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Can't sleep at night? A guide to understanding and curing insomnia

7 December 2017

MyUCL student journalist Soleil Samanor explores what can keep us awake at night.

Bedroom

At what point does being unable to sleep become something more serious? Insomnia can start from something as simple as a few poor nights of sleep, according to Clinical Psychologist Dr. Steve Orma, the acclaimed author of Stop Worrying & Go to Sleep and expert on insomnia. After these few poor nights, "you start to worry and get frustrated when the not falling or staying asleep continues. You start to dread going to sleep and worry even before you get into bed that you won't sleep, which creates more anxiety and stress, making sleeping more difficult, leading to more frustration and worry." Efforts to "compensate" for the sleep disruption (such as sleeping earlier) result in long-term poor sleep and stress. 

"Eventually", Dr Orma explains to me during our interview, "because of so many sleepless and frustrating hours and nights in bed, your mind and body start to associate sleeplessness with your bed and bedroom. Instead of your bed becoming a signal for pleasant rest, it becomes a cue for anxiety, frustration, and wakefulness."

Considering how insomnia reportedly affects over 30% of people, this situation might be one you're familiar with yourself. As much as life at university is an exciting one, it's also often the period in your life where your sleep is the most disrupted. Essay deadline-related stress (for both lecturers and us students!) and late nights partying are only two of the many causes for those sleepless nights. 

Luckily, there are ways to overcome insomnia and much research has been done with regards to long-term solutions for this condition. If poor sleep is something you've been suffering from, this article is everything you need right now. I caught up with Dr. Orma and Professor Colin Espie, world sleep expert from the University of Oxford and co-founder of Sleepio, to help answer your most pressing sleeplessness-related questions. 

In order to even begin tackling the issue of how to overcome insomnia, you have to realise what factors are causing it. Professor Espie categorises the causes of insomnia into what he calls the '3ps':  'predisposing', 'precipitating' and 'perpetuating' factors.  

The classification is an incredibly illuminating one. "Predisposing factors do not 'cause' a problem but may increase the likelihood of it occurring. When thinking about insomnia, these could include having a family history of poor sleep, or generally being a 'worrier.'" 

On the other hand, precipitating factors, or, as Professor Espie also terms them, 'triggers' "might include lifestyle changes, sudden illness or the birth of a baby, for example. In fact, many people who struggle with poor sleep can identify a specific trigger for their sleep disturbance." 

"Finally, perpetuating factors cover anything that is seen to maintain or exacerbate a problem. Important amongst these is getting into the habit of trying to sleep." 

Thus while we may assume that insomnia is caused by sudden changes, the causes of our sleeplessness can often go much further than that.  

Personally, I'd never considered this deeper level of insomnia. After I started university, I'd assumed that it was my deadlines alone that had caused my sleeplessness, and that once they were over I would go back to sleeping normally. I didn't. As someone who has the tendency to overthink everything, I was already at a risk of insomnia. When I found I was unable to sleep after a few days, I did exactly what Dr. Orma described: trying to 'compensate' for my sleeplessness, worrying even more than usual, and associating my bed with sleeplessness, making me put off sleeping and spiral further into a pattern of insomnia.  

And yet there is hope for a way out of the vicious circle. According to Professor Espie, "the most effective, long-term solution to insomnia is CBT or Cognitive Behavioural Therapy which addresses both the mental (or cognitive) factors associated with insomnia, such as the 'racing mind', as well as helping people establish a healthy sleep pattern." 

This approach involves "taking practical steps to make your day more pro-sleep - like exercising regularly, avoiding caffeine after lunch and taking some time to wind down before you head to bed. Keeping a bottle of water at the bedside for rehydration during the night can be helpful and, most importantly, try not to nap during the day - save your sleep for the night."

Treating insomnia needn't be a journey you take alone though. There are clinics across the country and the world specialising in helping you overcome the condition. Halfway between tackling insomnia alone and visiting a clinic though is the option of reading a book dedicated to just that, or trying out an online programme. Professor Espie's Sleepio, a world-famous digital sleep improvement program, is celebrated around the world for transforming healthcare; you can find the incredible programme at: https://www.bighealth.com/

I've already mentioned Dr. Orma's wonderful book, Stop Worrying & Go to Sleep, but I'm going to mention it again because the whole concept of the book and story behind it is so inspiring. The book is a step-by-step guide for overcoming insomnia, based on cognitive behavioral therapy for insomnia, and is definitely worth buying and reading, especially as it comes written by someone who has been exactly where you are now. Dr. Orma himself developed insomnia while at graduate school, but cured his sleep problem in just eight weeks after extensive researching. All his advice is contained in his fantastic book, which you can buy here.