"Insomnia - It's a claustrophobia of crawling through a tunnel of unbroken, undifferentiated time, a night time landscape that's neither sleep nor a dream" - Gayle Green from her book 'Insomniac'¹

After facing a long-term battle with insomnia; like many others out there who've had a similar experience (or a similar sleep disorder), you will know that it is much more than ‘just a bad night’s sleep’. Insomnia can affect your day to day functioning, your physical and mental wellbeing and so much more¹.

I chose to write this article for a few reasons; one being my fascination with the study of sleep, but also to bring awareness to knowing the difference between a ‘normal’ night’s sleep, feeling sleep deprived and overall, how to improve the quality of your sleep.

What is Insomnia?

According to the National Sleep Foundation³, almost a third of the population report some symptoms of insomnia during any given year. But sleep can vary for different people, for example - if it takes you 60-90 minutes to fall asleep but you're ok with this and you feel rested during the day, then you don't have a problem. On the other hand, someone who also takes 60-90 minutes to fall asleep, but finds this stress provoking and is then fatigued the next day could consider themselves to have a problem with sleep² . It just depends on how you 'see' your sleep and the quality of it.

I reference to insomnia a lot as I'm basing this on my own experience, but this article is for anyone out there who has trouble sleeping, whether it's the occasional bad night or more than that. But what is insomnia exactly? In basic terms it means having frequent trouble falling asleep at night, waking up too frequently, too early, can't go back to sleep or even if you have a reasonable number of hours, you are still not rested the next day²; i.e. 'You can't get the sleep you need to feel good, for no reason other than you can't'¹, or, one of my favourite quotes from the film Fight Club, 'You're never really asleep and you're never really awake'.


Why Is Sleep Important?

We've probably all experienced the feeling of having a sleep- deprived night, the next day we're groggy and as the day goes on we can become irritable and unfocused.² Why is this? Research tells us that we spend about one third of our lives asleep², it's essential to our survival as much as eating or drinking¹ , sleep is energizing, both physically and mentally ². So, even minor sleep deprivation over a few days can impede our ability to think clearly,⁴ it is difficult to do work efficiently and productivity can be diminished. Everyone's sleep needs can differ, but on average a person generally needs 7-8 hours a night to feel fully 'functional'².

Cohen et al (2009)⁵ suggest that those who don't get enough sleep can be more susceptible to illnesses such as the common cold, and similarly, Gayle Green (a chronic sufferer of Insomnia), in her book 'Insomniac'¹ describes the link between sleep deprivation and a lowered pain threshold. She suggests that sleep loss increases pain sensitivity and thus the increase of headaches and migraines. It is suggested, particularly with insomniacs, that sleep deprivation makes it difficult to function in the world and that insomniacs have a harder time getting jobs, performing well and holding onto jobs.¹ Insomnia can also have the tendency to overlap with other disorders, for instance, not sleeping could make you anxious which further interrupts your sleep and thus causes you to feel more anxious and irritated and so on.² A lack of sleep can affect the part of the brain that is used for things like memory, language and a sense of time, which means that when you're tired, it will spend more time trying to keep awake rather than using these functions.

"When you don't sleep, it erodes your ability to deal with things you can deal with otherwise; things you can deal with fine during the day get magnified when you can't sleep. It's not just about what happens at night, when you lose sleep; you lose the better part of yourself. Sleep is how we manage to be all there. I sleep, therefore I am." ¹

Ways To Improve Your Sleep Duration & Quality

There are hundreds of books out there on ways to improve your sleep; here I've included methods which I think are worth mentioning, but also some techniques I've used over the years that I hope will be of use too. It's about perseverance and endurance; it is not an easy task to overcome sleep loss or deprivation, particularly if you've been dealing with it over a long period of time. It may not be an easy journey, and your sleeping patterns may not change overnight (excuse the pun!) The most important thing is to learn what works for you and what doesn't.

Back to Basics

There's a lot of research and literature out there that will repeat the same techniques to help improve sleep quality. If you’ve experienced a sleep disorder such as insomnia then chances are you've already read about most of these and tried them, but they're a great starting point. So one of the most crucial tips is to get into a regular sleep cycle, this enables your body clock to get into a normal routine.

Avoid caffeine for at least a few hours before bed, this includes tea, coffee, hot chocolate and soft drinks⁷. It's also worth noting if there's anything else you eat or drink that could keep you awake; individuals can react differently to certain foods and drinks¹. For instance, some might find that a hot drink before bed can aid in sleep, whilst others might find the opposite.

Similarly, there's a lot out there on what to eat and making sure you get enough exercise. According to Peter Hauri, the writer of 'No More Sleepless Nights'⁸, there is a strong link between how your sleep may be affected by what you eat, and the diet best for your sleep is the diet best for your health in general, meaning whole grains, fruit and vegetables. Everyone differs here; in general it's best not too eat too late to give your body enough time to digest before you sleep, and exercise when you have the most energy, whether in the morning or evening. Similarly, this shouldn't be too close to bedtime, some may find that exercise too close to sleep actually keeps them awake.

Investigate what's causing your sleep loss; do you just have trouble falling sleep? Do you wake up for long periods of time? Do you just generally feel tired all the time? People particularly with insomnia can have unrealistic expectations of how much sleep they need⁹; the actual amount of sleep you may need can vary from others and can be assessed by how you feel during the day. Learn how your body reacts to things such as food and exercise, and how much sleep you need to do the things you need to do.¹

Create Your Sleep Retreat

This I feel is one of the most important areas to be improved that affects those with sleep problems. Poor sleeping can be a 'learned behaviour' ² and by that I mean if you start to suffer from sleep deprivation you can associate the bedroom and the bed with negative feelings from worrying too much about sleep which then leads to frustration and anxiety. For some, you can be 'biologically vulnerable' to disturbed sleep ¹⁰, such as light sleepers and night owls who may not necessarily have sleep disorder but external factors can still interfere with sleep. It's worth altering your sleep environment and assessing your sleep hygiene to help improve your sleep.¹

• Be Comfy - Invest in a good bed and mattress, plus comfortable sleep attire and sheets.
  
