“I couldn’t sleep last night” is becoming an increasingly common phrase among young women. So how and why did we become Generation Z – and what can we do about it?
Through the gloom, I squint at the clock next to my bed. To my horror, I see that it’s 5am. I’ve been awake since 2am and I’m desperate to sleep. With mounting anxiety, I calculate the hours I have left before my alarm goes off, panicking about how I’ll cope on only three hours’ sleep.
It’s my sixth consecutive night of insomnia and each night I’ve fallen asleep with no problem at 11pm, but woken, my brain fizzing, after a couple of hours. The next day, I have a jittery, tired-but-wired feeling, as though I’ve downed 20 espressos. A slightly terse email from a colleague sends my sleep-deprived mind into a state of high anxiety and a headache pounds around my temples.
I stumble through the day, trying to boost my energy with carbs and caffeine. A sense of dread arrives as the evening approaches – every time I think about going to bed, fear knots my stomach. This, of course, is not conducive to decent sleep and so the insomnia cycle goes on and on…
Since childhood, I’ve gone through phases of insomnia that last weeks at a time. It started at the age of seven when I lay awake for nights because I couldn’t do a sum at school. I was prescribed medicine, which, I now realise, must have been a placebo (if only that still worked).
These days, insomnia usually kicks off when my mind goes into overdrive due to anxiety or – equally likely – excitement. I’ve tried herbal sleeping pills, meditation and hypnosis, but every time I end up begging my GP for pills.
In the past, I would take temazepam, but my current doctor won’t prescribe it because it’s so addictive (about 5% of users have counselling for the addiction), so for the last few years I’ve taken zopiclone, which still has a danger of psychological dependence. I’ve always been careful to take it only for a few nights – usually enough to break the pattern of not sleeping.
One of the worst things about being awake in the early hours is the sense of sheer isolation, even with my husband beside me. Lying in the dark, I feel like I’m the only person in the world who’s awake. In reality, of course, I’m far from alone.
In 2011, 15.3million NHS prescriptions were handed out for sleep medication and according to The Economic and Social Research Council, one in 10 of us now regularly takes sleeping pills. And there’s evidence the insomnia epidemic is increasingly hitting young women.
One in six (15.9%) of women in their 30s use over-the-counter sleeping pills. “The latest statistics suggest that there has been a steady increase in insomnia among women over the past decade,” says Colin Espie, professor of clinical psychology and director of the University of Glasgow Sleep Centre at the Sackler Institute of Psychobiological Research. “This is echoed by recent results from the Great British Sleep Survey. Between 2010 and 2012, the proportion of women in their 30s who struggle with insomnia rose by almost 20%, which highlights the huge number of young women who suffer from disrupted sleep, often in silence.”
Our stressful modern lifestyles are partly to blame, believes Dr Nerina Ramlakhan, sleep therapist at London’s Capio Nightingale Hospital.
“Women in this age group are often unable to switch off,” she says. “You might be working long hours and even when you’re in bed, you’ll be checking emails on your phone. The economic climate has made things worse because people feel under pressure to be available all the time.”
Emma Duncan, 31, a university administrative manager, believes her insomnia started as a result of work issues last year. “A colleague began to bully and undermine me, and I’d lie awake at night worrying about it,” she says. “Even now I still think about the situation late into the evening, so I’mvery much awake when I go to bed. I feel panicky and tearful because I’m so exhausted, which isn’t helping the way I deal with things at work.”
Unfortunately, problems at work are much more likely to affect women’s sleep, according to sleep physiologist Dr Guy Meadows, who runs The Sleep School, which organises workshops and retreats to help insomniacs sleep naturally.
“Between 65% and 70% of insomniacs are female,” he says. “Women worry more, which is a risk factor for insomnia. Your brain interprets stress as meaning there is a threat to your life and the amygdala (an area of your brain) floods your system with adrenaline and cortisol to keep you alert. This would have kept our ancestors safe from wild animals, but in modern life it just keeps us awake.”
In fact, anything that affects your body chemistry ups your chances of insomnia – and again, simply being a woman can mean you’re more likely to experience body chemistry changes. “Hormone changes are another reason women suffer more from insomnia than men,” says Dr Meadows.
Experts think hormonal changes associated with the female cycle affect other hormones, such as melatonin, which help induce sleep, and your body temperature can also rise above the optimum temperature for sleep in the second half of the cycle.
