Over the last 15 years, I have tried almost 70 different “solutions” to manage my insomnia. Yes, you read that correctly.
Temazepam. Zopiclone. Zolpidem. Amitriptyline. Beta blockers. Antihistamines. Progesterone.
I got tramadol and oxycodone (opiate painkillers) from my beloved mother’s supplies.
Many pills didn’t work, some did. But I was afraid of taking drugs long-term, and every time I stopped, I stayed awake.
Natural sleeping pills? Don’t get me started. From Bach flowers to magnesium, B vitamins, melatonin, ashwagandha, chamomile, lavender, passionflower, valerian, lemon balm, hops, poppy, skullcap and sour cherry juice to adaptogenic mushrooms, L-tryptophan, ferritin, CBD, 5-HTP, GABA and Adrenocortical extract, I took them all.
Ingeborg Van Lotringen has tried over 70 remedies over the last 15 years to get her insomnia under control
The sleep psychiatrist Dr. Dipesh Mistry has developed a five-week CBTi (Cognitive Behavioral Therapy for Insomnia) course to help people overcome insomnia
On social media, they are sold as “miracle capsules” or “knock-out drops” by people who have never been sleepless in their lives. Some may benefit specific individuals and support the nervous system.
But for people with severe insomnia, they are comparable to treating a third-degree burn with paracetamol.
Non-ingestible remedies? Covered. Sleep masks, sprays, oils, blackout blinds, earplugs, apps, countless gadgets, sleep pillows, mattress pads, weighted blankets, hypnotherapy, brain wave therapy, sound therapy, LED therapy, walking therapy – I’ve been there and done that.
I went to the world-famous Mayrlife health clinic in Austria and subjected myself to a strict 600-calorie-a-day gut health diet, enforced rest, and a series of tailored, doctor-prescribed treatments.
High achievers revere the method as the ultimate way to indulge and relax, but I barely slept.
I even flew to the Caribbean to learn how to sleep through mindfulness exercises, which was nice. But I still haven’t slept.
I was stuck in a vicious circle that was scary
Although the length of this encyclopedia of potential cures may seem surprising, it is less surprising when you consider that a third of the British population sleeps no more than five hours a night. We sleep-deprived people are an extremely lucrative market.
That was not always so. I slept like a baby for almost 40 years until a financial crisis hit in 2008 – I had invested my entire savings in an Icelandic bank. . . They disappeared – which meant I didn’t do it anymore.
Things went downhill quickly: I woke up at five, three, then 1 a.m. and stayed awake until morning.
It was the start of a three-year battle that brought me to my knees mentally and emotionally, resulted in me being laid off from work for two months, and on the verge of quitting my dream job as Beauty Director at Cosmopolitan.
I was lucky at the time to have a brilliant GP who taught me to try anything in search of a breakthrough.
He made sure I did yoga and did breath work and meditation (all important stress control techniques that, while they didn’t let me go back to sleep, still brought and continue to bring me important mental stability).
He suggested acupuncture and craniosacral massage, which brought comfort, if not sleep.
Finding that I didn’t have an addictive personality, he tried me out on courses of all kinds of sleeping pills and sedatives. But nothing gave me lasting relief.
Ingeborg slept very well for almost 40 years until a financial crisis in 2008 caused her to stop sleeping. She woke up at 1am and lay awake until morning
I became a shell of my former self. Many people who suffer from insomnia gain weight because the condition disrupts their metabolism, but I became uncomfortably thin.
I realized that I was stuck in a vicious cycle in which the lack of sleep caused great anxiety that prevented me from sleeping.
My body was primed to recognize sleep as something dangerous: it literally woke me up with panic attacks as soon as I fell asleep.
Then my family doctor recommended mirtazapine. It is an antidepressant (under the brand name Remeron) and is also prescribed as a sleep aid.
Two weeks later I was sleeping. The pills seemed to suppress the panic attacks and allowed me to escape.
I weaned myself off after six months, but my sleep remained good, despite the loss of my father and other upheavals.
I cut my pills into tiny pieces and never travel without them, as a backup in case I wake up and can’t go back to sleep. It worked well for eight years, until about two years ago.
I’m sleeping an hour and a half more every night – for the first time in years I feel like I have everything under control
It was a voluntary blood test that helped improve my sleep again and showed that information overload is undoubtedly a factor in the increasing incidence of insomnia.
The test to measure how much cortisol was in my body revealed that my stress hormone levels were spiking almost constantly.
Chronic elevated cortisol levels mean increased inflammation and therefore accelerated aging of all your organs and systems.
The test result was no surprise – the constant fight-or-flight panic attacks in my chest have long been part of daily life for me.
But when I saw it on paper, I went into a tailspin: I immediately went back to sleeping less than five hours a night and mirtazapine stopped working.
As before, it was uncontrollable: I woke up with my heart racing and breathing short before I was fully conscious again.
In my dreams I was running but getting nowhere. When I came to, all I could think about was how the panic was sending me to an early grave preceded by Alzheimer’s, Parkinson’s, or some other degenerative disease.
Living in such a state is not sustainable. And so, in desperation, I find myself in Dr. Dipesh Mistry.
Ingeborg remembers waking up from her sleep with her heart racing and shortness of breath before she regained full consciousness.
Dr. Mistry is a consultant sleep physician at the Insomnia Clinic at the Royal London Hospital for Integrated Medicine. He privately combines his other specialty, psychiatry, with sleep medicine.
He doesn’t tolerate any nonsense about insomnia. “The way to overcome it is a tailored program of evidence-based techniques,” he says.
“There is no single silver bullet; People are wasting their time looking for them, especially given the flood of unproven “solutions” out there.’
