Sept 26: five hours 14 minutes

Now forgive me, Harvard Medical Review. I know you think I might be picking on you – and that this advice is given out everywhere from GP’s surgeries to Sleep Books – but the email that popped up in my inbox this morning has really annoyed me. (Below, edited for length):

The Harvard Review writes: General ways to improve sleep

Many things can interfere with sleep, ranging from anxiety to an unusual work schedule. People who have difficulty sleeping often discover that their daily routine holds the key to nighttime woes.

First-line strategies
Before we examine specific sleep problems, it makes sense to address some common enemies of sleep and tips for dealing with them.

Cut down on caffeine
Caffeine drinkers may find it difficult to fall asleep. Once they drift off, their sleep is shorter and lighter. For some people, a single cup of coffee in the morning means a sleepless night. Caffeine can also interrupt sleep by increasing the need to urinate.


Those who can’t or don’t want to give up caffeine should avoid it after 2 p.m., or noon if they are especially caffeine-sensitive.

Stop smoking or chewing tobacco
Nicotine is a central nervous system stimulant that can cause insomnia. This potent drug makes it harder to fall asleep because it speeds your heart rate, raises blood pressure, and stimulates fast brain-wave activity that indicates wakefulness. If you continue to use tobacco, avoid smoking or chewing it for at least one to two hours before bedtime. EDITOR’S NOTE: CHEWING IT?!?

Use alcohol cautiously
Alcohol depresses the nervous system, so a nightcap can help some people fall asleep. However, the quality of this sleep is abnormal. Alcohol suppresses REM sleep, and its soporific effects disappear after a few hours. Drinkers have frequent awakenings and sometimes frightening dreams.

Be physically active
Regular aerobic exercise like walking, running, or swimming provides three important sleep benefits: you fall asleep faster, attain a higher percentage of deep sleep, and awaken less often during the night.

Stick to a regular schedule
A regular sleep schedule keeps the circadian sleep/wake cycle synchronized. People with the most regular sleep habits report the fewest problems with insomnia and the least depression. Experts advise getting up at about the same time every day, even after a late-night party or fitful sleep. Napping during the day can also make it harder to get to sleep at night.

If your goal is to sleep longer at night, napping during the day is a bad idea.

For more on the importance of getting a good night’s sleep and developing strategies to improve your sleep, buy Improving Sleep: A guide to a good night’s rest, a Special Health Report from Harvard Medical School. (REPORT ENDS).

Now, come on. Do you have to be an Ivy League academic to work out that caffeine keeps you awake, booze messes up your sleep, exercise helps you to drop off and keep you dropped off, and that daytime naps might affect a night-time’s rest? Ok, admittedly, I didn’t know about the smoking one – I have never smoked – but still.

Maybe I’m feeling especially grumpy today, but when I had my terrible nine-year period of insomnia, I wanted to murder people who gently offered that I might want to cut out double espressos after six pm (I didn’t drink coffee at all), or perhaps take a long walk when I was so exhausted and deranged, I couldn’t even go out of the front door.

Admittedly, ‘sleep hygiene’ is the first step in the longer and more comprehensive treatment plan of CBTi (Cognitive Behavioural Therapy for Insomnia). I have a lot of time for CBTi, to which I will returning at some point in the near future.

But as the sum total of a health practitioner’s advice, to a hard-bitten insomniac of several years’ campaigns? Please.

What does everybody else think?

First day back: Five hours, seven minutes

So hello again, everyone. After a jolly four months writing my Insomnia Diaries for the Telegraph, I am back here again. I will still be writing about sleep, mental and physical health for the paper (plus other rags, mags and websites) but as far as a blog goes, I am once again a private citizen.

When I started writing the Diaries, I signed up for a Google Alert on sleep (there is a LOT on this subject online, from the New York Times, then diluted down in publications called things like the Rockdale Newton Globe.) Skipping quickly through the Alert became part of my day.

Terrific.

Today, between deadlines, I went to have another look. The top article was from Harvard Health Publishing (courtesy of Harvard Medical School). The headline was: Weekend Catch Up Sleep Won’t Fix the Effects of Sleep Deprivation on Your Waistline.

A thing to note about sleep news stories: they are rarely good news. You are variously told your insomnia f*ck up your relationship, make you rubbish at your job and increase your risk of car accidents. What upsets me about these stories is their almost accusatory tone: as if you are defiantly choosing not to sleep.

Anyway, the best articles are those that cheerfully tell you insufficient sleep will give you high blood pressure, diabetes and Alzheimer’s. The worst thing I have read (in the Harvard Medical Review, thanks again, Boston) is that ONE NIGHT without sleep significantly raises your risk of dementia.

Now, I know all about the weight gain thing. My column research led me to an analysis of 36 studies, discussed in the journal Obesity. (Can you imagine working on the journal Obesity? Might stall conversations at parties.) According to its tubby researchers, insomnia disrupts the hormones that control hunger, causing sufferers to eat hundreds of extra calories a day, particularly refined carbohydrates. The daytime exhaustion means you can’t be bothered to exercise and so the weight gain spirals – as does a cascade into other health conditions.

