Stuck In The Twilight Zone

Nobody sings ‘Oh what a beautiful morning’ when they’ve spent the last four hours watching dawn approach. Gareth Mason certainly doesn’t...

Staring at your bedroom ceiling at 4am while the world around you snores contentedly can be one of life’s most frustrating routines. An instinct for some can be painfully elusive to others. One in three adults suffers with sleeping problems at some stage while most peoples’ daytime lives require an energy and alertness not well served by counting battalions of leaping ewes.

We’re not all so fortunate to have compliant minds. For me, the sprightly lambs soon metamorphose into mythical cross-breeds, with the heads of ex-girlfriends and a tendency for barrack room banter. Interesting but hardly restful. No two people share the same sleep pattern and needs. Some claim to need 10 hours of uninterrupted slumber to get them through the day while others survive on a handful. Margaret Thatcher was famous for only needing a few hours before setting off for her day job. Look what she did. OK, bad example.

But our needs differ. We don’t know much about how the body falls sleep and what it does within. We do know sleep consists of two distinct phases. One is rapid eye movement (REM), where the eyes move under closed lids, the heart rate quickens and body processes speed up. These are the dream-zones which last around 20 minutes and occur up to four or five times a night. These alternate with periods of longer non-REM sleep – usually four stages – the last two being the deepest. Insomnia involves problems falling sleep, frequent waking with difficulty returning to sleep, waking too early or feeling unrefreshed afterwards.

And it’s not how long you sleep but the quality that counts. Tiredness, apathy, irritability and poor concentration are chief culprits among insomnia’s symptoms. Extreme cases result in damage to the immune system which can lead to more serious problems. Some are more prone than others. Older people usually sleep more lightly and fitfully, often missing the stage 4 of non-REM sleep altogether. Women, particularly in late pregnancy, are also more prone as are those suffering from depression. Physical problems such as arthritis or a weak bladder are common causes as are mental stresses such as those with chronic asthma who believe they will struggle to breathe when asleep.

Many of these circumstances are unavoidable and treatment is either difficult or specific to individual needs. But many others can ease or overcome the symptoms. Common aggravating factors can combine to cause sleeplessness and with a little planning and effort are within your control. Chronic suffering may have a serious and highly individual root, often several. Your GP can help pinpoint the problem with the aid of a sleep and pre-sleep diary, but often the solutions can be found yourself. Often, the doctor merely reassures the patient that the symptoms can be relieved. A more serious physical or mental problem is sometimes responsible. Physical symptoms could include heart failure, asthma, kidney disease, Parkinson’s disease and hyperthyroidism.

It’s better to get checked than paranoid. Anxiety is a more common cause. The trails of everyday life are not easy to wish away, but if you can identify them you are half-way to overcoming them. A sensible change in routine can help greatly. One final warning. While sleeping pills may help sufferers sleep in the short-term they are not usually best for longer treatment. Apart from possible side-effects, reliance can, paradoxically, encourage sleeplessness. Sleep patterns can become inverted with drowsy mornings followed by sleepy days and wakeful nights. Fine for vampires, inconvenient for ordinary mortals.

Women’s’ Health 1999