Insomnia is hell. So why aren’t there any good treatments for it?

    15 April 2016

    Margaret Thatcher famously said that sleep is for wimps. But there are no two ways around it: not sleeping is hell. I regularly find myself lying awake at night, often for hours on end, applying intense concentration on not sleeping.

    I am a wimp. But I am not alone. It is estimated that up to one third of the British population suffers from insomnia, described by the NHS as ‘difficulty getting to sleep or staying asleep for long enough’. If you are all too familiar with counting sheep, or know well the cadence of the dawn chorus, you may be a sufferer too. (The NHS advises that a ‘normal’ night’s sleep for an adult is considered to be ‘around seven to nine hours a night’.)

    Many of history’s greats are said to have suffered from chronic sleep disorders. Abraham Lincoln, Charles Dickens, Vincent Van Gogh and Marilyn Monroe were all sufferers. Interestingly, Van Gogh attempted to combat his insomnia by dousing his bedclothes in camphor, which may have slowly poisoned him and affected his mental health.

    It was ever thus. Societies have been desperately attempting to find cures for insomnia since the ancients, who are said to have used opium to induce sleep.

    More entertaining old wives’ tales include eating a raw onion before bed (American), sea slug entrails (Japan) or fried lettuce (France). Herbal remedies have always been a popular choice, and 3,000 years ago the roots of Rauvolfia shrubs were used in India. More recently, plants such as mandrake, henbane and mandragora have been employed to combat the agony of eternal consciousness.

    The causes are widely debated, from the medical to the physical to the emotional. It is generally agreed that insomnia is indicative of stress and anxiety.

    Earlier this month the Royal Society for Public Health said that the average Brit under-sleeps for one hour a night, which adds up to one night a week. The society’s chief executive, Shirley Cramer, claimed sleep is an ‘often overlooked and undervalued component in the public’s health’, calling for the government to ‘develop a national sleep strategy.’

    It sounds bonkers, but what can be done? Counting sheep is infuriating, and slug entrails acutely unappealing. Let’s first consider the hard drugs. GPs are not wont to readily dish out sedatives but in spite of this, more than 10 million prescriptions for sleeping pills are issued per year in England. I have, in times past, contributed to this figure. Twice I have been prescribed Zopiclone, a nonbenzodiazepine hypnotic agent that works by tranquillising the central nervous system — and very successfully. GPs warn that it is highly addictive and, despite being extremely effective, Zopiclone should be used only as a last resort. But, reader, how I slept.

    The NHS also offers cognitive behavioural therapy, which aims to alter thoughts or behaviours that contribute to insomnia. Methods include stimulus-control therapy (helps you to associate the bedroom with sleep), relaxation training (to reduce tension) and biofeedback (connects you to a machine that monitors your heart rate). However, it can be tricky to secure appointments and the success rate is debated.

    The technological age has provoked the rise of sleep-inducing bedroom paraphernalia. One such example is the Withings Aura Sleep Sensor, which is placed under your mattress. It tracks your sleep through your breathing cycles, body movement and heart rate and comes with a lamp that emits different wavelengths of light depending on the state of your slumber. At £190, it doesn’t come cheap, and sadly it isn’t as swanky as it sounds: it needs a strong Wi-Fi connection and isn’t always accurate — I found that it sometimes confused me reading in bed for sleeping.

    There is a vast choice of apps too. One such example is the White Noise app, which offers a truly inspired list of sounds to nod off to — from the obvious (ocean waves, shower, crickets chirping) to the obscure (Tibetan singing bowls, air conditioner and cats purring). It’s clever, and helps you gently slip into the land of nod, but certainly doesn’t cure the problem of waking up before the birds and staring furiously at the ceiling — praying, praying for sleep.

    The grave problem with insomnia, aside from the lack of sleep itself, is that while it’s accepted as a serious health concern by medical professionals, there is no conclusive answer on how to solve it. Drugs, although helpful, are short-term solutions, and therapies and apps can be complicated and difficult to access. Sleep is essential for good health, happiness and day-to-day achievement, yet so many of us are unable to successfully get 40 winks. What would Mrs Thatcher say?