For the first six years of my recent insomnia saga, I would say I actually LOST weight (via muscle tone and even bone density – though I never had either of these checked). Then, three years ago the numbers on the scales started to go up. Exhausted and miserable, I threw away all my healthy eating principles. I couldn’t be bothered to exercise, then when I was prescribed a certain antidepressant – guess the side effect – all bets were off. (I’m off it now).

I’m losing the weight now, COUGH COUGH since Christmas. The first bit was easy, but it’s not fun. I am not a natural ‘diety’ person. I like carbohydrates. I like Kettle Chips. Slimline tonic water is the Mixer of the Devil. I like food and drink! The exercise is great (fast walking and boxing!) but it just makes me hungry.

Maybe as well as the Bridget Jonesy sleep numbers at the top, I will do food and alcohol unit ones. Or perhaps not.

Other than telling me to sleep more (I really am trying!) does anyone have any weight-loss tips that involve full-fat tonic and Pringles?

See you next time xx

Day six: five hours, 15 minutes

Some news to give me an anxiety ‘white night’.

This little blog has been picked up by the mighty Daily Telegraph, so I will be collecting my pillow and shuffling over there.

It will be a weekly online diary about my past and current sleep issues. I’ve been assured that I will covering pretty much the same topics that I was planning to do here.

This is great news, because I will obviously be able to reach a lot more people. 

Every day that passes I realise what a huge and horrible problem insomnia is, how I am not alone and how you are not alone.   

Please find me on the website www.telegraph.co.uk/health from Monday 10th June.

Knowing my luck I will sleep eight hours tonight and every night after this, and find myself out of a job.

Thanks for reading!

Miranda

Day five: five hours, 13 minutes

So my jagged, non-exponential sleep chart has an uptick today.

I couldn’t keep awake beyond 9.30 last night. Such a bone-crushing exhaustion that I had to check out early. 

Fellow insomniacs, how do you describe that sensation to a Somniac? ‘Tired’ hardly covers it. You don’t feel sleepy, or cosy, or fuzzily doped. Morpheus does not come to sprinkle us with poppy seeds.

(Gets Collins thesaurus from book shelf). Dead-beat. Done in. Drained, drooping, enervated, exhausted.

Knackered!

Weary is quite a good one, I think. Sums up the endless grey boredom. Brings to me mind a quote from Hamlet: ‘How weary, stale and unprofitable/ Seem to me all the uses of this world.’

Sorry.

But to the point, I passed out at 9.30, sprung up before 3am feeling refreshed and ready to watch Ukrainians shooting radioactive dogs on Sky Atlantic.

After five days of daily activity, I’m taking a blogging mini-break and will be back early next week.

Wishing you lots of zzzzzzzz s.

Day four: three hours, 36 minutes

This is the first time we have fallen short of the Four Hour Rule.

I went to bed when the little hand was on the 10 (is it the little hand? I have actually forgotten) and was awake at 1.36am.

I’ve tried the old ‘going back to sleep’ thing but it doesn’t work: unlike in bygone days when I could snooze ’til lunchtime. And actually, the early hours are the most creative for me.

On the other hand I am officially not responsible for anything that I might say or do this morning.

(Possible reasons why I didn’t sleep long: I’m now hungry because of eating dinner too early; I had my glass of wine AFTER my meal; I did a work interview too late in the day and was still buzzing a bit when I went to bed.)

People have offered a lot of advice over the years, some of it more useful than others. Although my actual favourite has to be from the (apparently trained) mental health care professional who said the following:

‘Accept you are never going to sleep again, and just get on with your life.’

In no particular order, here are some other bits of counsel that have come my way.

  • Try medication: A big subject. Sleeping pills can be helpful in the short term, but they have diminishing returns. And a particular kind were bad for me, as a psychiatrist briefly had me hooked on benzodiazepines (valium-type drugs), which did make me sleep a bit. However, I also recall standing, shaking, waiting for the chemist to open so I could get my new prescription. Antidepressants are different from sleeping pills. More on all this another time.
  • Don’t try medication: I totally respect those people who cured their insomnia with Jo Malone candles and camomile tea. Mazeltov. Didn’t work for me.
  • Eat more carbs, eat fewer carbs: Eat foods containing tryptophan, an amino acid that apparently turns into the feelgood hormone serotonin. This is then apparently converted into the hormone melatonin, which promotes sleep. You can find tryptophan in turkey, nuts and seeds, kidney beans and turnips. Didn’t work for me, and made me feel a bit sick.
  • Get a FitBit: which will prove you do sleep, actually. Except one night FitBit told me I was sleeping when I was down in the kitchen making some toast.
  • Try Cognitive Behaviour Therapy: another big subject. CBT contains a set of techniques ‘to help tackle the racing mind and behavioural strategies to help reset sleeping patterns naturally, without relying on sleeping pills.’ This is according to Sleepio, an online sleep improvement programme sponsored by the NHS. There is solid logic behind CBT and empirical evidence that it works. It didn’t work back in the day when I was really unwell. Perhaps something to revisit?

