Insomnia
In my life, for the most part, I have always been an amazing sleeper. If there was an Olympic category for hours slept, I would be stood on the podium holding gold. This was the case that is, until I started to unlock the pain and trauma that I had lived with all my life.
In 2021 I started trauma therapy and have been engaging ever since. Often before we start shadow work (where we unlock those parts of us, we prefer to avoid, to look at the festering wounds that we deny, ignore, distract from) we are blind to the suffering we delay by living life with our back to it.
Pain, trauma, suffering, abuse, will always come knocking eventually. You can escape it with order, hard work, avoidance, substance abuse, control, success, retail therapy, and much more. But it waits, patiently, in the subtle crevices where your shadow reaches.
My sleep can be severely disturbed when I am in fight/flight/survival mode, which can be anytime, with Complex-PTSD. There doesn’t always seem to be a trigger, and when I fall victim to its icy claws, my body is overwhelmed with panic and terror. These are not the best sleeping buddies. They come with you to bed, they lie next to you, they might even turn the page of your book for you, mocking your attempts to wind down.
If you turn out the light, it only illuminates their wicked grin, the excitement they express at the thought of a night tormenting you. You toss and turn, count your breathing, think “good” thoughts, slow down your mind, lay on your back, side, the ceiling. Nothing works in the moment.
The worse thing is the spiraling because once you don’t sleep on the first night, the bedroom, and your bed become frightening. Your mind associates these with restlessness, loneliness and wakefulness. Once a tranquil oasis of peace, with the inviting caress of sleep, now a war zone of fear.
According to the National Institute for Clinical Excellence the following is true of insomnia:
- Diagnose insomnia if (despite adequate time and opportunity to sleep) the person has persisting difficulty in getting to sleep, difficulty maintaining sleep, or non-restorative sleep that results in impaired daytime functioning or wellbeing.
- Daytime symptoms may include fatigue, depressed mood or irritability, malaise, and cognitive impairment.
- Sleep difficulties without daytime impairment do not meet the diagnostic criteria for insomnia.
- Short-term insomnia can be diagnosed if symptoms have been present for less than 3 months.
- Chronic insomnia can be diagnosed if symptoms occur on at least 3 nights per week for 3 months or more.
I have several perspectives on insomnia because I suffer from it at times, and I treat it for patients who suffer in my two roles as an advanced nurse practitioner. It allows me to extend empathy to these patients, and I have the desire to help wherever I am able. It is a very difficult condition to manage which is why I wanted to do a blog on it, in the hope of informing anyone who suffers.
There are many things that you can do to help alleviate the condition, before resorting to pharmacological support. I say resort, because if we start to rely on a pill or a medication to get us to sleep, we give away the power and ability to resolve the sleeplessness ourselves. The guidance is clear on sleeping medication, that it must only be used for the shortest period. When this is relayed to the patient, and they still want to have a short course, in my experience, almost all of them return wanting more. This is because without it, they have not developed coping strategies to enable sleep independently. I have absolute compassion however, for anyone who becomes dependent on such medication. These drugs are powerful and will enable you to drift off to sleep. But, from the research I have done, the advice I have taken from my therapist, and my own experience, knowing that I slept because I took a tablet, does not make me feel empowered. I just become worried, that when I don’t take the tablet, I am back to square one.
So, I have developed my own way to cope, for those times, when I must pin open my eyes with match sticks. First, I organize a therapy appointment because chances are, if I’m not sleeping, I am in fight/flight, which is a symptom of Complex-PTSD. She helps me to connect to the inner child, the younger parts of me, who, for whatever reason, are frightened, and need compassion and support. She has also reassured me that even if the brain does not fall to sleep, laying in a dry, warm comfortable bed, and closing one’s eyes, is sufficient for basic regulation and survival.
I also remember something that I read, which really resonates and helps when I am resisting insomnia, battling with it. I realised I needed to just accept it. Work with it. I don’t sleep, I stay safe and comfortable. If I wake at 0400 and cannot get back to sleep, clean the house, organize a draw, rearrange my wardrobe. Sometimes resisting life causes suffering. It is what it is. Take each day at a time. This part is hard, I admit! I work two jobs and have children, so cleaning a draw and opening my wardrobe at 04:00 isn’t necessarily going to cure my fight/flight symptoms.
However, with work and effort, I begin to tap into a different perspective on the experience of insomnia. It doesn’t need to be scary. It is temporary. At least the last 50 years of my life have proved this. I tell patients, they have been capable of falling to sleep at some point in their lives and the brain doesn’t forget that ability. The problem is temporary; it too will pass.
But in the dead of night, when it feels like everyone else is sound asleep, and you are alone with a million radio stations going on inside your head, unable to tune out, it can feel so frightening. We need sleep, our bodies, cells and homeostasis require it to maintain health. No wonder we feel helpless and scared without it. Furthermore, our mood can drop, we can become more agitated, less tolerant, develop lapses in concentration, thus impacting our waking day (not much different to our waking night).
If you suffer with insomnia, I hope that some of these insights have triggered some ideas in you about how you can restore your nocturnal rest. You can look up sleep hygiene and this provides even more tips on how to encourage restfulness at bedtime. This includes choosing the right food groups, avoiding certain triggers like alcohol, caffeine, eating heavy meals too late in the evening, minimizing screen time on our phones, or computers.
As you come to the end of this blog, I want to extend my compassion to you if you are suffering from lack of sleep and I hope that you develop some new strategies that empower you, make you laugh in the face of insomnia and restore your natural night/day rhythm. As always, seek support from your GP for any concerns with sleep deprivation or underlying mental health concerns. Remember, you have been able to sleep at some point in your life, and you will again! Goodnight!
