Can't sleep?
You're not alone.
Neither can I.
And as it turns out nor can millions of us.
Around 30% of people in the UK suffer from poor sleep
and one in 10 would meet criteria for insomnia.
If you're someone who struggles with sleep, you've probably seen a lot of this.
Hi guys, how I fall asleep quickly …
If you have insomnia, you're not working hard enough.
And you may have tried some of these.
I highly recommend this if you're having any issues with sleep.
But that elusive cure is hard to find
and all the while, you're still lying awake.
So I'm just going to lie here for the next three and a half hours
until about half an hour before my alarm goes off.
When I'll fall to sleep.
If it isn't already obvious, I'm an insomniac.
And I'm trying to find out why
curing insomnia is so hard when the problem seems so simple.
I'm speaking to sleep experts, other insomniacs and I'm also monitoring my sleep online,
which has been surprisingly helpful.
I'll come back to that later, but first I want to know what's going wrong.
Why can't I sleep?
Occasionally something happens in life that disrupts sleep for a bit
and it's acute but it settles.
You know, you move house, the dog dies, it's Christmas, mother-in-law is coming around …
It doesn't matter, there's something acutely stressful and it's a normal response,
at one level, to be a little on edge and not to sleep as well.
But that usually settles, it doesn't become this engrained habit
where you start to chase sleep.
If you go three, four, five nights a week, so most nights of the week, for three months or more
that would be defined as insomnia disorder.
You know, this has become a problem.
And then people with chronic insomnia, they start to do things,
not deliberately but they're making the night worse.
They start to chase sleep, they start to become much more preoccupied
with the act of sleep itself, so paradoxically, they are making insomnia worse.
It's 2:43am.
I woke up at half past 12, went back to sleep again, woke up at half past two.
It's quarter past five, I've been awake since 3:30.
My mind can't stop thinking.
It's obvious to me that insomnia has a lot to do with what's going on in the mind.
To find out more about it, I spoke to a clinical psychologist
and he started by looking over a sleep diary that I've been keeping for the past two weeks.
Hello.
Hi.
Nice to meet you.
Nice to meet you too.
So Leah, I've had a look at your sleep diary, very well kept by the way, so thank you very much.
Thank you.
What I can see is that you have quite an irregular pattern.
There's days where you are getting two or three hours sleep at night
and there are days when you are getting much more.
The times your getting out of bed can vary from really, really early in the morning to midday.
I'd like to add, that is just at the weekend.
Something that lots of people who describe poor sleep report
is that before they go to sleep, they tend to get this buildup of what we call
'excessively negative cognitions'.
Pretty unpleasant thoughts about sleep, so things like, you know,
I just know I'm going to have another rubbish night tonight,
you know, I bet you I'm not going to be able to get to sleep.
Oh yeah, I think about how well I'm going to sleep that night
probably for about two hours every day.
Up until relatively recently, sleep problems such as insomnia
was often seen as kind of a secondary complaint to things like mood disturbance or anxiety
and it was sort of relegated to the back of the queue
and we treated the other elements of the picture
but then also didn't really put too much attention on insomnia.
Yeah, I sometimes feel like embarrassed to complain about it
because all I'm really saying is that I'm tired and everyone's tired, aren't they?
But I kind of think if people understood a little bit more what it is we're saying
when we say we're really tired, then it would be taking a bit more seriously.
It's not only the effect it has on you, the change it brings into your life.
but it's also the social aspect of it which is very difficult to deal with.
I generally find it quite hard to navigate my way sensibly through a conversation.
I can't commit to people events even holidays that I love.
Even go to the cinema is sometimes an effort.
Poor sleep isn't just about feeling groggy the next day.
Stuff like mental health problems, heart disease,
diabetes and cancer are more likely if you're not getting the rest you need.
So it is a pretty big deal.
Every function within brain and body requires sleep.
So whether it's immune function, whether it's when your growth hormone's secreted,
whether it's the control of metabolism,
whether it's consolidating all of your memories.
So it's an absolute necessity, it's just not something we can do without or interrupt
for any length of time at all.
But if you've ever been to the doctor for this,
you've probably been told stuff that you've already heard.
Eat a banana before bed, turn off your phone,
take a relaxing bath, take some sleeping pills …
But if you're anything like me, you'll agree that this stuff just isn't good enough.
It can feel quite unfair.
So if it's like, getting up at 6am every morning to go for a run,
only eat salad all day, coming home, not doing anything an evening apart from read a book,
going to bed at 9pm …
Do you know what I mean?
So whereas people who just sleep don't have to think about any of this stuff
and I kind of think, well I can't be bothered to do any of this,
I just want to do what I want and then I deserve to go to sleep.
It's a really good point.
You do deserve to go to sleep
and you don't deserve to worry about all this stuff.
I see people in clinic every week and they say, you know,
all I've had for years is sleep hygiene leaflets
and it doesn't work and I would totally agree the evidence is very clear that
sleep hygiene is not a treatment in and of itself,
it's a foundation on which we build good sleep.
I don't smoke, I only drink socially.
I don't have any caffeine apart from the odd chocolate bar.
I've tried sleeping tablets and meditation and yoga and nothing really helped.
There's two problems that GPs have:
one is a practical management issue,
they don't have the resources to help people where sleep's concerned,
because they only have access to sleeping pills.
They don't like to disappoint the patients, so they end up giving them
a doses of treatment that are not effective like suggesting things
or maybe your room's not ventilated well enough,
things that people already know.
With professional medical help lacking,
there's an endless stream of videos, forums and products that all claim
to solve your sleep problem.
And I am definitely not immune.
I've downloaded all the sleep apps, tried all the at home remedies,
invested in expensive bedding and spent way too much on the latest sleep tech.
This is something really, really important and to get it right
it merits clinical help and what solves insomnia problems best
is something called cognitive behavioural therapy.
because you use strategies to deal with that mental preoccupation
to help get the sleep pattern back into a normal rhythm
and to allow sleep to happen naturally.
CBTI works by changing the thoughts and habits that might be making sleep difficult
and can prevent the negative patterns that stop us sleeping.
CBTI is really good for treating insomnia.
There's a wealth of clinical literature
that's showing this to be an effective way of helping people sleep better.
Unfortunately in the UK, it's not as widely available as I'd like it to be,
and I think as everyone would like it to be,
but it's worth looking out for the treatment whether that's provided through digital medicine,
through psychological therapy services or through some other means.
It's CBTI that you're looking for.
If this is something that we know works,
why it is that it isn't more widely available?
I think GPs are clearly under a huge amount of pressure these days.
We haven't got enough GPs in the NHS
and I think coupled with the fact that sleep medicine is a relatively new field,
clinically speaking, and it hasn't drawn the kind of attention that other things have
and we're beginning to recognise it as a legitimate complaint.
I need more sleep because I'd like to be a happy person and fulfilling my potential.
Bye.
Going into this process, I thought that I knew everything there was to know about insomnia.
I've also realised that I had basically given up hope of ever changing it
but actually this isn't the way it has to be.
I've decided to take it more seriously
because it is a genuine condition and I'm now going forward going to treat it as such
and for the first time, basically in my life,
I've got hope that potentially this could change for me.
Thank you for watching.
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