  • Other suggestions included: lavender oil on my pillow; spray magnesium on your arm (suspiciously white and gloopy); try reiki (too weird); stop taking naps (haven’t taken a nap since I was three.)
  • Give up coffee: give that person an NVQ!

Does anyone have any new advice? Please write in the comments section at the end.

All the suggestions above (except the coffee one perhaps) are worthy blog topics in their own right, which means I may have material to keep this going beyond the first week.

Ok, it’s getting light now. Time for my first cup of (caffeinated) tea.

Day three: five hours, ten minutes

So I guess that represents some sort of progress. Better than last night, although slightly down on the first day I posted.

I feel pretty good though, which ultimately is the only thing that matters.

During the past couple of months of my ‘recovery’, my sleep time has ranged from a pathetic two hours to a respectable six. The morning after my Daily Mail piece came out, I looked at my phone and the time had moved on by seven hours.

Seven hours!

I did a little Tim Henman fist-pump, texted all my friends and even posted it on my Facebook feed. The reaction was so sweet. Lots of little ‘party’ emojis and general rejoicing, even from contacts who have never even met me.

People can be very kind.

I didn’t feel particularly alert that day, but walked round with a smug sense of achievement. Or maybe ‘non-achievement’ would be more accurate because sleeping is a ‘non’ activity. I think I’ll write more on this another time.

Anyway. Today is a busy one. I have to wrap up some loose ends on one of my magazine commissions and then retune my brain to a task for my Start Writing Fiction course (they require very different ‘head spaces’).

Then I am having lunch with Anthony, my former therapist. Anthony is a wonderful, wise and humane man in his 80s who went far, far beyond the call of duty during my illness. About four years ago, we mutually agreed to stop seeing each other because it didn’t seem to be helping. When I called him to say I was feeling better, he almost dropped his phone.

Anthony does not want to be my therapist any more. He wants to be my friend, which is utterly flattering. So we are meeting at 1pm for a pub lunch in Highgate, my old stamping ground.

After that, I need to run a few errands. Then home for another creative writing task.

I need to stay off Facebook today. The past week or so I have fallen into the rabbit hole of reading and befriending and responding to all the clever people out there, many of them writers I admire. Sadly, this has happened to the detriment of some of my writing coursework.

So, hectic day. Let’s see if it makes any difference to my sleep system tonight.



Day two: four hours, 22 minutes


Two fifty-two am sounds like a brutal time to start the day, and it is. But I went to bed at 10.30, and have had over four hours’ sleep, so it’s okay.

After almost nine years of this shit, I have worked out that four hours is the threshold between lunacy and lucidity (not set in stone, so I may wobble over that line and back again today, even within this post.) The Four Hour Rule was a discovery from the early ’00s when my babies clucked and squawked their way through the night at 45 minute intervals.

Still, Margaret Thatcher famously only needed four hours a night to savage the country. As Maggie would say: sleep is for losers.

(She didn’t, actually. Though on more than one occasion, rumour has it that after yet another night huddled over her despatch box, husband Denis would snap: ‘Woman! Bed!’).

Another apposite quote. When Napoleon Bonaparte was asked how much sleep a person should need, he is said to have replied: ‘Six for a man, seven for a woman, eight for a fool.’

Does that make me a superhero?

Sarah is my sister-in-law, a GP and all-round lovely person. Not so long ago, she tried to give me some advice on this early waking thing. She stole some precepts from Gina Ford, the maternity nurse who has passed into legend for advocating a strict and controversial timetabled routine for babies.

– Try going to bed later, said Sarah, reasonably. You might wake up later, and then your days might be more in line with the rest of the world.

So for a few days in a row, I turned off my light at midnight. It didn’t make the slightest bit of difference. I was STILL awake at two or three am. So I canned that idea.

Anyway. Back to my early wake-up this morning. There’s not a great deal you can do at 2.52am. At around four, I tend to start messaging with my friend Marian, who lives in LA. I still had a couple of hours to fill.

So I googled Maggie Thatcher.

Here’s a brief look at how the rest of my day will be (and by extension, most of my other days.) I’ll normally have a cup of Earl Grey at four or five, and hold out for breakfast around six thirty. I used to be so hungry I ate toast at 3.30am, but I don’t do that any more.

Until I started writing journalism again, my days were filled with two online courses: one for fiction and another for advertising copywriting. Now I have to juggle the three. Then there are Twitter and Facebook: rich worlds which didn’t seem to hold the same opportunity when I was last ‘awake’ in 2010.

Sometimes in the afternoon I need to get away from screens and technology. So I take myself for walks around the beautiful fields (hitherto undiscovered) five minutes walk from the house.

By five pm I am craving a big glass of Pinot Grigio, which is not as ‘bad’ as it sounds, given five o’clock in my world equates to nine pm in most other people’s timelines. The problem then is that by seven o’clock, I have a hangover.

The short evenings I generally talk on the phone, WhatsApp my friends or text my children, work and cook dinner for my dad (I live in his house at the moment.) Then maybe some TV: Chernobyl on Sky Atlantic at the moment. Life could always be worse.

By 10.30 I am shattered. I have a bath, take my pills, read for a bit and fall into an all-suffocating black slumber. No dreams ever.

Four hours later, rinse and repeat.