Thursday, February 2, 2012

Our Guest Blogger Writes About Insomnia

We've suffered from insomnia on and off throughout different times in our life, most recently was almost a year ago (until just recently, again); it started to creep in last year when we stopped smoking cigarettes (a pack a day) and pot (1-2 grams, on our own) every day to cope with our life and to fall asleep, and it lasted months…so we took up drinking scotch, gin and wine to cope and sleep, instead. Yeah, we’re a regular picture of health sometimes.

It’s always funny (but only to us, obviously) how Kerry’s guest posts sit in our mailbox, unread, and then pounce on us at just the right time. We were cleaning our e-mails today and as we were deleting crap (and remembering we had a big e-mail from a reader to follow up on - you're still in que, Alan M.) we uncovered two blog entries Kerry sent a month and a half ago; granted we’ve had a busy month and a half, but never mind that. It’s funny because just last night we were talking to The Boyfriend, James, asking about how he was going to handle our growing insomnia, if it hit full again…because we can feel it creeping in...we are finding it increasingly difficult to fall asleep (even hours after we disconnect from Twitter). Chances are it’s being caused by the uncertainly we feel about things in our life, which are still in the air: James having to go back to the UK in January, the house still not being sold in the city where we used to live, our impending United States adventure next year, general anxiety about our writing, our painting/art, our life, our bills, employment, our health, our relationship, each other…it’s no wonder we’re not finding it easy to fall asleep. Not to mention, we've been decreasing our drinking on average. We still have a glass of wine or two an evening, but that merely means we’re more often than not, drinking below 50% of what we used to…which means we're not falling asleep as easily. Tonight we may find our way to the bottom of the bottle, just to see if there are some ZZ's there for us.

So, after reading Kerry’s entry, we thought today would be a great day to post it, not only because it's applicable to our current health, but because a lot of people (particularly on Twitter) claim to be suffering from insomnia, AND because people are stressed about the holidays meaning there are likely a lot more people experiencing it.

Kerry provides some great tips/techniques that can be used to try to help overcome insomnia. She also talks about why sleeping medication is not a great idea (though, man…if someone wanted to send us some Ambien for Christmas…we sure wouldn’t mind, that stuff is amazing) and she speaks from clinical and personal experience.

Anyway, read what Kerry has to say about it, she’s a nurse, and she knows what she’s talking about, and she’s funny too!

~Frank et al

I Can’t Get No Sleep!

Classic opening line to the Faithless tune Insomnia [
v=tBrUjvONIrA]. From those of you who follow me on twitter you and my blog post ‘Fear’, you will know that I have been suffering from clinical insomnia. I really just can’t get no sleep.

What constitutes insomnia? At least 3 nights with an significantly interrupted sleep pattern over the period of a month according to the DSM-IV (2000) and NIH, 2 trusted sites; you know that I do not like to give you either wishy washy or mumbo jumbo bullshit in these posts. The thing with insomnia is that there is normally a definite reason as to why you get it. Although not uncommon it is rarer for someone to develop spontaneously. Poooofff out of the blue you can’t sleep!

Now most people don’t go to the GP straight away and whine that they can’t sleep. Normally try a range of things to help. Things generally start with an extra glass of alcohol (which ever type takes you preference) or a nice large take away meal that you feel all sleepy with afterwards. But really we all know, and evidence backs this up, that you may initially go to sleep but you end to wake earlier and not refreshed. Generally feeling as though there is a gnome hitting your head with a hammer and some bastard cat has shit in your mouth. Although we are probably all aware of this we still keep doing it. This is because it gives us temporary relief from the anxiety or not being able to sleep.

The first most sensible thing I can suggest to you is that if your insomnia has just started, it would be a good idea to checked out by your GP just to make sure that there is no medical cause; of which there are hundreds. It may be easily remedied. However, sleeping pills or other medications may not be the best option for you. The thing about medication, particularly sleeping pills is that they tend to give a ‘chemically’ sleep, not natural with a hangover effect in the morning. With long term use they do not help with the body’s natural circadian rhythms (sleep/wake pattern) and can cause a reliance or addiction in a very short space of time. This is why they are not recommended for long term use. Not just that the GP is being a bastard and not giving them to you; your GP may well be a bastard but they are actually keeping within clinical guidelines and trust me you don’t want to be addicted. The emphasis is always on getting you to return to your natural sleeping pattern. Drugs always have their uses but they are not everything. Getting to the underlying cause is the best place to start and using meds to bridge the support between helping your health and regular sleep pattern.

The flowing self help information is by Dr Helen Oataway, a psychologist and cognitive behavioural therapist who specialises in sleep. It is her work that I use for myself and my patients but there are other people out there with similar techniques. I am laughing my ass of because I took the clinical lead on sleep and the sleep clinic whilst I worked in prison and now I have insomnia, the irony is hilarious!

The next place to look at is your environment. The bedroom should do exactly what is says, it should be a room with a bed in it. Most people have TV’s, DVD’s, computers, books, game etc in their bedroom, particularly children. The brain is then not sure if you want to sleep or play so remains active therefore it’s not really so surprising that we can often wake up again when we get to bed. The bedroom should be shrine to sleep. It should be a grown up space, free from children and kids toys, it should be tidy so that when you walk into the room, your brain automatically thinks ‘sleep’, or sex; you can do both but let’s face it we spend most of the time in our bedroom sleeping. A tidy room is best because then we are not thinking that we need to clean up or put something away, clutter free too if at all possible. Having a nice comfy bed, duvet [comforter] and pillows is essential with some luxury bedding, the best you can afford because life without quality sleep sucks! The temperature of the room is key as well, too hot or too cold and we can’t sleep, some nice fresh air also helps a lot.

