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Interesting article
=============
…….Insomnia is on the up. A 2022 study from Nuffield Health’s Healthier Nation Index based on 8,000 people found 74% of UK adults reported a decline in quality sleep over that year alone, with one in 10 getting just two to four hours per night.
Sleep deprivationworsens depression and anxiety, and impacts reasoning and alertness. I felt like a tapped tuning fork, vibrating with nerves. I had the sensation I had swallowed something enormous, and it was lodged in my body and throat.
I would have parted with a considerable chunk of my savings to get one night’s unbroken sleep, to feel halfway normal for a single day.
I was aware of being in a particularly vulnerable state, with many products promising expensive quick fixes (the biohacking company Eight Sleep is promoting an Elon Musk-endorsed mattress cover that responsively controls the temperature of your bed, promising an additional hour of sleep per night – yours for just £2,495) and so it was unsurprising to find that an insomnia treatment overview predicted the global market would reach $6.8bn in 2024.
I bought a CBT-i course from the Insomnia Clinic, one of the UK’s only specialist insomnia services (though more recently the NHS has introduced a similar digital treatment, Sleepio).
“Course” was the right nomenclature for the package, as it felt like I was relearning something, practising a new skill.
CBT-i offers a combination of interventions, including relaxation and distraction techniques, stimulus control and sleep hygiene, most of which are eminently sensible.
You shouldn’t eat or drink caffeine, or doom-scroll through your phone, two to three hours before going to bed. You should lower the lights in the evening. Your bed should only be used for sleeping and sex, not for watching YouTube or staring at spreadsheets.
The first week of the course involved keeping a sleep diary, then calculating how many hours I had slept on average a night, before beginning the main bulk (and hardest part) of the treatment: sleep consolidation (or sleep restriction).
Once you have an average, you then permit yourself only that amount of time in bed. Not asleep. Just in bed.
There is a paradoxical intentionality to CBT-i, depriving yourself of sleep in order to access it. I was permitted five hours a night in bed, between 1 and 6am (a consistent routine is also part of the training).
And even then, you shouldn’t go to bed unless you are actually sleepy. This part of the training required perhaps the most amount of discipline I have ever expended in my life.
Before bed, I would do housework, watch entire series’ worth of gently calibrated television: nothing too engrossing, but captivating enough to keep me awake.
Sometimes I’d just walk circles around the dining table. The theory is that you build “sleep pressure”, and the more experience you have sleeping in the bed, the more you strengthen your association with it and sleep.
If I wasn’t asleep in 15 minutes, I had to get out of bed, walk around the dining table until I felt sleepy, then return to bed, where the same rule applied. If you spoke to me around this time, it is likely I seemed unhinged.
The first few nights were punishing. I was exhausted, entirely wrung out with sleep deprivation, returning to work and childcare, but even after keeping myself awake for hours, I would often find myself in bed, blinking at the ceiling, still unable to sleep.
I’d drag myself out of bed, return downstairs, leaf through a book while slowly sipping water, until I felt adequately sleepy again.
My morning alarm remained a horror. I’d get up, drink coffee in the backyard, shivering in the gloomy winter dawn. But I gradually saw improvements.
My hypnic spasms – those involuntary muscle contractions as your body transitions from wakefulness to sleep, experienced more frequently by insomniacs
– started to lessen. I had fewer false starts. The biggest improvement was the flattening of my sleep into larger chunks – fewer middle-of-the-night wakeups – which is why the treatment is called sleep consolidation.
Once I was consistently sleeping five hours, I was able to gradually extend the amount of time I was allowed in bed, by 15 minutes every few weeks or so.
It took around six months before I was getting a nailed-on eight hours (though this is not a goal – in CBT-i you are encouraged to figure out how much sleep you realistically need, which may well be less).
Alongside this more gruelling bulk of the treatment were more familiar cognitive and relaxation techniques. I learnt to allow my adrenaline to spike as I lay in bed, instead of fighting, conditioning my body to the idea there was nothing to be afraid of, nowhere to run.
The key message delivered generally seemed to be: just calm down. Place less emphasis on sleep as part of the broader architecture of your wellbeing; there are many other reasons why you may feel bad……..
www.theguardian.com
=============
…….Insomnia is on the up. A 2022 study from Nuffield Health’s Healthier Nation Index based on 8,000 people found 74% of UK adults reported a decline in quality sleep over that year alone, with one in 10 getting just two to four hours per night.
