Is there any way to cure insomnia? - egraph

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12:18 | Author: David Perry

Treat insomnia
Is there any way to cure insomnia? - egraph

Saturday 18 October 2014 By Hannah Betts.

Prof Colin Espie at Oxford’s Nuffield Department of Clinical Neuroscience looks deeper: “Most people have an easier life than they would have 100 years ago. Then, the pressures were very real. Child mortality was high, there were fewer treatments for illnesses, greater poverty. The problems we have now are more self-inflicted. We put ourselves under a huge amount of pressure and fail to take full advantage of having more free time to live a full and healthy life. We are victims of failed expectations and disappointments, and we end up with a lot of essentially psychological problems.”

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This nightmare-based insomnia is the most punishing of the sleep disorders I have experienced since childhood. There is also a good deal of traditional insomnia, what I think of as the stoical person’s panic attack: that lacerating, mind perpetually racing, not-falling-asleep-until-dawn-when-all-hope-of-a-normal-day-is-gone guise. There will be long weeks of morning insomnia – the depressive’s choice – lunging early into sleep, then waking from it at 4am, despairing that that is one’s lot.

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I am no less hypersomniac, subject to daytime sluggishness and a desire to slumber in great gluts. I once slept for 48 hours, waking disorientated having lost two days. I could sleep at any hour of the day: day sleep being becalmed, indulgent, medicinal, unlike the ragged, angsty non-rest of dark. But I do not allow myself to, since – like all creatures of the night – I endeavour to observe rigorous “sleep hygiene”

Science is forever looking for solutions. For a time, Dr Meadows deployed traditional methods such as advising patients to get up when wakeful and resist negative thoughts. However, his Damascene moment came when he realised that fighting insomnia merely created a tug-of-war situation, stimulating the amygdala, the region of the brain that governed the fight-or-flight mechanism, ensuring the situation became self-perpetuating.

He continues: “No aspect of daily functioning is unaffected by sleep – from concentration and energy, to mood, productivity and social interactions. The results of 2012’s Great British Sleep Survey revealed that long-term poor sleepers are seven times more likely to feel helpless, five times more likely to feel alone and twice as likely to have relationship problems as good ones.”

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As a culture, we are fixated with sleep and, correspondingly, beset with sleeplessness. Almost 40 per cent of people endure at least one symptom, with a quarter of these experiencing chronic traits at any one time. Insomnia is widely considered an epidemic, with scientists increasingly unearthing dire implications for sufferers’ physical and mental health, weight and life expectancy. Popular culture blames our 24/7 lifestyles, technology, and our inability to switch off, brains as buttons.

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Physiologist Dr Guy Meadows, founder of London’s Sleep School, concurs: “Insomnia can affect every aspect of people’s existences. I see clients who have compley stopped living their lives in the hope of controlling their sleep. They have given up working to avoid stress, stopped socialising to avoid being out late, stopped going away on holiday or staying with family for fear of not being able to sleep in a foreign environment, and even chosen not to have children for fear of being bad parents.”

He found attending a CBT session helped: “I thought I was a bit of a nutcase before I attended the workshop, then realised all the things I did were recognised CBT strategies: not having a clock in the bedroom, not looking at the time after 10.30pm, having a bedtime routine. There is also the recognition that the fear of not sleeping is the greatest contributor to not sleeping, so controlling that is key, and that quality of sleep is more important than quantity – hence not using alcohol.

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The anorexia analogy feels apt, if only because I consider myself a sleep bulimic, alternating between extremes of feast and famine. When not wildly thrashing, emitting blood-curdling screams, I am told I repose like Sleeping Beauty, tranquil, arms thrown back like a baby, revelling in the dense luxury of it all: yin to my disordered sleep’s yang.

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In my own case, I try to sit with my insomnia; learn its lessons, if any; pile on the under-eye concealer. In the end, I find I come back to Prospero’s closing acceptance of Caliban in The Tempest : “This thing of darkness I acknowledge mine.” The Sleep School Sleepio Read more Health.

He is now advocating an “acceptance technique”: he is the first to apply the lessons of ACT, or acceptance and commitment therapy, to sleep. His work centres on a mindful approach, with clients sitting – or rather lying – with, and even “befriending”, the mind’s demons. His axiom is that while sleeplessness is outside our control, one can control one’s reaction to it – which can, in turn, break insomnia’s vicious cycle. His success rate is impressive: 87 per cent of 2010-11’s patients reported significant improvement (with 10 per cent not responding).

This will not sound in the least extreme to anyone who has been afflicted by the condition. At the most banal level, one wonders what one would look like with sleep (younger, surely?), one fantasises that one would eat and drink more wisely sans lag, function better, be less of a bitch. While, at a less banal level, there are moments when sleeplessness feels akin to madness, or mental illness.

