chance. Even at night, if you drift off as soon as your head hits the pillow, it’s a strong indicator you are not getting enough sleep. The first time I tried the spoon test, I was out in less than five minutes. however, with this test, there’s always the danger that, when the spoon falls, it misses the tray — so I prefer a simpler version, where I set an alarm for 15 minutes, close my eyes, then see if I fall asleep before the alarm goes off. This almost invariably used to happen, confirming what I already knew: that my way of sleeping, where I would lie awake and worry, had plenty of room for improvement. Since finding out about biphasic sleeping six months ago, my solution to my ‘chronic insomnia’ — or rather, my old-fashioned sleeping patterns — has been to accept that my body wants to sleep that way. Rather than fight it, I go with the flow. I accept that I will probably wake up at 3am, and plan accordingly.
If I know I am going to get up at 7am, I make sure I’m in bed by 10.30pm, which allows me a block of four hours for my ‘first’ sleep, followed by about an hour of wakefulness and then a further three or so hours of ‘second’ sleep.
when I wake naturally at 3am, rather than lie there fretting, I get up quietly (my wife sleeps soundly, so I don’t disturb her).
I go downstairs, have a glass of milk (which contains tryptophan, a sleep-inducing amino acid), listen to music, meditate or read a book.
when I start feeling sleepy — normally within an hour — I go back to bed and soon fall asleep.
A word of warning, though. Don’t be tempted to use this time in the middle of the night to watch television or check your emails because the blue light that screens typically emit will almost certainly interfere with your body’s production of melatonin, making you feel more awake.
Since I’ve embraced sleeping biphasically (rather than just ‘badly’), I’ve felt much less drained during the day and am much less likely to fall asleep in the cinema, for example, or watching a play.
And the sleep latency test confirms that I am no longer chronically sleep-deprived.
Though I’m sleeping about the same overall number of hours as before, when I fretted, the quality is much better.
In the past, I would drift in and out of sleep for the second half of the night, but now, my sleep is much less restless.
The only real downside to my new approach is that I sometimes embarrass my children by wandering downstairs in my pyjamas while they and their friends (who have not yet gone to bed) are settling down to play computer games.
I’ve also discovered that there are lots of others who do this as a way of life. Some take biphasic sleeping to a whole new level. I’ve come across stories on the internet of people who wander round town taking photos at 3am or do yoga in the middle of the night with other biphasic friends.
I like to think that, just as I came across the benefits of intermittent fasting a few years ago (and, in the process, invented the 5:2 diet), I have stumbled upon the benefits of intermittent sleeping.
Perhaps I should call it 4:3 sleeping, to denote the fact you have four hours of deep sleep, followed by a pause, followed by three hours or so of lighter sleep.
It may be more natural but, at the moment, I don’t have any evidence that it’s better for you than getting a good burst of continuous sleep.
I am sure, however, that it is better than relying on sleeping pills or lying there worrying about not being able to get to sleep.