Why modern women can’t sleep

Look at her below – totally spark out and without any of the apps, gadgets or gizmos we have these days. Why? Because you don’t need fancy tech to help you nod off – the answers are all in your head, says former insomniac Kate Mikhail.

insomnia
The Maas Gallery

Lack of sleep is a huge problem. Studies suggest that at least 30 per cent of the issues GPs face are directly or indirectly related to it. Yet just one Briton in ten talks to their doctor about insomnia, despite 30 per cent taking medication to try to deal with it. I know, I was one of them.

I could never take sleep for granted. I can remember the knot in my stomach and the rising anxiety and exhaustion that came with still being awake at 3am, knowing I had to get up for work just a few hours later. I tried an eye mask, ear plugs and lavender oil. Sleeping pills were my last resort – not that they were any match for a good night’s sleep. They left me feeling leaden come morning, but having a few hours’ sleep was better than nothing.

Even when I did get enough sleep, going to bed ridiculously early or playing catch-up with a lie-in, I still woke feeling exhausted, weak and hollow. There were times when I just hit a wall, burnt out and too weak to do anything. Sporadically, I asked that my doctor run tests for deficiencies and conditions that didn’t exist.

What changed was stumbling across a book written by my great-great uncle, Richard Waters, a pioneer in cognitive therapy and the far-reaching effect thoughts and words can have on our emotions, behaviour and health. At the time my sleep was worse than ever, which is why the insomnia segment jumped out at me.

Waters wrote about sleep and the power of thoughts and words. He believed that in combining the biology of sleep with the power of suggestion – the brain is very suggestible – you can harness both the conscious and the unconscious mind with amazing results.

I decided to investigate and what I learned not only dismantled my chronic insomnia but also set up a strong sleep pattern that I hadn’t enjoyed since I was a young child.

Talk nicely to yourself

There are many mind-boggling behavioural-science experiments out there that expose how suggestible we all are. For example, I can tell myself, ‘I feel excited’, when, in fact, I feel sick to the stomach with anxiety – and my brain will miraculously buy into this. So when it comes to sleep you have to change the story you tell yourself.

The problem with calling yourself an insomniac, rather than just someone who is having trouble sleeping well right now, is that it feels like a done deal: it’s part of your identity that you have to live with. Instead, you’re better off seeing your sleep issue as something that might affect you today but doesn’t have to tomorrow.

So rather than repeating you’re a ‘bad sleeper’, tell yourself ‘I might not be sleeping easily right now, but I am someone who sleeps easily.’ It is possible to change things. The brain is not fixed.

Halt those thoughts

If your overactive mind is keeping you awake at night, thought-stopping can help. This means trying to break obsessive or intrusive thoughts – such as ‘I’m never going to sleep’, ‘Tomorrow is going to be ruined’, ‘I’m going to be exhausted again’ – which can set off negative feelings. Thought-stopping is a gentle but firm way of holding up a hand to stop the chatter – a mental ‘shhh’.

Even thoughts that are not negative, such as planning tomorrow or next week’s to-do list, need to be stopped. These sort of thoughts used to be one of my worst sleep habits, and it is the same for many people. If we don’t pause or catch our breath during the day or have any alone time, going to bed can end up becoming our window to reflect, ruminate and solve problems.

I managed to put an end to my ‘bed is my time to think’ habit by writing down my to-dos and work schedule before I went to bed, so I could tell myself, ‘That’s all been dealt with, I don’t need to go over it now. I can think about it tomorrow.’

If unwanted thoughts do creep in, I either swap them for mentally listing things I am grateful for (which research shows gets concrete sleep results after just a few weeks – increasing sleep duration by nearly an hour) or just say (in my mind): ‘Stop! Enough of that. It’s time to sleep.’

The cue ‘Stop!’ is effective because it distracts you (breaking that habit sequence) and because it is recognised by the brain as a ticking off and a ‘punishment-orientated command’. By punishing yourself when you find unhelpful thought patterns or sleep-blocking mental loops taking over, you weaken the habit. The more frequently you do this, the more effective the cue.

insomnia
London/Bridgeman Images

Get with the science

Having a basic grasp of the biology of sleep can really help. For example, I know that deep breathing at night dramatically slows down my brainwaves, as well as setting up the rest-and-digest state I need to be in to nod off, so I try to visualise the way the slow-down message is sent around my body.

While I know stress and overstimulation disrupts this slow-down process, creating chemicals in my brain that prevent me from sleeping, I also know there are things I can do to counteract this. During the day, for example, I can opt for a morning walk, mindful pause, mini reward, chat with a friend – anything to up the levels of the happy chemicals that promote sleep.