A bed time routine. We often think that we are ‘grown up’ because we can do whatever we want to. Yes we can but all that means is that we can make the choice to be grown up or arseholes, whichever way you want to look at it. One of the things that we desire as children is to not be told when to go to bed but we tell children to go to bed because as good parents we understand that they require enough sleep. Why should we not afford ourselves that same level of self love and respect? Unfortunately self abuse, such as the eating, drinking, gaming, etc. – of any sort tends to be fun and the consequences, such as getting a good night’s sleep, can go hang! Being sensible is not sexy but it’s what keeps us healthy.

Having a regular bed time and routing allows our brains to cotton onto the idea that we are going to sleep. In a similar but the reverse way to how we gear ourselves up to go out. We may go for a shower, put on some music, and dance around as we dry our hair, put on perfume and make up and then dress – no? Just me then? Each one of those things that we do enforces the concept within our brains that we are going out and going to have a good time. Therefore in reverse it must work too. Having a shower, getting into our PJ’s, having a hot drink (not caffeinated), a chat with our partner, putting hot water into the hot water bottle or the wheaty bag in the microwave, cleaning our teeth, then going into a tidy bedroom and snuggling down. All of these actions help out brain realise that it is sleepy time and that the only place we are going is to the land of dreams. Playing on the X-Box, loud music, exciting films or TV or reading an exciting book are not conducive to a good night’s sleep and expecting our brains to switch off after such stimulation is just asking for the impossible. You would not expect others to be able to sleep after such stimulation, so why expect it of yourself?

Firstly there are different types of sleepers; some people naturally sleep for a long time 10-12 hours and some people only need a little amount of sleep 4-6 hours and everything in between. Knowing what type of sleeper you are and what disturbance you have is a good idea because then you can if you are really having difficulty with your sleep or if you are falling within your ‘normal range’. We all wake up at night, about every 90 minutes, it’s kind of like coming up for air. If we roll over and go straight to sleep our brains will often not register that we have been awake at all. We might remember waking but we then roll over and going to sleep. If we do wake it is generally at the end of these 90 minute cycles. You know the days where you feel really sluggish and can’t do anything, well this is probably because you have been woken in the middle of your sleep cycle. People also generally fall into the categories of being a ‘night owl’ or an ‘earl bird’ and function better at either the morning or evening as is your preference.
Eating and drinking the right stuff before bed is a good idea. I do not subscribe to those types of diets that say you should not eat after 6pm or 7pm or 8pm. It’s (in my opinion) not necessary to be so restrictive and no fun at all! Eating heavy meals such as takeaways that have a lot of fat in them, is difficult for the body to digest. Which is why often if we’ve had an Indian takeaway the night before, we don’t always feel hungry the next day because it’s still in out stomachs trying to be digested. Once in a while is fine but perhaps not every night. The same goes for alcohol. Yes it knocks us out if we have enough of it but the type of sleep it gives us is not of good quality and most people wake up early after having had a drink and feel pretty crappy too. In addition if this is an antidote to insomnia it comes and a high financial and physical price; it’s expensive and fucks your liver!

So there you are lying in bed; awake, what to do now? Well provided that you have done the above, you should be at least part of the way there. When we feel tense, we can forget how it feels to relax. Having a good stretch from the tips of our fingers o out little tippy toes is good and feels nice. Tensing then relaxing, then tensing, then relaxing each area of out bodies is good i.e. tensing out feet by curling our toes, then pointing them, then relaxing and repeat. Do that with your feet, calfs, thighs, hands, fore arms, upper arms, bottom, and finally tummy. Be aware of how this feels. You can also used visualisation; picture a warm ray of sunshine, starting again at your feet and warming your body up slowly bit by bit; warming all of your muscles p and releasing that tension.

Other methods include linking your mind with your breath. Giving your brain something to occupy itself without over stimulating it. Breathing normally but deeply, count backwards from 100, it’s a nice juicy big number. Linking means breathing in 100, breathe out, breathe in 99, breathe out, and so on. The reason for not counting forward is that we can all do that automatically but counting backwards takes a bit more concentration. In addition if you get muddled up (I hope you will, it shows that you’re sleepy) go back to the start, what else were you going to do, you need to sleep right? In addition to this technique you can re-count to your self things that you are grateful for or feel blessed by like friends, getting that last piece of chocolate cake, breathing anything you can think of. For each blessing allow 5 breaths.

Other techniques include what time you fall asleep. If you don’t fall asleep until 2am, don’t go to bed until 2am. There is no point in going to bed when you are ‘supposed to’ when all you are going to do is toss and turn and wriggle. Go to bed and mean it, bed is to sleep. What this does means that you sleep in bed and it retrains your body and mind. After a week of this technique working, bring your bed time forward by 30 minutes so you go to bed ½ an hour earlier. Repeat, until you are going to bed at the right time for you. If you are lying in bed for more than 20 minutes and these techniques are not working; get up, do something else but something quiet and soothing.

Common mistakes that people make are cat napping and lie-ins. With more recurrent sleep disturbances cat napping, or sleeping during the day, whilst very tempting when tired only compounded the inability to sleep at night thus adding to our nocturnal anxiety. Having a lie-in is one of my personal favourite occupations, except when I have insomnia. Having a regular time to get up helps retrain the body and mind, no matter how much you want to stay in bed, so get your ass up.

Focussing on why you are not sleeping rather than just shrugging and accepting that you are not sleeping is a good idea. Please try some or all of the things that have suggested and I hope we all get a good night’s sleep.
Night night
More on our blog written by Kerry (@kerrystott) :

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