My brain flickered into consciousness and, a moment later, a tiny lift in my chest made itself known. Glee. A simple but palpable joy on waking. I bounded out of bed, looking forward to the day. Then a sudden jolt had me standing, motionless, gazing across the room in wonder. I’m looking forward to my day! I’m looking forward to my day? Bloody hell! A slow grin squeezed my cheeks as energy zipped around my body and, refusing to be contained, had me gyrating my hips and arms in sync, dancing, naked, around my bedroom, wondering whether I’d care – or stop – if either of my teenage children walked in. I’m looking forward to my day! I’m looking forward to my day! Whaaaaa-hoo!
It was, in fact, an ordinary day. I was getting the train to work, sitting in an office, then coming home again. But my energy! I could feel it pulsing through me and my body tingled with vitality. Later, at my desk, my concentration was focused, the words I was reading hanging together. Walking around the building, my torso stood tall. In conversations, my brain and mouth played ball. None of which had been the case all on the same day for a long, long time.
The best part of this energised, vivacious me, however, was the absence of any niggling doubt. No background anxiety that I’d never feel like this again: that this was a one-off; that this was how everybody, except me, got to feel most of the time; that this being part of the human race again would be zapped away tomorrow.
No, this joyous life force, this jubilant exuberance for merely existing, was a part of me, propelling me into each moment. And, fabulously, amazingly, miraculously, I knew how to get it. After 20 years of not knowing and desperately trying, hoping, longing, and oh, so-wretchedly failing, I now knew how to sleep.
Sleep. The elixir of life. Something most people take for granted. Like oxygen. Or a skeleton. Or the sunrise. “I’m tired,” people say. And I resist the temptation to give them my life story. Or, at least, my night-time story of the past two decades.
It began when I was expecting my first child. “Pregnancy insomnia,” Google told me, “is common in the third trimester.” The discomfort of a distended stomach, added pressure on the bladder and heartburn were the reasonable-sounding causes – and I certainly experienced all those symptoms in the day. But at night, I would easily drop off to sleep only to wake, suddenly and completely, assuming it was morning. But it wasn’t. It was 4am. Or thereabouts. I was not uncomfortable and didn’t need to pee. I was, simply, maddeningly, wide awake and hyper alert.
The first few times, I heaved my body on to its side next to my peacefully sleeping husband and told myself that at least I was resting. Little nagging thoughts passed the time. Should I really have bought that tiny orange baby dress? Is the receipt in my purse? Heeding online advice, I bought a special pillow to wedge under my belly, reduced fluid intake in the evening and chewed dried papaya. Still I woke.
Ping! 4am. Sometimes it was 3am. Or 2am. I stared at the red neon numbers, blood crawling beneath my skin. Slumping back down, my wide open eyes fell on faint shadows on the blank ceiling. Why? Why can’t I sleep?
It was a pattern that continued after my daughter was born – and four years later my son – only now, getting up through the night to feed or soothe my young children was part of the sleeplessness cocktail. Sometimes I shouted “go away” at my young daughter, as the door clicked open, waking me from precious sleep. Then I’d lie in the dark, my back, neck and head wracked with tension, tortuous thoughts circling. “What’s happening to me? Why do I find life so difficult? My poor kids. I wish they had a better mother. I hate my life. I need to get away. Maybe I’ve gone mad?” There was no going back to sleep for several hours or, more often, the rest of the night.
The days passed in a treacle of fatigue, the armchair in the corner of the kitchen beckoning. In spare moments, I’d sink into it, relief washing over my tightened limbs. Some days I’d retreat to bed with a self-help or parenting book as soon as my husband got home around 6pm, understanding words and my duvet providing comfort and hope. Other days I’d long for the children’s bedtime so mine could follow. Turning the light off anything later than 10pm made me nervous. 8.30pm was not unusual. My social life narrowed to the few friends who consented to the increasingly specific parameters I had for going out: not too late, not too far, not too long, not the night before I had something important happening, not the night of something important happening. Getting to bed early and conserving my energy were my overarching priorities. Meanwhile, my husband, stretched in his job as an assistant head in a secondary comprehensive school, was becoming increasingly distant, another source of anxiety for my bewildered mind. Indecision had become as normal as fatigue and it was only once my son started school that I managed to summon the wherewithal to search in earnest for an explanation and treatment.
