Trouble Sleeping

Drop-in posts written by Dr Kitty Wheater.

2nd of July 2020

Dear all,
I hope that your week is going well. For today's virtual drop-in, we look to the wee hours...
Photograph of a woman in bed struggling to fall asleep, watching the clock tick by.

Trouble Sleeping

‘It's late and I'm feeling so tired,’ sings Corinne Bailey Rae. ‘Having trouble sleeping…’

It’s a sentiment familiar to many. A King’s College London study finds that two thirds of us have experienced some negative effect on sleep since the pandemic began, with a disproportionate impact on women, young people, and those facing financial difficulties. Intriguingly, though, most of us are sleeping more than we did pre-lockdown. With commuting shelved, and no pub to go to on a Friday night, total sleep time is actually up – it’s just not so restful.

So what might this look like? You may find yourself sleeping in fits and bursts, with long periods of wakefulness in between; waking groggily early in the morning, and watching the clock until it’s time to get up; finding it hard to fall asleep at all. You may have unusually vivid dreams, and remember more of them when you surface. If you have recurring stress dreams, or nightmares, these are probably putting in more of an appearance during your slumbering hours at the moment. They may be specifically about the pandemic, or they may be older stress patterns, flaring up with new potency thanks to the extra layer of lockdown worry-fog.

As we go about our days tired and stiff, the worst part of disturbed sleep is often creeping dread or anxiety about it. Sleep can become a place in our minds that is not restful, a sanctuary to enter at the end of the day, but rather a site of stress and fretfulness. We fear not sleeping – or if we sleep and have nightmares, we fear sleep itself. The other week I came across a passage that captured this cycle perfectly, in The Long Winter, by Laura Ingalls Wilder. An autobiographical children’s book, it depicts a ferocious seven-month winter in the tiny settler town of De Smet, South Dakota, in the 1880s.

Sometimes in the night, half awake and cold, Laura half-dreamed that the roof was scoured thin. Horribly the great blizzard, large as the sky, bent over it and scoured with an enormous invisible cloth, round and round on the paper-thin roof, till a hole wore through and squealing, chuckling, laughing a deep Ha! Ha! The blizzard whirled in. Barely in time to save herself, Laura jumped awake.

         Then she did not dare to sleep again. She lay still and small in the dark, and all around her the black darkness of night, that had always been restful and kind to her, was now a horror. She had never been afraid of the dark. “I am not afraid of the dark,” she said to herself over and over, but she felt that the dark would catch her with claws and teeth if it could hear her move or breathe.

It’s a poignant description of how fear can flavour sleep and the wee hours. Unseasonal though The Long Winter might be, there’s reassurance in knowing that trouble sleeping, in the face of trouble, is an age-old experience. The psychological impact of endless howling prairie blizzards, with no end in sight, is not unlike that of being steeped in uncertainty and hard news.

So how might we look after ourselves in the face of sleeping troubles, and soften some of those internal blizzards? Here are some ways of responding, when sleep goes haywire.


1.     Find Your Rhythm

Your body has powerful circadian rhythms. It wants to rest, and when it doesn’t, it will find a way to make it happen – as we’ve all discovered at one time or another, falling asleep after lunch. Fortunately, there’s a lot of wisdom out there on sleep hygiene: practical steps to realign the body’s sleep/wake cycle. During a tricky sleep patch, it can feel as if it will take forever to get back on track. But our circadian rhythms thrive on routine. Sleepio, for example, is an effective cognitive behavioural therapy app, that intervenes pragmatically and quickly to reset sleep patterns. But a few simple steps – a time limit on your smartphone in the evening; re-establishing some daily exercise – can also promptly make a difference.

Simple though such moves are, entrenched habits often get in the way. A quick message turns into twenty minutes on Twitter; rain clouds gather, and your walk looks less than inviting. Autopilot is a powerful thing, so outsource the willpower on this. Delete that app, and charge your computer in a different room overnight. None of us can quite be bothered to walk next door, at 3am, in order to scroll through BBC News.

Part of the misery of sleep disruption is that it can feel mysterious. If it has been relatively short-lived, cast your mind back and make a note of what triggered it. Often this is something quite straightforward. It could be that the heat kept you awake, that you missed a walk or online exercise class one day, or that a difficult message last thing at night had you up for hours. Re-establish your usual routines as soon as you can, bookmark any difficulty that requires some attention, and be patient with yourself: you will be a little slow and tired at first, but you will find your rhythm soon.


2.      The Tell-Tale Mind

When it feels, as it did for Laura Ingalls, that the dark awaits you with claws and teeth, this is because your stress system is amped up. Thoughts scurry around in the mind, and your body holds itself up away from the bed, poised to fight or flee. As you try ever harder to fall asleep, rest seems more and more elusive, and you worry ever more about what will happen tomorrow.

The mind tells powerful tales about the past and the future. As if its usual fears and worries weren’t enough, many of its stories may be about what will go wrong if you don’t sleep enough, or what has happened to cause your restlessness. We may try to fight our thoughts, angrily batting them away, generating more thoughts about how badly this night is going. Remind yourself that thoughts are not wrong: they are your mind trying to help, but because you are tired and stressed, it is helping in a way that is tired and stressed.

Instead of trying to stop the thoughts, see if it’s possible to label them gently as they come up: ‘here is planning; here is self-criticism; here is prediction.’ Thoughts, you will notice, come and go: they are flickering, not solid. So you might imagine that your thoughts are like a waterfall, and that they can just fall past you as you sit beside them. You may get a little damp, but the thoughts need not drench you; and imagine that your seat beside them is soft, and comfortable.


3.     Creature Comfort

When the mind is whizzing with memories, and plans, and what-ifs, the body as it lies here is not the past and future. It’s just the back, and the backs of the legs, and arms and head, against the sheets and pillows. So gently practice bringing your attention into the places where the body is held up: the surface of the skin, the texture of the sheets. When your mind veers off, acknowledge the story it tells, and just come back. You are reminding yourself that you are a body, safe and supported in this moment, in this space – nowhere to go, and nothing to do. Often, people find that a body scan helps provide some structure for this. It’s something you can do with the track a few times, and then just by yourself.

Photograph of a cosy bed, with white sheets. On the wooden floor beside the bed there is a vase with dried flowers in it. At the top of the bed is a headboard with different blue wooden pieces.

Often, as the mind quietens, sleep comes naturally. But sometimes you may realise that you are physically uncomfortable. You may be too hot or cold; you are hungry or thirsty. Tune in to what you most need, in this moment, and give yourself permission to follow it through. We are creatures, not floating brains.

‘Daytimes were not so bad as the nights,’ Ingalls Wilder wrote. ‘The dark was thinner then and ordinary things were in it.’ And so in daylight hours, when the dark is thinner, give some attention to the ordinary things that may make your sleep more comfortable. A soft blanket, a fresh pillow, a turned mattress; an open window for the smell of summer air; and something lovely to look at, when you open your eyes in the morning.

I wish you all good sleep and rest this week.