When I can’t sleep, that Faithless song "Insomnia" starts playing in my mind – the lyrics “Tearing off tights with my teeth… I need to get some sleep… I can’t get no sleep” and then the techno chorus, which briefly makes me want to get up and dance with a glow stick until I realise it’s 3am and I’m in bed, not in da club.
Typically I get into bed around 11pm, still optimistic after all these years that it might be fine – but then I’m too hot, then my right leg is too cold, then there’s an itch going around my body that flares every time I think I might be dropping off. I try the sofa, I open the window, close it worried about birds flying in, go to the loo an absurd amount of times thinking it might be that single drop left in my bladder holding me back. I change into more comfortable pants. I switch my cotton pyjama top for a silk pyjama top. I tussle, turn, give up, regain hope, give up again, disintegrate, cry, resolve to keep calm and carry on, accept with psychopathic calm that it’s 7.04 and I’m still awake. Get up for work, take zoomed-in photos of my puffy eyelids to use as evidence in a future court case where I have to prove my sleeplessness, give in to tears in the shower, then again on the Tube, then again in the coffee line, wondering if I’ll ever sleep again.
I’ve suffered from insomnia since I was about five. I remember my primary and secondary school teachers’ disbelieving faces as I tried to explain why I had had so many mornings off school or why I was always late or why I’d fallen asleep in class. I think they thought my mum just wasn’t strict enough as her honest sick notes – “Sarah couldn’t sleep again” – sounded soft. “Go to bed earlier!” my form teachers shouted and told me to get on with it. I did learn to get on with it but sadly that’s never resulted in any increased shut-eye. I’ve been on medication that sedates me before bed for around six years now, which works most of the time and helps me function as a normal person but sometimes, like the last 10 days, it stops working, and then all the clocks start dripping around me.
After decades of sleeping with the enemy, I’ve heard every well-meaning sentiment from friends, colleagues, coffee shop baristas, doctors, and therapists. Apart from the hardcore prescription drugs which continue to save me (thanks Doc), there’s only one piece of advice that’s actually helped, and it’s from Fight Club in the scenes – notably – before Jack’s insomnia gives way to schizophrenia and Tyler Durden’s mass destruction. He goes to the doctor to ask for some sleeping tablets and the doctor says, “No, you can’t die of insomnia” and Jack says, “Maybe I died already. Look at my face” and the doctor says, “You need to lighten up” and Jack says, “Can’t you give me something?” and the doctor says, “You need healthy, natural sleep. Chew valerian root and get some more exercise.” So not the valerian root bit – that’s definitely in the pile of things not to say to an insomniac, but the “No, you can’t die from insomnia” bit is what comforts me most as dawn breaks – because it’s true! I’ve asked every doctor and psychologist I’ve ever met and they’ve affirmed that as far as medics know, no one has ever died from insomnia alone (without other conditions).
So you could start by saying that. And if you know someone struggles with sleep and they look a bit wild or vacant today, try actively asking how they’re sleeping and listen to the answer even though – irony to one side here – it’s insufferably boring listening to someone’s accounts of sleeplessness, like listening to someone’s dreams about their old family home. But you’ll be rewarded for your patience in heaven and it will mean that the insomniac will always look upon you fondly, and probably also put you forward for promotions and things when opportunities arise.
On the other hand, here are a few things to avoid:
"Have a bath before bed" / "Try reading a book"
I write this from my fourth bath this week on a cloud of Radox ‘Sleep’ bubbles surrounded by Diptyque candles, a book strewn on the floor that I stopped reading 45 seconds ago because it’s impossible to turn a page unless you have a dedicated book flannel. If you suffer from insomnia, you will have had more baths than the average person in an attempt to relax as everyone says you should. This basic advice is, infuriatingly, top of the tips list for treating insomnia on the NHS website and is the first thing anyone over 50 who’s usually in during the week suggests. But… reverse the bath tip for a second and imagine your friend is saying "I just can’t concentrate at work at the moment, I don’t feel alert during the day" and you saying "Have you tried not having a bath the night before?" It doesn’t make sense.
"Well, you look fine!"
This sounds like a nice thing to say, and it is, thanks, but whenever I’m having a bad bout people will say, "Well you look great! You’d never be able to tell!" which is hard because if my face did show that I hadn’t slept in three days, then people would be able to see that actually I wasn’t alright, which would be a comfort I think, as well as confirmation that myself and my insomnia are real things.
"You’re probably sleeping more than you think you are"
You may as well ask me why my pants are on fire. This is hard to hear if you’re having a tough time sleeping and you’re trying to confide in someone with your face fixed in a serene position so as not to scare them when inside you feel like Jack’s raging bile duct.
"Have you tried weed?"
I’m yet to understand the benefits besides gorging on oven pizza and one out of every 10 times falling over laughing.
"Have you tried going for a run?"
Lots of doctors actually advise against cardio in the hours before bed because as well as wearing you out, it pumps you with adrenaline and stimulates the brain, keeping you awake.
"Margaret Thatcher only slept four hours a night"
It’s true that some people need less sleep than others. And that older people need less sleep than younger people, and that teenagers and babies need the most of everyone. I tell myself this one a lot but the fact remains: I’m not Margaret Thatcher.
"Apparently lying down in bed is almost as good as sleeping"
This one must be true, because otherwise people would die from insomnia/ exhaustion. Maybe it should be in the do’s pile. Sleep guru Dr. W. Chris Winter swears by this theory, going into the details in his book The Sleep Solution. From personal experience, I would say it almost definitely helps, which is why I lie in bed during the ‘sleep hours’ trying to sleep instead of getting up and ruling with an iron fist.
"Have a glass of wine"
This seems to work for most of the nation but alcohol, while a suppressant, stimulates the gut so usually people fall asleep after wine, but get woken up a few hours later as their stomach starts to digest it.
"Try not to worry about it"
Insomnia is caused by lots of external factors – many of which are within a person’s control such as alcohol, caffeine, temperature, noise, looking at screens before bed – but the number one cause of insomnia is stress, anxiety and depression, which is a lot more complicated to tackle. It’s a maddening Catch 22 because anxiety, stress and depression cause insomnia, and insomnia causes anxiety, stress and depression, so irrespective of whether the chicken came first or the egg, you end up scrambled. With chronic or acute insomnia, far from ignoring your worry, you must address it – so speak to a doctor, psychologist, sleep expert or medical professional if it persists. You'll likely hear some of the above tips, but hopefully take away something useful too. Cognitive behavioural therapy is thought to be an effective treatment, as well as anti-anxiety medications, which sometimes have sedative effects.