I know staring into a pitch-black bedroom will also produce chemicals that help to turn off my awake state, and that by sticking my hands and feet out from under the duvet I will bring down my core temperature, which is needed for sleep and is useful if I wake from overheating in the middle of the night.

By being aware that we sleep in roughly 90-minute cycles, I can dispel panic about broken sleep if I wake between cycles, and nod off for another cycle when waking too early.

Similarly, understanding that there isn’t a hard line between deep rest and sleep, between the conscious and the unconscious, takes the stress out of feeling that you’re only half asleep. I tell myself, ‘You’re getting more sleep than you realise’ and I find this reassuring and calming to the extent that any niggling insomnia panic immediately backs down and I can relax into sleep and leave my conscious mind behind.

Write a sleep script

A sleep script is, quite simply, a form of self-hypnosis or auto-suggestion. Hypnotherapy has been shown to work in a number of medical situations – one study of 1,000 patients with IBS showed that after 12 weekly clinical hypnotherapy sessions, 76 per cent reduced their symptom severity by half. But self-hypnosis can be just as effective.

While this isn’t a silver bullet, when it is combined with other positive sleep behaviours, an understanding of the biology of sleep, the power of suggestibility, and the physiological changes that words can have, it can help to change your attitude towards sleep and prepare you mentally before bed.

The sleep script works best when you listen to it, so you can either record yourself reading it, or have someone else read it. But it needs to be read slowly, with lots of pauses, to slow you right down, to make you more receptive and give your brain time to absorb the messages.

Ideally, you should listen to a script in the same place at the same time each day, as the associations wrapped up with a particular setting send a very clear signal to the brain. If you can choose a particular armchair, room or park bench, your brain will know what’s about to happen and you’ll feel more relaxed and in the zone, even before the script starts to roll.

That wasn’t an option for me, although I did set a 5pm alarm on my phone to anchor the script to this part of the day, and I would try to listen to it then or soon after. A 6pm or 7pm reminder might suit your lifestyle better, but only you will know the most convenient early evening time slot for you.

Why hormones are sleep’s worst nightmare

Hot, bloated, uncomfortable, in pain… when it comes to sleep, women have extra obstacles thrown at them. These might include the cramps of the monthly menstrual cycle or, generally more disruptive, the hot flushes, night sweats, anxiety and insomnia that can come with perimenopause and menopause, which can last for decades. Up to 90 per cent of menopausal women in the West suffer from hot flushes and night sweats that ruin their sleep. And while the average age for menopause is 51, the range is anything from 45 to 55 years and the lead-up to this, known as perimenopause, begins four to six years before, with sleep problems sometimes starting then and subsequently dragging on.

The body’s thermostat goes slightly haywire during the perimenopause, menopause and post-menopause thanks to fluctuating hormones and a drop in oestrogen. Previously, oestrogen worked to keep the body’s heat on an even keel, but now, with lower oestrogen levels, the body cools itself down by releasing heat via a hot flush. Night sweats are the nocturnal version of this, where sleepers wake up to find themselves soaked in sweat, and it’s these broken nights due to waking up hot that women say is the main reason their sleep falls apart, leaving them exhausted during the day.

So what can you do?

First of all, set up your bedroom to be a cooling space – use light, natural fibres for bedding and nightwear and consider a wool mattress topper, which can disperse body heat effectively. Keep a fan, wet flannel or cool pack close to hand if needed. Hot flushes are very responsive to the way we breathe. So if you wake up feeling like you’re overheating try some controlled breath work: inhaling slowly to the count of five and slowly exhaling to the count of five. This will bring the number of resting breaths down from 12 to 20 per minute to around just six, and can be incredibly effective in subduing hot flushes.

At the same time, challenge and replace any sleep-panic thoughts by saying to yourself, ‘This will pass and I will get enough sleep to manage.’

For the best rest

In my book there are other, longer sleep scripts, but this short one, written by Richard Waters, is the one that I used to listen to religiously at around 5pm when I was trying to sort out my sleep.

‘Tonight, as soon as I decide to go to bed, my sense of the realisation of bedtime will be followed by strong and sustained action throughout my system, which will prepare me for sleep. As I move off to my room, I will commence automatically to relax in mind and body. All the nervous strain and tension of the day will drop away and as I undress and generally prepare for bed, I will be inwardly preparing for rest and sleep even more completely. Thus, I will find myself in bed, restful in mind, functionally restful in body, and as this good habit of changing my state every night develops ever more fully, I will obtain ever more complete, full and restful sleep.’

This is an edited extract from Teach Yourself to Sleep: An Ex-insomniac’s Guide by Kate Mikhail to be published by Piatkus on 10 June, price £14.99. To order a copy for £13.34 until 14 June, go to mailshop.co.uk/books or call 020 3308 9193. Free UK delivery on orders over £20.

Book extract edited by Claire Coleman