In the Dark

This afternoon I remembered a discussion I had with a few friends last week about insomnia and I thought I’d comment a bit on it here. This topic has come up before, e.g. here, but I’m very happy to say that sleeplessness is not a problem I’ve had recently (apart from once or twice when I’ve had a fever, but that’s different).

When I was struggling to come to terms with insomnia, much of the advice from NHS doctors and psychiatrists concerned sleep hygiene. This does not mean having a shower before you go to bed. It’s a collection of behavioural modifications designed to ensure you get a full night’s sleep every night. Here’s an example of the sort of things:

Received wisdom is that this actually works in most cases. I am, however, bound to say that it didn’t work at all for me. During the worst of my brushes with insomnia I was considered such an intractable case that I was passed around a collection of consultants who, despite their best intentions, didn’t really help either.

Then I had an appointment with a doctor who was refreshingly honest. She said that if insomnia is a result of anxiety or depression then making strict rules about how long you should sleep and what you should do to comply with them can easily make the anxiety worse and hence perpetuate the insomnia. She went on to explain that the practice of sleeping eight hours per night is a relatively recent one. In pre-industrial societies periods of wakefulness in the middle of the night were considered quite normal. Literature from the Victorian period in England, for example, describes how in some communities people would get up in the middle of the night – and even visit their neighbours for tea – before returning home and going back to bed for their `second sleep’. There’s an article in a recent edition of the Irish Times that describes this and cites studies that appear to show that two periods of 3-4 hours each is in some sense more natural than 6-8 hours in one chunk.

So the advice given to me when all else had failed was not to attempt to impose rules on myself but simply not to get stressed if I found I woke up at 3am and couldn’t immediately get back to sleep. Get up if you want to, she said. Relax. Listen to some music. Make a cup of tea. Iron a shirt for the morning. Then go back to bed, but only when you start to feel sleepy again. I’ve done that many many times over the last few years, without feeling anxious about it, although I have to say that nowadays I more often get a solid six to seven hours.

Since I only observe one or two of the list of ten steps to sleep hygiene given above I must be a dirty sleeper, but I much prefer that than being trapped into a cycle of insomnia and anxiety. My advice is sleep the way you can, and don’t worry if it’s not what others think should be the norm.

Come to think of it, that goes for many other things in life.

P.S. If they want us academics to obey rule number 2, why do seminars always go on for an hour?

P. P. S. Anxiety isn’t always the reason for lack of sleep. Sometimes it’s this: