Here's how to manage your anxiety and finally get a decent night's kip, with help from a seasoned insomniac. Photo / 123RF
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For those of us who have trouble sleeping, the past month has brought two new scientific studies to keep us awake at night. First, there was a paper presented at the European Society of Cardiology sharing the news that seven in 10 heart attacks or strokes experienced by those over 50 could be prevented if everyone got "a decent night's sleep". The best scores in cardiac health were achieved by those who slept seven or eight hours a night.
This only twisted a knife that had been plunged in three days earlier by a study from the University of California, Berkeley. Its research showed that losing just one hour's sleep a night could dampen down the part of the brain that encourages social behaviour, making us more selfish and irritable.
"We discovered that sleep loss acts as a trigger for asocial behaviour, reducing innate desire of humans to help one another," says Professor Matthew Walker, co-author of the study, and largely seen as the world's leading sleep guru.
It's not surprising that we're feeling grumpy and distracted. Now we can't even look at the news without yet another expert telling us how we are racing to an early grave – as well as compounding what failures we are – because we can't even perform this basic, primeval function.
We are, it seems, suffering from "sleep guilt".
Study after study claims that, unless we reach the "magic number" of eight hours (or, in the more generous academic papers, seven) we're in for heart problems, weight gain, type 2 diabetes and dementia. One particularly terrifying 2018 paper claimed that just one night's missed sleep raised the risk of Alzheimer's by increasing the level of a certain protein in the brain.
According to research published last month by Nuffield Health, 74 per cent of British adults have reported a decline in quality sleep over the past 12 months. Of those, one in 10 poor souls are only getting two to four hours of sleep per night.
The number of people experiencing insomnia has risen to one in four since the pandemic: Google searches for "insomnia" have soared, the majority around 3am. There's an important difference between the involuntary sleeplessness of insomnia and the "self-neglectors" who eat into their sleep hours by surfing eBay or watching box sets. It's the former that's the most distressing, and self-perpetuating. But are we really sleeping less? And, crucially, is worrying about making it even worse?
As a hardcore insomniac for almost a decade in the 2010s, I can certainly testify to the hell of those "white nights", watching the clock inexorably march from midnight to 2am to 3.45 to 6am, until the first peeping of grey light under the curtains signified ultimate defeat. Adding to my exhaustion, anxiety and mounting depression, those repeated reminders of the prospect of an early death did not do wonders for my mood.
"There's a risk that these studies can be interpreted in a negative way, and that they can be counter-productive, " says behavioural psychologist, Dr Sophie Bostock. "Bear in mind that the study might not be representative of the wider population. People who answer these questionnaires often have higher rates of insomnia to begin with."
The problem is that people already suffering from insomnia can get worse if they read anything to do with sleep deprivation, says Bostock. "Their brain selectively pays more attention to information they regard as 'dangerous'," she says.
And what do we do when we feel bad? We try to solve the problem, as rapidly as possible. "If we're desperate to relieve our suffering, we convince ourselves that there might be one missing ingredient," says Bostock. "We're seeking a quick fix."
In what feels like the blink of a tired eye, sleep has become an industry. According to market researchers BCC Research, the global market for sleep aids is forecast to grow from GBP£74 billion (NZ$146b) in 2020 to £104 billion ($206b) in 2025.
During my eight years of sleeplessness, I tried sleeping pills, expensive lavender candles, gloopy magnesium sprays, hypnotherapy and weird electromagnetic pulses attached to my scalp. None of these worked, and my wallet became lighter. "Such products are well intentioned, but of questionable benefit," says Bostock. "There are few clinical trials to back them up."
At some point in the late 2010s someone bought me a sleep tracker. (The market for sleep trackers was worth £14 billion ($27.7b) last year; Amazon even launched a high-tech 'sensor only' product last week). After one night, I found this device uncomfortable, and ended up throwing it at the wall. Others, like my friend David, 60, have persevered with their sleep trackers, but find they unleash a new set of problems. "I used to sleep pretty well," he says. "But ever since I discovered I could analyse my heart-rate, body temperature and night-time movements, I find myself anxiously peering at my smartwatch every morning. It's almost as if these numbers are telling me how rested (or not) I should feel that day."
There's a scientific-sounding name for this pursuit of the perfect night's sleep: "orthosomnia". Guy Leschziner is a consultant neurologist who runs the Sleep Disorders Centre at Guy's Hospital in London. He is also the author of The Nocturnal Brain: Nightmares, Neuroscience and the Secret World of Sleep.
"For starters, sleep trackers are not accurate," he says. "They can monitor the time you have spent in bed, based on your movement. Some of the more sophisticated can tell you how long you have been asleep. But what they cannot do is tell the quality of sleep; what stage of sleep you are at, or how many times you have woken up."
Leschziner believes these devices are unhelpful because: "anything that draws attention to sleep can make it worse. This is why people fall asleep while watching TV or reading a book. They are distracted. But if you feel you have poor quality sleep, and the tracker confirms this, it will only increase your anxiety. Sleep trackers do not contribute to the treatment of insomnia. In fact, they may do significant harm."
Most sleep scientists now agree that it's the very opposite of tracking and trying that will lead to an elusive night's sleep, as is the adoption of an approach called Cognitive Behavioural Therapy for Insomnia (CBTi – see box). The primary focus is based around changing your actions or "behaviours", and thoughts (the "cognitive" bits) that perpetuate insomnia, with the end result that your natural "sleep pressure" takes over, and the cycle of wakefulness is broken.
Sophie Bostock is an evangelical proponent of CBTi. The most important thing, she believes, "is to just go about our daily lives, getting 'normally' tired, so that sleep becomes intuitive".
This "laissez-faire" approach has certainly transformed my sleep over the past few years, and hence, my life. Just earlier this week, I went to bed around 11. A minor family worry – amplified by the late-night stillness and dark – was stopping me from dropping off. The hours started to creep by. So, I turned my clock around to face the wall, and convinced myself I'd be fine with just five hours' sleep – or fewer, if it came to that. My brain accepted this compromise, and shut off.
The next morning I walked the 15 minutes to the tube, instead of taking the bus. I got through the day at work. My brain was busy. And, that night: boom – out for eight hours. Nine, actually. And all because I have taught myself not to "try". By nixing my sleep guilt, I had found my own "magic number".
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