I found no shortage of either: it was my circadian rhythms, my digestive tract, lung activity, hormones, vitamin deficiency, ancestral shadows, the direction my bed faced, karmic activity, the colour of my curtains. I explored it all, taking whatever alternative remedies I could get my hands on, from common or garden Nytol to ordering melatonin from the US. I saw a sleep therapist, and a homoeopath, had acupuncture, cranial osteopathy, learned to meditate, studied Buddhism, tried hypnosis, rubbed balm into my temples, drank camomile tea, had lavender baths, tapped parts of my body, listened to whales, burned candles, opened the window, shut the window, changed my duvet, and my pillow, put a healing stone next to my bed, barely consumed alcohol, never caffeine, stopped my water intake at 6pm, ate lettuce…
The burst of optimism that accompanied each new fix may or may not have been responsible for the minuscule and short-term relief each one brought. Hurray, I’d slept until 4.30am. Or even 4.40am. Very occasionally 5.30am. But after two or three nights of progress, a 2am waking followed, as night follows day. I dreaded going to bed, would see each foot place itself ahead of me as I ascended the stairs, a slight churn in my stomach.
The history and brutal treatment of anxiety and mental health issues on the female side of my lineage hung over me, informing two key decisions: I never used the word insomniac about myself and I was not going to take drugs. My grandmother had been diagnosed with postnatal depression in the 1940s and given electric shock treatment, which she hated and was terrified of. Her doctor told her she was “unfit to be a mother” and two of her children were sent to an orphanage. A generation later, my mother was diagnosed with manic depression and given lithium – the poison in batteries – and told she’d have to be on it for the rest of her life. Thirty years later, digestive problems led to a chain of operations in her stomach, kidneys and bowel. Then there was the doctor who, back when I was born, told her with, as I have always imagined, a wagging finger and stern expression: “You must get your sleep.” I was brought home from hospital and put in a room furthest from hers so my cries didn’t wake her. And most mornings, as I was growing up, she would ask, in a slightly urgent tone: “How did you sleep?” We tiptoed around the house in the afternoons so as not to disturb her nap. Pills rattled on the kitchen table at breakfast.
A generation later, the world of self-help offered an alternative to the “mad woman who needs to be subdued with drugs” narrative that has wreaked havoc with so many women’s lives. Immersing myself in books and courses, the next 10 years took me on a long, deep journey of self-discovery. My past unravelled and so, to my immense regret, did my marriage. I learned how to handle my state, no matter how tired, desperate, furious, or despondent I felt. When I woke in the night, I now knew how to tune into my anxiety and to distinguish between the fears in my head and the feelings in my body. I had learned how to calm myself, but not how to sleep. My discoveries did help me hold down my part-time job on a national newspaper, though I sat, as hidden as possible, in a corner of the office, lest someone spot my head jerking suddenly, as it did on the handful of occasions I nodded off at my desk. And I raised two beautiful, caring, gifted and hard-working children. I took up exercise, something I hadn’t managed to maintain when the children were little, but which had been a big part of my younger life. I had a sports degree but it was only now that I saw how integral to my spirit cycling the Sussex hills, joining the park run or swimming in the sea were. My life turned around, slowly but surely. I saw friends, travelled, ran a half marathon, fell in love. But still I didn’t sleep. Now, my 4am brain buzzed with excitement. Venetian architecture, a joke with my daughter, my lover’s hands fuelled my wakeful brain at night with delight instead of fear.
One Saturday afternoon in December last year, on the phone to my sister, I mentioned feeling irritated that I didn’t have the energy to go Christmas shopping. “It’s not surprising when you sleep so little,” she replied. I realised both how much I had learned to cope on a few hours a night and that I’d stopped expecting to find a solution. Opening my iPad, I Googled “sleep cure” and scrolled through the first page of familiar remedies and scary sleep “disorder” sites linking insomnia with mental breakdown, migraine and loneliness. On the second page, the phrase “for those for whom nothing ever works”, under a book entitled The Effortless Sleep Method, caught my eye. The details described a guide to “rediscovering your innate ability to sleep without pills, potions or external sleep aids.”
A few days later, the backstory of its British author, Sasha Stephens, had me engrossed. Its tragicomic misery was soberingly familiar. Sasha was not a medic who had studied sleep problems, but a “chronic insomniac” who, after 15 years, found her own solution – and now slept for eight or nine hours. Every night. Sleep, she says, is natural and normal and we can all do it. We just have to learn how.