Sleep deprivationworsens depression and anxiety, and impacts reasoning and alertness. I felt like a tapped tuning fork, vibrating with nerves. I had the sensation I had swallowed something enormous, and it was lodged in my body and throat.
I would have parted with a considerable chunk of my savings to get one night’s unbroken sleep, to feel halfway normal for a single day.
I was aware of being in a particularly vulnerable state, with many products promising expensive quick fixes (the biohacking company Eight Sleep is promoting an Elon Musk-endorsed mattress cover that responsively controls the temperature of your bed, promising an additional hour of sleep per night – yours for just £2,495) and so it was unsurprising to find that an insomnia treatment overview predicted the global market would reach $6.8bn in 2024.
I bought a CBT-i course from the Insomnia Clinic, one of the UK’s only specialist insomnia services (though more recently the NHS has introduced a similar digital treatment, Sleepio).
“Course” was the right nomenclature for the package, as it felt like I was relearning something, practising a new skill.
CBT-i offers a combination of interventions, including relaxation and distraction techniques, stimulus control and sleep hygiene, most of which are eminently sensible.
You shouldn’t eat or drink caffeine, or doom-scroll through your phone, two to three hours before going to bed. You should lower the lights in the evening. Your bed should only be used for sleeping and sex, not for watching YouTube or staring at spreadsheets.
The first week of the course involved keeping a sleep diary, then calculating how many hours I had slept on average a night, before beginning the main bulk (and hardest part) of the treatment: sleep consolidation (or sleep restriction).
Once you have an average, you then permit yourself only that amount of time in bed. Not asleep. Just in bed.
There is a paradoxical intentionality to CBT-i, depriving yourself of sleep in order to access it. I was permitted five hours a night in bed, between 1 and 6am (a consistent routine is also part of the training).
And even then, you shouldn’t go to bed unless you are actually sleepy. This part of the training required perhaps the most amount of discipline I have ever expended in my life.
Before bed, I would do housework, watch entire series’ worth of gently calibrated television: nothing too engrossing, but captivating enough to keep me awake.
Sometimes I’d just walk circles around the dining table. The theory is that you build “sleep pressure”, and the more experience you have sleeping in the bed, the more you strengthen your association with it and sleep.
If I wasn’t asleep in 15 minutes, I had to get out of bed, walk around the dining table until I felt sleepy, then return to bed, where the same rule applied. If you spoke to me around this time, it is likely I seemed unhinged.
The first few nights were punishing. I was exhausted, entirely wrung out with sleep deprivation, returning to work and childcare, but even after keeping myself awake for hours, I would often find myself in bed, blinking at the ceiling, still unable to sleep.
I’d drag myself out of bed, return downstairs, leaf through a book while slowly sipping water, until I felt adequately sleepy again.
My morning alarm remained a horror. I’d get up, drink coffee in the backyard, shivering in the gloomy winter dawn. But I gradually saw improvements.
My hypnic spasms – those involuntary muscle contractions as your body transitions from wakefulness to sleep, experienced more frequently by insomniacs
– started to lessen. I had fewer false starts. The biggest improvement was the flattening of my sleep into larger chunks – fewer middle-of-the-night wakeups – which is why the treatment is called sleep consolidation.
Once I was consistently sleeping five hours, I was able to gradually extend the amount of time I was allowed in bed, by 15 minutes every few weeks or so.
It took around six months before I was getting a nailed-on eight hours (though this is not a goal – in CBT-i you are encouraged to figure out how much sleep you realistically need, which may well be less).
Alongside this more gruelling bulk of the treatment were more familiar cognitive and relaxation techniques. I learnt to allow my adrenaline to spike as I lay in bed, instead of fighting, conditioning my body to the idea there was nothing to be afraid of, nowhere to run.
The key message delivered generally seemed to be: just calm down. Place less emphasis on sleep as part of the broader architecture of your wellbeing; there are many other reasons why you may feel bad……..
‘The first few nights were punishing’: how sleep restriction cured my lifelong insomnia
After giving birth, novelist Lara Williams feared she might never sleep again. So she turned to CBT-i, a radical therapy that rewired her relationship to sleep