• Use Light and Dark to Your Advantage - Keeping the bedroom dark before sleep is a natural way to aid your biological clock to get into a routine². Scientists believe a hormone called melatonin, nicknamed the 'Dracula Hormone' can contribute to our natural sleep, this is stimulated by darkness and ceases in daylight. You can use heavy curtains or blackout blinds to block any outside light and only use soft lighting before bed. Similarly, using a natural bright light (sometimes referred to as phototherapy)¹¹ can help us wake up.
• Keep it Airy - A stuffy room can be uncomfortable, it can help to keep a window open before bed. Ultimately, keep the temperature the way you like it, hot or cool.
• Banish Noise - External noise is unfortunately unavoidable, whether it's outside noise, a partner’s snoring, if you're a particularly light sleeper, then this can all be very frustrating. It's worth investing in some earplugs if you find yourself waking up frequently during the night. If it's just a problem with getting off to sleep, it can help listening to something with little stimuli such as natural sounds, audio books or white noise. For instance, I love listening to the sound of natural rain, these are easily available and free on many apps or via the internet.
• Work Space Vs Sleep Space - It's important to keep your work space and bedroom as separate as possible. Keep electronics such as computers, laptops and mobiles away from your sleep area, try to stop all electronic activity at least 30 minutes before bed and only use the bedroom as a place for naps or sleeping.
• Ignorance is Bliss - This is a quirky little tip I like using; if you find yourself clock watching, either before falling asleep or during the night... Stop! More often than not this can increase anxiety from the thought of not falling asleep yet, or the thought of having to get up in 30 minutes. One way to stop this is to turn your alarm clock around before bed, or put it out of arms reach.

Hakuna Matata

(The Swahili phrase, actually translated as 'there isn't a problem', but many will know from the Lion King as 'No Worries' or 'Don't Worry, Be Happy'). Here I lastly wanted to note some tips, not to use to get to sleep but for helping to get through the day and to increase your focus.

Relaxation techniques such as deep breathing, meditation, yoga or using a mantra are a good for progressive muscle relaxation¹ and increasing mindfulness. This is something you can do at a time that suits you, such as first thing in the morning or last thing as night. As an example, I will try to do at least 15 minutes of Yoga before bed, for me this is a way of 'bringing my thoughts in' and coming back to myself after a busy day.

I hope this article has been of use to you, if you'd like to know more there are numerous books, articles and sleep-help chatrooms out there for further information. As I started with a quote, I shall end with another that I hope helps those out there not just with insomnia, but with any problems you may have sleeping at night.

Sweet dreams.

"Sleep is personal, sleep is intimate. Sleep is interwoven into the fabric of our deepest beings. We have relations to sleep that are as individual and distinctive as we ourselves are. You must find your own way with insomnia and make your own terms with it." ¹

A Final Note

If you feel you have trouble falling asleep due to worry, stress or depression; as well as relaxation techniques I feel it is worth addressing those negative thoughts or 'many' thoughts as it may be. Much of what I have talked about in this article is teaching the body to sleep but sometimes a lot of the time it’s teaching the mind. If this is something you feel you need further help with, it's worth talking to your GP to see if there's anything they can recommend.

(See Holisticshop's sleep products)

References

1. Green, G. (2008). Insomniac - A fascinating exploration of insomnia for sufferers and practitioners. Piatkus Books.

2. Barlow, D. H., Durand, V. M. (2012). Abnormal Psychology, An Integrative Approach. (6th Ed). (pp. 289-305).

3. National Sleep Foundation. (2009). 2009 Sleep in America Poll.

4. Buysse, D. J., Tu, X. M., Cherry, C. R., Begley, A. E., Kowalski, J., Kupfer, D. J., & Frank, E. (1999). Pretreatment REM sleep and subjective sleep quality distinguish depressed psychotherapy remitters and nonremitters. Biological Psychiatry, 45(2), 205–213.

5. Cohen, S. P., Doyle, W. J. P., Alper, C. M. M. D., Janicki-Deverts, D. P., & Turner, R. B. M. D. (2009). Sleep habits and susceptibility to the common cold. Archives of Internal Medicine January, 169(1), 62–67.

6. Benedetti, F., Colombo, C., Serretti, A., Lorenzi, C., Pontiggia, A., Barbini, B., & Smeraldi, E. (2003). Antidepressant effects of light therapy combined with sleep deprivation are influenced by a functional polymorphism within the promoter of the serotonin transporter gene. Biological Psychiatry, 54, 687–692.

7. Stepanski, E. J. (2006). Causes of insomnia. In T. Lee-Chiong (Ed.), Sleep: A comprehensive handbook (pp. 99–102).

8. Hauri, P., Linde, S. (1996). No More Sleepless Nights. Jossey Bass.

9. Sidani, S., Miranda, J., Epstein, D. R., Bootzin, R. R., Cousins, J., & Moritz, P. (2009). Relationships between personal beliefs and treatment acceptability, and preferences for behavioral treatments. Behaviour Research and Therapy, 47(10), 823–829.

10. Spielman, A. J., & Glovinsky, P. (1991). The varied nature of insomnia. In P. J. Hauri (Ed.), Case studies in insomnia (pp. 1–15).

11. Bjorvatn, B., & Pallesen, S. (2009). A practical approach to circadian rhythm sleep disorders. Sleep Medicine Reviews, 13(1), 47–60.