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In time, everyone patches together their own semi-solutions. I say semi because, for too many of us, the idea that there exists some sort of cure remains a naive fantasy. One gets better at handling sleep disorder; there are good and bad phases. “I’ve accepted it – which you have to, otherwise it gets worse,” says Morgan. “I treat it like a minor illness.”

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As I write this, it is turning noon. I am exhausted. My mind runs through the verbal alternatives – done in, beat, dead, shattered, jiggered, drained, wiped, consumed, finished, spent – and settles on what the OED informs me is its British vulgar slang option: buggered. My skin is stretched taut over my cheeks, charcoal smudged under each eye. I am shivery, a tightly wound neurotic; yet vague, mentally clouded, doomy with apprehension and jittery with caffeine. I am not a great weeper, but do not feel far from it.

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This method – in which the insomniac disciplines herself to a regular waking pattern with a view to establishing a corresponding sleeping routine – will be one of a catalogue of solutions the sufferer will have deployed. I have also tried hot baths, warm milk, caffeine bans, lavender, camomile, valerian, magnesium, calcium, cherry capsules, alcohol, Nytol, melatonin, antidepressants, massage, intercourse, foot patches, aromatherapeutic oils, eye masks, earplugs, state-of-the-art clocks, open windows, electric blankets and a small chunk of amethyst clutched in the palm. Psychotherapy, cognitive behavioural therapy, yoga, exercise, nutritional approaches, hypnosis, nature noises, sound-wave technology and sleep hypnogram apps have also featured. I have consulted experts and attended sleep lessons – anything, in fact, to relieve me of my jagged, forever slightly spinning daytime existence – and all to no avail. And, yet, nightmares apart, I do not even consider myself a particularly chronic case.

How can I cure my insomnia?

“CBT has been shown to help around 70 per cent of sufferers and is what we call an 'evidence-based therapy’, meaning that it has been shown to be effective in controlled clinical studies. works by training people to use these proven CBT techniques over a six-week course. So, yes, I do think insomnia can be fixed, but CBT is the only proven means.”

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Huw Morgan, a 41-year-old prospect researcher, is a lifelong insomniac. “I think it is a bit like anorexia in that it’s an inability to do something quite simple, vital and instinctive that most people take for granted. You can feel as if you are going genuinely mad, something tied into the loneliness, depression and anxiety inherent in the condition – as if your mind is broken and leaking all over the place at 4.30am on a Tuesday morning in your living room. Colleagues would guess how much sleep I’d had based on the bags under my eyes, or assume I’ve been in a fight and acquired a black eye.”

Burberry’s chief, Angela Ahrendts (£1.02 million plus benefits and bonus), clearly sees herself in the four-hours-a-night Thatcher mode. At 4.35am she rises, without an alarm, boasting that if she scores more than six hours’ rest she gets a headache. While media mogul Arianna Huffington, who once shattered her cheekbone by falling asleep at, and on to, her desk, is forever encouraging women to “sleep their way to the top” – in the most blameless, but stressfully counterproductive, of fashions.

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“The other crucial thing I have gleaned is that you can achieve quite a lot on little or no sleep. I ran my first marathon on none. I’ve had days when I’ve forgotten I hadn’t slept the night before, and it can give you a 'what the hell?’ feeling. But you always have that dull headache and odd taste in the mouth.”

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And oh, how we love a spot of breaking sleep tragedy or hypno-machismo. In December 2011, António Horta-Osório, chief executive of Lloyds Banking Group, was famously forced to take several weeks’ leave after a bout of particularly torturous insomnia. This summer, Bank of America Merrill Lynch intern Moritz Erhardt, 21, died after working until 6am three days in a row, having slogged throughout the night eight times in two weeks. Offered the chance to renounce their shackles after his death, none of his peers took up the opportunity.

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Prof Espie is a co-founder of the online sleep-improvement programme, which costs from £6.99 a week. He ls me: “The most effective treatment for poor sleep, by far, is cognitive behavioural therapy” (CBT – a psychotherapeutic approach that addresses behaviours and thought processes through goal-oriented, systematic procedures).

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Insomnia is always different, always the same. Last night, I was in nightmare mode. I woke five times, at the end of every sleep cycle, wild-eyed and terrified. My dreams are baroquely violent – physically and psychologically – stabby gore fests, rich in psychopathic detail. Twice I woke shouting, once weeping; every time gripped by some sort of hallucinatory hangover as sleeping and waking states crossed. In the past, such visual lags have included figures lurking in the room, an image of the crucified Christ and a vast, revolving skull.

It has become one of Western culture’s most cherished neuroses that we exist in a constant state of sleep deprivation: which is not to say that this is not the case. Hours are notched up where once we might have totted up calories. Friends compete to determine who has passed the more fitful night. Magazine covers that were wont to holler “hot sex” now lure us in with promises of “deep sleep”

Treat insomnia