“Sleep is our ‘early warning system’ – often the first thing to go when anything is wrong in our life, whether physical, emotional or psychological,” says Espie. In your 30s, you’re likely to go through some weighty life events – marriage, buying a home, pregnancy, a big promotion, for example. And, says Dr Meadows, positive changes can affect your sleep as much as negative ones.
“People often associate sleep disturbance with difficult, stressful events, but even positive events can have an effect on your sleep – excitement raises adrenaline, which makes you alert and wakeful.”
Our indoor lifestyles may also be contributing to the rising tide of insomnia. Being tied to our desks and taking regular exercise inside sweaty gyms may mean we don’t get enough vitamin D from the sun, which, according to American research, could play a role in insomnia. Scientists believe that as there are vitamin D receptors in areas of the brain connected to the sleep-wake cycle, including the anterior and posterior hypothalamus, a lack of vitamin D may contribute to lack of sleep. Pilot studies suggest more than half the UK’s white population and up to 90% of the multi-ethnic population is deficient. Most of us need to be outdoors without sunscreen for about 15 minutes each day in the spring and summer to make enough vitamin D, though people who have darker skins need even more exposure.
Russell Foster, professor of circadian neuroscience at Oxford University, also points out that while we don’t get enough natural light during the day, we get too much artificial light at night, which has an effect on our body clock. “The circadian clock in the brain needs to be reset every day to 24 hours and the 24-hour light-dark cycle performs this role,” he explains. “The circadian pacemaker interprets light to mean ‘daytime’, even if it’s actually night, and therefore starts to readapt. This is why our 24-hour society is so disruptive to sleep.”
when insomnia strikes
Insomnia isn’t just about being unable to fall asleep in the first place. According to Espie, doctors recognise five insomnia subtypes – difficulty initiating sleep, difficulty maintaining sleep, early morning waking, mixed (trouble in both falling and staying asleep) and nonrestorative sleep (unsatisfying sleep that leaves you feeling tired).
“In short-term insomnia, which may last for a few weeks, the problem usually resolves itself when the trigger – for example, a stressful period at work – has passed,” says Dr Meadows. “But chronic insomnia sets in when you fall into a downward spiral of worrying about your inability to sleep. Chronic insomnia is a learned condition and you may feel frustrated when you’re constantly asked what’s going on in your life to cause it, when the only thing keeping you awake is worrying about your whole world collapsing because you’re sleep-deprived.”
Melody Palmer, 34, an IT manager, has struggled to sleep for years. “I go to bed around midnight but rarely fall asleep before 3am. It makes no difference what’s going on in my life – even when things are fine, I sleep badly. I used to take pills but they stopped working. I often have headaches and I rarely feel like socialising, which I’m sure is one of the reasons I’ve been single for a long time. Sometimes I wonder if I’d be happier if I was able to sleep better.”
The bad news for us insomniacs is that there are reasons to worry about lack of sleep. Insomnia doesn’t just leave you with dark circles; let’s not forget sleep deprivation is used as a form of torture and, at its most extreme, can lead to hallucinations and psychosis. “Poor sleep increases your risk of depression and anxiety,” says Dr Meadows.
Recent data from the Australian Longitudinal Study on Women’s Health revealed women who have trouble sleeping in their 20s have more than double the risk of depression in the next three years (scientists believe sleep affects the ability to process emotions). Not only that, The Great British Sleep Survey showed that women in their 30s with insomnia are twice as likely to struggle with low moods as those without insomnia, almost seven times as likely to feel helpless and five times as likely to feel alone. “And if you have insomnia, you’re four times more likely to have relationship problems,” says Dr Meadows. “As lack of sleep decreases your ability to regulate emotions, it can lead to difficulties in all areas of your life. You may become paranoid about perceived slights, have a shorter temper and become upset more easily.”
Research has also linked insomnia to serious health problems including heart disease, Alzheimer’s, diabetes and obesity and earlier this year, scientists at the University of Surrey hit on a possible reason for the connection with so many illnesses – discovering that losing sleep altered more than 700 genes in the body, physically changing its chemistry.
But you can reframe how you think about sleep. First, by not obsessing about getting ‘eight hours’, which has skewed our approach to sleep, making us believe that anything less will end in disaster. That is simply not true. We need a healthier, more relaxed attitude and our cut-out guide to effective insomnia solutions can help you achieve just that.
Our tips on how to keep sleeping till the morning...