How to put insomnia to bed
IT’S NOT one of the first side effects of pregnancy you read about, but the bump can also quite commonly bring with it hormone-driven bouts of insomnia.
On my third pregnancy in nearly as many years — and with months of night-feeds in between each one — quite honestly I think I lost the ability to sleep.
Waking at midnight after an hour’s sleep — and not even so much as dozing back — became my normal night time routine. Except there was nothing normal about it at all. Not with a full-time job and young children at home.
Exhausted and irritable, with a 24/7 headache, my insomnia took over my life, consuming every moment of my waking day.
I once read an insomniac’s description of ‘the day after the night before’ — he wrote of stumbling through his morning as though his shoe laces were tied together. There is no better description.
At night, I would pace the house in frustration, all the more exasperated by the fact my baby was sleeping 11 hours. My 12 month old could sleep — why couldn’t I?
It got so bad my doctor prescribed me sleeping tablets, a step I was too terrified to take while pregnant.
And then, there was a little reprieve. Cherry Active, a cherry concentrate with natural melatonin, gave me four weeks of steady sleep. I’d wake, yes, but somehow, I would drift back. The adrenaline-fuelled over-thinking, heart-pounding-in-my-head, hours in bed somehow disapated.
After years of watching with seething jealousy my husband’s ability to fall into the deepest, soundest sleep the moment his head hit the pillow, now I was just like him. I felt normal again. Refreshed, focused, energetic. I had my life back.
And then, very gradually, my little miracle cure became less reliable. It gave me six nights sleep out of seven — not a bad strike rate, but I was terrified that one night of sleeplessness would become seven all over again. This time it was the fear of insomnia that consumed me.
Enter Dr Guy Meadows, clinical director of The Sleep School and his new book, The Sleep Book – How To Sleep Well Every Night.
I read his words and it was as though a light switch went on in my head. It was a complete perspective shift. Every sentence rang true.
It made me step back from myself and observe my sleep obsession; I realised I ticked every insomniac’s box. My bedside locker, as Guy pointed out in his book, was indeed a shrine to sleeplessness. Natural remedies to do this, a night light for 3am reading, meditation CDs intended to relax me back to sleep.
Guy helped me to understand what was physically happening in my body too. Yes the pregnancy had caused a physiological change — just as menopause and other hormonal changes in a woman’s body can — but I had exascerbated the problem psychologically.
Sleep had become a flight or fight situation — because I dreaded the night times so much, adrenaline was surging through my body and my mind began to associate sleep with danger. In Stone Age terms, my body was on alert, as if I could be attacked by a bear at any moment. It explained why often I couldn’t even nap the next day — tired but wired, the adrenaline was pumping. My body was in a state of hyper arousal.
Inside my head, meanwhile, I was wallowing in self pity. I recognised the words of every case study in Guy’s book: How would I get through the day on no sleep? Why can everyone around me sleep and I can’t? What would years of no sleep do to me? I was living with the short-term effects of insomnia, but what about long term — what of the terrifying studies that talked of dementia and cancer?
And then, because I had removed myself from it, because I was simply observing my thoughts and behaviour, I found myself laughing at the ridiculousness of it all. I embraced the fun, playful approach to insomnia that Guy advocates and realised I was fighting the most natural thing in the world.
As Guy puts it, the more I fought it, the more I fuelled it.
“We are hardwired to fix, so we want to do the same with sleep,” explains Guy.
“But we need to learn we can’t control everything — and this is out of our control.
“Think about it. What do normal sleepers do to go to sleep? Nothing. And what do insomniacs do? Everything.”
So we use props, sleeping tablets, anything, to try and fix it.
Instead, Guy says we need to create a perspective shift. And he suggests five ways to achieve that (see panel).
Guy follows an ACT approach — Acceptance Commitment Therapy — rather than the more commonly used cognitive behavioural therapy. That was a treatment he tried initially at his sleep school, but it was nowhere near the soaring 87% success rate he enjoys now.
“CBT wants you to get rid of all problems before you live your life again. So the goal of their life becomes getting over insomnia,” explains Guy.
ACT, on the other hand, takes more of a mindfulness approach.
First, you must accept your insomnia — not just be resigned to it, but truly accept it.
Then, when you wake as usual at 1am or 2am or 3am, acknowledge your worries and fears — but label them and have fun with them. So, for example, when you think ‘how will I cope tomorrow?’ just say ‘hey self-pity, welcome, nice to see you again’. Worried about work? Well give that a name too. ‘Hey work stress, come on in’. I found myself imagining all those labelled thoughts floating away — and with them, incredibly, I found myself drifting off to sleep too.
It sounds a little mad, a little new age, but it worked. I relaxed as I had fun with the late night voices in my head. My heart began to slow down, the adrenaline eased. And I fell asleep.
In Guy’s words — I had welcomed the thoughts and broken their power.
The SleepSchool does, however, go against the grain when it comes to the usual night time advice. First of all lose all props — the pills, the potions. Then when you wake, stay in bed — no roaming around the house. And there’s no reason to avoid looking at the clock either. Simply do, what Guy says, whatever a ’normal’ sleeper does. The fact is we are programmed to wake a few times each night — most of us just drift back without even realising.
Guy does recommend avoiding phones and technology in bed though — the blue light that is emitted is like shining a sun in your face, confusing your body into producing day time adrenaline instead of night time melatonin.
Speaking of melatonin, I still haven’t found the courage to lose my one insomnia prop. Sorry Guy, but every night I drink my melatonin enriched Cherry Active. Just in case…
But I don’t carry the fear of insomnia I had before I read The Sleep Book. Now I know I just need to do what a ‘normal’ sleeper does: nothing at all.
Sleep is a natural physiological process that can’t be controlled and having a reliance on unnatural night time rituals or props (e.g. warm baths, pills and alcohol, etc) can fuel sleep anxiety and further sleeplessness. Follow a normal, regular wind down each night to retrain your brain to sleep.
Worrying about poor quality past sleep or imagining how bad things will be in the future if you don’t sleep only helps to increase night time arousal levels. Whilst noticing things objectively and without judgment in the present moment, like the touch of your duvet on your toes or the gentle movement of air in and out your nose, can actually promote sleep.
Fearful thoughts or strong emotional reactions such as anxiety at night can keep you more awake. Learning to change your relationship by getting to know them and welcoming them when they arrive will reduce arousal levels and lessen sleep struggle.
Go to bed and get up at ‘roughly’ the same time each night — this will help to keep your body clock on time and promote your natural drive to sleep. If you are awake at night choose to stay in bed and conserve your energy by lying still and being calm and mindful.
Fear of not sleeping drives us to stop living our lives — avoiding going out at night with friends or sleeping in the spare room. Commit to making small actions everyday that take you closer to what is important to you. A happy and content brain is a sleepy brain.
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