I spent the Christmas holidays following her 12-point plan, getting up at the same time every morning, as well as writing and reciting affirmations to “tell a positive story of sleep”. My favourite affirmation was: my body knows how to sleep. Having already burrowed deep into my mind, I knew the power of changing habitual thoughts and the determination it takes to do that. It meant my mind – with the multifarious ways its insidious drive for control insinuates itself – didn’t need to get involved. And when it tried, as it surely would, did and does, I now knew to ignore it.
By far the toughest task was getting out of bed when I woke in the night. Your body must learn, says Sasha, that bed is for sleep or sex only. If you lie awake for more than around 20 minutes – which you must guess at, because not looking at a clock is one of the 12 points – you get up and do something calming. She suggests cleaning. I huddled on the floor and wrote affirmations.
I didn’t make it to a night’s sleep in the month she said it would take. In fact, it took me three to get a single seven-hour night, but the blissful, unfettered awakeness that followed that full night’s sleep was encouraging and so, after that, I upgraded to Sasha’s online course, sleepforlife.com. On I ploughed, blindly optimistic that her premise – that sleep is a normal, natural activity that our bodies know how to do – would prove correct.
Short nights continued. I would get up at 6am, my fixed getting-up time, after just a few hours of sleep, and sit on my bedroom floor, my body tender to touch and my head, cloudy with fatigue, telling me that none of this was working and that I really must be careful not to do too much today. I should take it easy and get to bed early. I listened to Sasha instead. After a bad night, she says, I must do more in the day, go for a longer run, see more people. Her advice defied all the messages clogging my furred-up brain. But I trusted her. She had also taken a cautious, energy- saving approach during her own insomnia before a bout of unprecedented exercise during a boot-camp style holiday revealed to her the key to sleep: she had to stop obsessing about getting enough sleep and spend a part of every day doing physical activity.
In my own switch from a tendency towards caution to a seize-the-day mentality, I immediately felt a lift, a murmur of excitement, the stirrings of vitality. I pulled on shorts, did up my trainers and stepped out into the day, running along the seafront, into the light, powering my system with fresh air, toughening my bones with impact… and tiring my body in preparation for sleep that night. The daytime is for activities, for challenges, night-time is for sleep: this was what I was teaching my body. With more blind optimism.
One particularly groggy morning, my limbs throbbed more than usual, my skin winced when my fingers brushed it and my throat and glands raged. The toughness of Sasha’s programme, designed to be followed for a single month, was taking its toll after five. Daring myself to relax the rules, I stopped getting up in the night when I woke, cut exercising to five times a week and, at weekends, set my alarm an hour later, to 7am. And I listened over and over to Sasha’s finely tuned mind exercises, using them in the early hours when my thoughts were free-wheeling… The freezer is clogged with ice, I need to hire a car, take the contents to my mum’s, then bring it back the next day. Have to write myself a note…
The memory of my dad, a working-class boy who became a philosopher, saying, with a glint in his eye, “I’m paid to think”, was not lost of me… Is thinking an indulgence? A middle-class one? Einstein wouldn’t have said so. But then he was a man. So he got to think about interesting things. Women still do most of the thinking about domestics…
Damn. I’m lost in thoughts again. A slight tension in my neck. I remember that that’s OK. “Allow it,” Sasha’s voice now. “Feel it.” Muscles all over my body relaxed. Focus the attention, Sasha says, on the body, not a specific part of it but the body as a whole, the energy of it just inside. A moment later, a faint rushing. The movement of my blood. It was carrying me. I sank a little deeper into the mattress.
The seven-hour nights became more frequent – once or twice a week. But when one morning, in the sixth month, I woke knowing I had been awake earlier in the night and had therefore drifted back to sleep, I knew things were really shifting. The waking was ceasing to become so abrupt and absolute and one Sunday morning, after sleeping a solid seven hours, I spent another two dozing – a deliriously happy twilight state in which I was both aware of and yet fully immersed in a deliciously relaxed slumber.
By now I have had had a few email exchanges with Sasha but I wanted to meet her, see her in the flesh, ask her things. How could I get seven or even eight-hour nights, all the time? Should I go back to getting up in the middle of the night? Exercise more? And I wanted to look her in the eye and ask if she really slept for eight to nine hours a night. By some quirk of fate it transpired we lived in the same town, so one day she came to my house. Opening my front door, it was all I could do not to hug and kiss this diminutive woman I’d never met before, but who had held my hand through dark nights for 11 months.
