Updated: Nov 28, 2019
"What is it you're worrying about when you're lying awake at night?"
"Have you tried lavender?"
"Have you tried just not thinking about it?"
"Doesn't your meditation help?"
Just a few of the comments I've faced when I tell anyone I have insomnia. Whilst I appreciate it comes from a good place and most people are trying to be genuinely helpful, the lack of insight and awareness, like any misunderstood psychological issue, is the source of a lot of frustration for the suffering.
So what is insomnia?
Insomnia can be defined as:
"difficulty falling asleep or staying asleep, even when a person has the chance to do so."
Symptoms according to health professionals can include: " fatigue, low energy, difficulty concentrating, mood disturbances, and decreased performance in work or at school", which in layman's terms, translates as: "very tired, a bit moody and scatty".
And herein lies the problem. So I'm here to give you the reality from someone who has walked the well-trodden path. I'm going to be pulling back the curtain on symptoms, busting dangerously pervasive myths about how to 'fix' sleep, and tracking my progress on the road to recovery.
Low immunity leading to being a semi-permanent snot-rag with a few throat infections thrown in as a Brucey Bonus
Constipation - I won't elaborate
Hormone imbalances leading to tits from hell and the skin of a grease-slicked newly pubescent teenager (I'm 30)
Swollen painful glands in the neck
Memory of a goldfish (if it ain't in the calendar, it doesn't exist)
Irritability equal to that of Ursula the Sea Witch or Miss Trunchbull
Preferring the thought of having Trump, Putin and Boris Johnson's 3 way love-child as the next Prime Minister to the thought of having to expend enough energy to actually have sex
Anxiety and depression with no obvious trigger other than the sleep deprivation
Social isolation - giving up on making plans to do anything because you're never sure whether you're going to feel well enough, and every time you cancel you feel like a let-down
But it's not all negative, the time spent awake, although not preferable, doesn't half allow you to get a lot of planning and organising done, and in fact, some of my best creative business ideas have come to me in the wide-eyed hours at 3am.
Why am I telling you all of this?
I have been suffering for around 18 months now, which is nowhere near as long as some of the chronic sufferers I have met in person or read about online...but it's long enough and I don't want anyone to suffer any longer than necessary if they don't have to.
It's important that I begin this section with a caveat: EVERYONE IS DIFFERENT.
Unfortunately finding a cure for insomnia is a case of trial and error. I will give a brief account of my journey here but you will need to find what works for you, as frustrating as that may be to hear. The best advice I can give is to do as much research as possible so that you're armed with the information to try as many things as you need to until you find what works.
Unsurprisingly, the trigger for my unwanted wakefulness is usually stress, predictably. I had a very brief account with this back in 2013 when I was working as a secondary school teacher and living with my husband at the time who was suffering with his own mental health issues. Fast-forward to summer 2018 and the cause was, on this occasion, very physical. I suffer hayfever pretty extremely and managed to catch a summer cold on top which left me with a nasty sinus infection.
Cue steroids; absolute magic for clearing infection and inflammation but blimey...I went from rag-doll to Duracell Bunny in an extreme fashion. 2 hours sleep per night. Not ideal. The sinuses cleared, the medication stopped, but the sleepless nights didn't... I had no idea why but by then, the damaging sleep behaviour had already established itself as a nasty habit: sleeping late in the morning to make up for lost sleep during the night, persisting with staying in bed in wakeful periods and getting more and more frustrated at simply being awake, and the worst one, thinking about it ALL DAY. I had a small amount of let-up last winter when I was averaging 6 hours per night but come May 2019, I was back down to 3-4 hours when life stresses triggered another flare up.
Here's a list of everything I tried to fix it:
Not drinking any fluids after 8pm
Switching my phone off at 9pm
Investing in black-out blinds AND curtains
Making sure the heating is switched off at 10pm
Exercising to the extreme to try and 'tire myself out'
Getting at least 10 minutes of direct daylight every day
Cutting out caffeine
Cutting out alcohol
Taking Amitriptyline (they may as well have given me sugar pills)
Smothering lavender all over myself and my house
Taking hot baths before bed
Eating 'sleep foods' like nuts and anything else the internet suggested
Writing down my worries before bed
You get the idea...
Now please don't misunderstand me here. I dare say that without putting some of these measures in place my situation may have been a lot worse and in fact, I'll need to continue doing a lot of these things to maintain my sleep health. However, unfortunately when not sleeping becomes a deeply ingrained habit, they're just not enough.
The Wake-up Call
So what sparked the research mission and what's the magic formula? Around a week ago now, I slept for 1 hour. Not the first time it's happened but I spent a good majority of that night downstairs crying and beginning to feel really quite hopeless. I was sick and tired of allowing this condition to rule my life. I cried my tears, dried my eyes and made a decision. No more.
