Did you get enough shut-eye last night? With insomnia on the rise, the answer is probably ‘no’. But what exactly is keeping you awake?
When was the last time you had a really good night’s rest? A third of us now regularly battles with poor sleep, and the numbers are rising. But it’s not just a case of tossing and turning and counting a few sheep, our nocturnal problems seem to be increasingly, well, weird.
‘We’re seeing many more people with sleep disorders than ten years ago,’ says Dr Irshaad Ebrahim, medical director of the London Sleep Centre. ‘This is because of higher stress levels and also due to people having greater awareness of all different kinds of sleep disorders.’
Although a good night’s kip is fundamental to our well-being, the nation’s most comprehensive sleep study, conducted last year, showed that 46 per cent of us manage just six hours a night, which for most people is not enough. Founder of The Sleep School, Dr Guy Meadows, who led the Big Sleep Survey, says, ‘We work longer hours than ever and are more stressed, but we all take sleep for granted. Our modern lifestyles mean we’ve forgotten that it helps us recharge, rebalance and renew our minds and bodies. This causes us to make less time for sleep, resulting in further stress and tiredness. On average, we need between seven and eight hours a night, but some people need as little as four hours and others as much as ten.’ Frequent disrupted sleep can lead to serious problems. ‘Without proper rest, we experience higher blood pressure, a lack of concentration, a weakened immune system and loss of libido,’ says Dr Matthew Hind, consultant physician at London’s Royal Brompton Hospital. ‘It can also lead to depression and weight gain, because we eat more to keep going.’
Here’s what to look out for – and what to do if you are affected…
Exploding head syndrome What is it? ‘It feels like someone has fired a starting pistol in your head and usually happens as I’m nodding off,’ says Jess, 32, from London. ‘I’ll shake my partner, saying, “What was that?” but he doesn’t hear it. You feel panic and your heart’s racing until you realise that it’s not an explosion; it’s in your head.’ Dr Brian Sharpless, associate professor at the American School of Professional Psychology at Argosy University in Washington DC, confirms this is a real phenomenon. ‘It can be terrifying,’ he says. ‘You’re falling asleep and suddenly you’re woken up by a very loud noise. Some people also see flashes of light. We’re just starting to do systematic research on it and I’ve interviewed many people about how it affects their lives.’ Although it is rare, experts believe that exploding head syndrome occurs when, for some reason, the part of the brain that shuts down your auditory neurons before you go to sleep makes them fire all at once. ‘It can be caused by any type of sleep disruption,’ says Dr Sharpless. ‘But some substances, like alcohol, may make it more likely to occur.’ How to fix it: As doctors don’t really understand it, it’s hard to know. But if you’re stressed, try to unwind before bed, and if you suffer from disturbed sleep anyway, address the causes. Certain chemical elements, such as calcium channel blockers (which widen and relax the blood vessels) and antidepressants may be helpful, but as yet there have been no large-scale treatment trials. However, learning about exploding head syndrome and knowing that it is not dangerous may reduce the occurrence of episodes.
Restless leg syndrome
What is it? Contrary to its name, this is not just about having a twitchy leg. ‘It’s about strange sensations in your lower limbs when you’re lying in bed or sitting in front of the TV, which are only relieved by moving or walking about,’ says Dr Ebrahim. ‘The most common cause is pregnancy and low iron levels, so it is more prevalent in women than men by four to one.’ Melissa, 41, experienced restless leg syndrome in all three of her pregnancies. ‘It’s not life-threatening, so people don’t really give you much sympathy, but the sleeplessness that goes with it is debilitating. It feels like you’ve been sitting on a plane for 12 hours, unable to stretch your legs – however, nothing you do alleviates it. For me, eventually a midwife suggested taking iron tablets – although I wasn’t officially anaemic – which cured it almost overnight, but this only happened at the end of my third pregnancy. If you’re suffering, ask your doctor if you can try this remedy.’
How to fix it: ‘People should have a think about their diet and whether they are getting enough iron,’ says Mary Morrell, professor of sleep and respiratory physiology at London’s Imperial College. ‘This, of course, has wider health benefits, too.’ Iron-rich foods include fish, meat, leafy green veg, brown rice, nuts and pulses.
Sleep maintenance insomnia
What is it? Waking in the early hours. Dr Meadows says, ‘It’s common to wake around 3am because, by that point, you’ve had two sleep cycles – during which you move from light to deep sleep and back again. It only takes about four hours for the really urgent need for sleep to drain away, explaining why you wake after a few hours even though you haven’t yet had enough sleep to recharge your brain and body.’ Insomnia is far more common in women – around 70 per cent of sufferers are female, and a third of us have experienced it at some point in our lives. ‘The first reason for this is hormonal, as progesterone and oestrogen play a key role in sleep,’ adds Dr Meadows. ‘Women also tend to worry more than men – and anxiety is insomnia’s best friend.’
How to fix it: Annoyingly, this kind of behaviour can become programmed in the brain. ‘If you establish a cycle of sleeping poorly, that tends to continue,’ says Dr Hind. ‘Keeping a diary is useful to spot the patterns, and cognitive behavioural interventions, such as sleep restriction, can help. Simply, you push back your bedtime to much later than normal and set an alarm to get up earlier – even at the weekend. At the end of a two-week period, you are so tired that you sleep all the way through until morning.’ As an alternative, Dr Meadows teaches his clients mindfulness. ‘Being in the present helps retrain the brain that it’s OK to fall back to sleep.’
Sleepwalking
What is it? This is a so-called ‘parasomnia’ – characterised by abnormal nerve behaviour – and it affects two per cent of adults. Sufferers may get out of bed or even carry out activities while asleep. And although most sleepwalkers’ eyes remain open, they will usually have no memory of it. ‘This condition is often carried over from childhood,’ says Dr Ebrahim. ‘About 20 per cent of kids do it, but more than 90 per cent of them stop in adulthood.’
How to fix it: Sleepwalkers have low levels of serotonin – a chemical that transmits signals along the nerves. ‘We often use antidepressants to boost serotonin,’ says Dr Ebrahim. Better sleep routines help, too. ‘Stick to a regime and make sure your bedroom is quiet and dark,’ says Dr Hind. ‘It should also be made safe – move bedside cabinets and install a bell on the door that goes off if you try to leave the room.’ Reducing alcohol consumption is also recommended to avoid triggering episodes.
Sleep-eating
What is it? Less common than sleepwalking, raiding the fridge while asleep is another parasomnia. Again, sleep-eaters will have no recollection of it. ‘Nocturnal eating is a variant of sleepwalking and most sufferers will have had a history of that,’ explains Dr Ebrahim. ‘I find it mainly affects women, although the jury is still out.’ Kate, 28, from Aberdeen says, ‘I had no idea why I was putting on weight. I used to have massive rows with my flatmates about food that was going missing. It was only when I woke up one morning surrounded by chocolate bar wrappers that I realised I must have been sleep-eating.’
How to fix it: Antidepressants are often prescribed, but Dr Meadows says, ‘Treatment is more about prevention and having a good sleep cycle. Go to bed and get up at the same time each day and limit stimulants like caffeine and alcohol.’ Morrell adds, ‘It can be scary if you’re getting out of bed at night. Make sure any partners understand your condition so that they can support you.’