“When I got to your stage of having a whole night’s sleep several times,” Sasha told me, “I did just one thing. I paid absolutely no attention to ‘it’ whatsoever. I pretended it wasn’t there. I decided I’m not going to give up another second of my life to this ridiculous problem. You are still paying too much attention to it just by having this conversation with me. You’re already better.”
I knew the truth of what she was saying. It had been my mind all along that had prevented me from sleeping. Which means it’s within my grasp to do something about it. But tackling that incredibly complex piece of wiring and its capacity to evade reason was no small task.
She explained: “The body has a self-righting mechanism, which will come out when the circumstances are right – mainly when you stop thinking about sleep, because sleeping is not something you have to do, it’s something that happens naturally. If, today, you forgot you ever had a sleep problem you’d sleep for eight hours a night for the rest of your life. More than anything, tell a positive story of sleep. Fake it until you make it.”
I had evidence that she was right. I had slept on enough nights to know both that I could and that I would sleep the whole night through. Those were the thoughts and memories I would fill my head with.
I wasn’t finished with Stephens yet. “Do you ever relapse?” I asked her. “No,” she replied immediately. “I did for quite a long time afterwards. But now, this year, I haven’t had a bad night once.” What about a run of bad nights? She looked up, thinking. “It hasn’t happened for years now.”
I had one last nagging doubt to clear. I told her about my low-grade, constant anxiety.
“That’s probably the case for the majority of the western world,” she replied. “It’s certainly true for me and I would say that that’s a separate issue to sleep itself. I still get stressed, but it doesn’t interfere with my sleep. My bed is my happy place where I let everything else go.”
The relief that I didn’t need to fix any lingering patterns of anxiety in order to sleep was immense. And her assertion that “it’s bright, high-energy, over-thinker-type people” who were more likely to struggle was another nail in the “mad-woman” hypothesis coffin.
I thanked her and said goodbye, marvelling that she’d drunk coffee during her visit in the afternoon. And, as I made dinner that evening, I chuckled, imagining Sasha’s reaction if I’d told her that someone once told me my red-check duvet cover was the problem. Those deep strong colours hovered in my mind now. I saw them adorning my bed, inviting me, making that corner of my bedroom, beneath a sloping ceiling, into a sanctuary, a place of peace, the haven I would curl into each night, that would pull me into a deep, restorative, blissful unconsciousness.
A month later, I continue to wake gently, gradually, most mornings, and if it’s early I usually drift back to sleep. When worrying thoughts begin, I welcome them. As Jalaluddin Rumi says in his poem The Guest House: I “meet them at the door laughing and invite them in”. Mostly. And, during the day, I dance as if nobody is watching.
Sleep crisis or business opportunity? Neil Tweedie reports
Donald Trump says he gets four. Margaret Thatcher, on the other hand, managed with just three. Two solid arguments, then, for getting enough hours of proper sleep – somewhere between six and eight for we mere mortals, according to experts in the burgeoning field that is sleep science.
And not just a science. Sleep is big business, worth some £30bn globally and growing consistently by 8% a year, say the management consultants McKinsey. Deluxe mattress makers, herbal remedy concoctors, manufacturers of electronic sleep trackers, writers of self-help books, all are cashing in on our seeming inability to close our eyes and fall effortlessly into the embrace of Hypnos.
The South Koreans, who have turned insomnia into a national art form, have a term for the massive commercial edifice built on the simple goal of attaining nightly oblivion: sleeponomics.
We are suffering a sleep crisis, according to this booming industry, drained by overlong working hours, assailed by ubiquitous communications invading the supposed sanctuary of home and, when we finally fall exhausted into the sack, tortured by racing minds, victims of chronic job insecurity and the ridiculous demands of dumb macho management still buzzing around in our heads at 1am.
Think-tank Rand Europe claimed in 2016 that sleeplessness was costing Britain 200,000 lost working days and £40bn a year – 1.86% of GDP and not far short of the then defence budget. This calculation assumes that endemic sleep deprivation translates directly into absenteeism and reduced productivity. It is also said to kill people: Rand cited research showing that adults sleeping fewer than six hours per night were 13% more likely to die early than those getting seven to nine hours. The World Health Organisation thinks seven is the minimum for a good night’s sleep, but the average in Britain is just 6.49 hours, according to the National Sleep Foundation, which campaigns for the Great British kip.
“We are in a sleeplessness epidemic,” claims Dr Guy Meadows, co-founder and clinical director of the Sleep School, which runs a chain of insomnia clinics. “Tiredness,” he asserts, “is the new norm.”