I didn't believe medication was the answer. I'd discussed the possibility of trying benzodiazapines with my GP and my family and there were just so many reasons why it wasn't a good idea for me:
The morning fog - I have to drive most mornings and operating any machinery under the influence of these drugs is strongly discouraged
Sleep Fallacy - Sleeping pills don't actually make you sleep in the purest sense of the word. They sedate you and you achieve a kind of zombified rest
Addiction - This type of drug is addictive. You can't just stop it whenever you like due to withdrawal and you may struggle to come off them altogether.
Logic - Something has always told me that if it's behavioural or psychological and NOT linked to a chemical or hormonal imbalance, you can be 'retrained'.
And so the search began and I remembered doing this same research last year and coming up with what I knew in my gut was the answer: CBT-I: Cognitive Behavioural Therapy for Insomnia. So why didn't I just do it last year? One word: unavailability. This is a widely researched and evidenced treatment in the US, but there has been very little research or publication on the treatment by comparison in the UK. When I asked my GP for a referral last year, they hadn't even heard of it. This was infuriating. I begged to be referred to a sleep clinic but the only one anywhere near wasn't under the NHS Trust in my area, so I was told the CCG wouldn't fund it. I knew exactly what I needed, but I was being told I couldn't have it. Hence pretty much 'giving up' on all hope until breaking point a week-or-so ago.
The Light at the End of the Tunnel
And then I found it. Sleepstation. Before I get into the nitty-gritty of this fantastic resource, I'll just close my not-quite-finished rant. Again, this is something that my friend Hannah had suggested I look into last summer. There was one problem, I had to pay for it (or so I thought), and I couldn't afford it. Fast-forward to this year and according to Sleepstation's now updated website, NHS GPs have been able to refer into this service since 2012, but my GP didn't even know... How many other GPs are unaware and how many patients that don't need medicating are being prescribed medications unnecessarily?
Anyway, rant over.
What is Sleepstation?
" Sleepstation is a drug-free and clinically validated sleep improvement programme. Delivered entirely online and carefully tailored to each individual, Sleepstation helps people identify the underlying causes of their sleep problem and provides the support and guidance needed to improve sleep. Clinically proven to combat even the most severe insomnia, the personalised support is what makes Sleepstation so effective. Our team of coaches and sleep experts will support and guide you on your journey to better sleep."
This programme delivers 2 key treatments: Sleep Restriction Therapy (SRT) and Stimulation Control Therapy (SCT). SRT works by asking you to initially reduce your time in bed to 30 minutes longer than the time you spend asleep on average. So if you sleep on average for 6 hours per night, you would stay in bed for 6.5 hours. However, time in bed should never be reduced to less than 5.5 hours as this is considered 'dangerous' (which did surprise me given I'm currently surviving on 3!). The idea is that this builds up 'sleep pressure', sending your brain a signal that your body only has a short window in which to sleep. SCT works by conditioning your brain into associating bed with restful sleep again. You have 20 minutes in which to fall asleep, if you don't, you get out of bed, sit quietly in low lighting and participate in a sedentary activity for a further 20 minutes (say reading). After this time period you return to bed and repeat the process until you fall asleep. The idea is that by staying in bed when you're awake, your brain learns to associate bed with wakefulness; this breaks the connection.
My First Encounter
I tried this for one night and it was hell on earth. Feeling like I was on a ticking timer to fall asleep within a 20 minute window put my sleep anxiety through the roof and I was less than pleasant to be around the following morning. However, the following night, I fell asleep within 2 minutes and STAYED ASLEEP FOR 6 HOURS. I couldn't remember the last time I hadn't got up to have a wee at 4am and then lie awake until the alarm went off at 7am. I didn't even think that was possible anymore, I had just resigned myself to being a 'poor sleeper'.
Unfortunately I had to stop because I started with a raging head cold. Also, by this point I had requested a referral from my GP and figured it was probably a little extreme to be doing this alone, without any professional support.
Today, I received the first glimpse of real hope; a text message from Sleepstation
"Hi, we've received your referral from your GP. To get started just login here"
And so my journey begins. I'll be blogging weekly about my progress, reviewing the service and hopefully providing hope to anyone in a similar situation. Until the next time, sleep well.
#health #insomnia #insomniac #nosleep #mentalhealthmatters #mentalhealth #depression #anxiety #treatment #sleeplessnights #struggles #shattered #knackered #recovery #cbt #cognitivebehaviouraltherapy #therapy #sleeptherapy #sleepstation #hope #dontgiveup