Colin Espie is not so sure. Professor of sleep medicine at Oxford University’s Nuffield Department of Clinical Neuroscience, he argues that sleep deprivation is nothing new. “The idea that challenges with sleep are a modern phenomenon is manifestly ridiculous,” he says. “People have had much more stressful lives historically than they have in the modern west. Life for people in the past, faced with a lack of clean water and food, was stressful. Electric light, international flight and travel between time zones… these can add additional pressure to some extent. Light from your phone may theoretically have a sleep delaying effect, but not really an effect on insomnia. Light effect in labs relates to a small number of minutes, a bit of a difference but not terribly important. These things are not important triggers to insomnia.”
This has not stopped the inhabitants of South Korea, home of Samsung, seeking electronic solutions to their nocturnal malaise. South Koreans sleep 40 minutes less than the global average, according to the OECD and, in 2015, 721,000 of them were suffering sleep disorders, up from 325,000 in 2011. Cue an industry for sleep-related goods and services worth £1.4bn.
Infinitely adjustable “motion beds”, black-out curtains, memory-form pillows, soothing facial sprays, heated eye masks, smart bands supposedly measuring one’s biorhythmic state, this most industrious of nations deploys no end of gizmos to attain that most natural of states. There are sleep pods, also, situated in business districts, providing office workers with a place to cat-nap.
“Tracking devices claim to model the architecture of sleep, but they are not medical devices,” says Espie. “There is very little evidence in medical literature on the veracity of their makers’ claims.”
Sleep deprivation, he explains, falls into two categories: lack of sleep caused by lack of opportunity – simply too much to do in waking hours; and the inability to sleep when the opportunity arises. Tossing and turning in bed, to put it another way. About one in five adults is estimated to suffer from chronic sleeplessness at some stage of their lives.
“Over the past three decades we have come to understand the fundamental importance of sleep,” he says. “Mental and emotional state, metabolic function, all depend on sleep patterns. Chronically mis-timed sleep – people constantly fighting the clock over long periods – we know to be damaging. For example, there is a greater risk of cancer in airline aircrew crossing time zones, and in night shift workers.”
Instability in the circadian rhythm, the 24-hour body cycle, is known to impair signalling in the immune system, making sleep-deprived people more vulnerable to illness. This daily process is observable even in a single cell. Impaired judgement, anxiety, depression, hypertension, diabetes, all are associated with chronic sleep disorders. If you have had difficulty sleeping on three or more nights per week for at least three months and your difficulty sleeping is troubling you, you may be suffering from insomnia disorder.
“In a sense, sleep is the preferred state of the brain,” argues Espie. “The brain does some of its most important work during sleep: repairing, regulating, laying down memory and managing growth. Sleep is a varied and productive time. Saying that you do not need sleep is like saying you do not need clean air, water and nutrition.”
Treatment for sleep disorders has been dominated by medication, some 12m prescriptions for insomnia being written each year. But sleeping pills carry the risk of side-effects. Espie has helped devise the Sleepio app, available via the NHS, which guides users through a programme of cognitive behavioural therapy, helping them overcome “racing mind” and other pitfalls.
“Think of insomnia as a kind of sleep preoccupation syndrome,” says Espie, who warns that tracking devices may do the opposite of good. “People get caught up in monitoring: ‘Am I asleep? What time is it?’ This turning of something meant to happen automatically into an issue can result in a vicious cycle. A good sleeper is oblivious to all of this, has no skills and sleeps quite naturally.
“Compare sleeping to breathing: your first preoccupation when learning to scuba dive is ‘How do I breathe underwater?’ Well, you breathe just like you do when you are not diving. Overthinking the issue results in it becoming problematic.”
People need different amounts of sleep – just as they vary in height, weight and shoe size. Adults require between six and eight hours generally, with a slight tapering off in the need for sleep as one enters old age. Sleepio aims to teach you how much sleep you as an individual require, and how to establish a healthy sleep pattern with techniques like thought-blocking, which helps banish recurring anxious thoughts.
The modern world makes a fetish out of measurement but attempts to understand the still-mysterious world of sleep can result in the opposite of what is desired. Dr Sabra Abbott, a professor of neurology and sleep medicine at Northwestern Memorial Hospital in the United States, says a new breed of patient has started seeking her help.
“Their primary concern was that their tracker was telling them they weren’t getting the right amount or right type of sleep,” she explained. “It seems that the device was creating a sleep problem that may not have otherwise been there.”