Its five-week CBTi (Cognitive Behavioral Therapy for Insomnia) course is medically validated with more than 30 years of clinical data.
It is available on the NHS, but only at the Royal London, where it is taught in group sessions by specialists (not doctors).
If you receive a referral, you should expect to wait at least six months for a first appointment.
The special CBTi approach from Dr. Mistry is based on his special interest in sleep disorders caused by mental illnesses such as anxiety.
Lo and behold, and not to my surprise, he diagnosed me with moderate generalized anxiety disorder.
The cause lies in my perfectionist mindset and my tendency to control and catastrophize – things I picked up from my dear mother over the course of my life.
The sleep psychiatrist Dr. Mistry diagnosed Ingeborg with moderate generalized anxiety disorder, which in turn influenced her individual sleep schedule
The last thing I want to do is cause fashion “anxiety.” I’m part of the last “keep it up” generation, for heaven’s sake. But it’s a relief to know I’m not just overreacting to exhaustion.
Dr. Mistry explains that the diagnosis has some impact on my sleep schedule, but he also points me to a lot of free information on the website getselfhelp.com.
“It breaks down fears in a simple way and offers practical advice on how to deal with them,” he says.
However, of the CBTi, he says: “You can’t do it alone because it’s tailored to your obstacles.” But if you do the work, your chances of success are 80 percent.” What follows are five weekly one-hour training sessions via Zoom.
Dr. Mistry takes me through an avalanche of information, advice, graphics and fun graphics in separate modules.
He immediately lets me revise something and sends me homework in the form of practicing techniques and taking notes.
For someone as detailed-obsessed as I am, it’s easy to accept. The idea is to regulate sleep patterns, change beliefs, abandon old habits and learn new ones that make sleeping second nature again.
This requires time-consuming practice and dedication, which Dr. Mistry encourages compassion and a sense of humor.
I can no longer catch up on my sleep
His sleep facts, which balance out all the unproven and misleading nonsense we’re presented with, are encouraging and immediately make me sleep a little better.
I learn that the fabled “rule” of eight hours of sleep to ward off all sorts of degenerative diseases is nonsense and that sleep needs are completely individual. As we get older, we naturally sleep less.
Deep sleep, which is important and restorative, takes up less than 20 percent of the night and should primarily occur shortly after falling asleep.
While the goal is to live without sleeping pills, Dr. Mistry states that they are not a cause for concern if taken under the guidance of a doctor.
Trendy CBD — cannabidiol, an active ingredient derived from the cannabis plant that is legal and non-intoxicating but that users swear can help them sleep — is a different story.
“It affects brain chemistry, but it’s unregulated, so we don’t know what it’s doing. Don’t use it,” he says. Other “natural” dietary supplements are okay “because they don’t work anyway.”
Importantly, he explains that we have a “sleep tank”: a supply of the sleep chemical adenosine. It is a compound known as a neurotransmitter, meaning its job is to send messages within the brain.
Levels in the brain rise while you are awake and begin to fall as soon as you fall asleep.
Once your adenosine supply runs out, you wake up. That’s why the heart of the program is sleep planning to ensure that the adenosine tank is full at night and doesn’t run out until the morning.
If you consolidate your sleep and optimize its quality in this way, the quantity should also improve over time – but it won’t be easy.
In the fourth week of treatment, Ingeborg noticed that she was already sleeping a little better. At her last session she slept an hour and a half longer
All my waking and sleeping hours at night are now recorded in a “sleep diary” in an Excel spreadsheet (estimates are permitted, as intensive clock watching is the insomniac’s arch-enemy).
It is forbidden to lie awake in bed for more than 15 minutes: I have to get up and do something “restful” (reading, knitting, no screens) until I feel sleepy in order to relearn to associate bed only with sleep (as opposed to frustration). , despair or anything awake).
The numbers from my first week’s “basic diary” are crunched to give me a set bedtime of 11 p.m. – after which I can go to bed, but never before – and an early rise that I must stick to, no matter how late I stay awake at night.
The “sleep window” is what matters, not the amount of time you sleep. So no more “catching up” on sleep and certainly no more napping. Ignoring this will shorten the time slot by 15 minutes the following week.
This is not something you can dictate to yourself: my timing is based on complex calculations that change from patient to patient and week to week.
Dr. Mistry’s top bedtime tips
- Treat yourself to a relaxation routine that helps you feel relaxed.
- Starting in the late afternoon, avoid stimulants, especially caffeine and nicotine.
- Make sure your bedroom is cool.
- Only use your bed for sleeping and sex.
- No panic. Sleep problems are common and treatable!
Sleep psychiatrist Dr. Dipesh Mistry
Of course, that means initial sleep deprivation – and facing the demons that come in the night when my worries about my mother (who has dementia), my health and the loss of my childhood home spiral out of control.
I’m taught techniques to deal with intrusive and unhelpful thoughts, but the threat of a 6:20 a.m. wake-up call initially causes so much panic that I can’t sleep at all.
However, by week four, I commit to the rules (instead of making excuses for why I should sleep through my alarm) and notice that I’m sleeping a little better.
It is supported by a variety of daytime instructions and techniques, introduced gradually, aimed at putting me in the right mood for a healthy sleep.
These include half an hour of yoga before bed, journaling – writing my thoughts in a notebook – and no alcohol after 8 p.m.: These are all well-known “sleep aids,” but “they don’t work in isolation,” says Dr. Mistry.
Some patients may also need to exercise more, avoid caffeine, or make other lifestyle changes.
For me, he prescribes a deep tissue massage once a week for eight weeks: “Fear manifests physically in the body and needs help to be released.” I can definitely agree with that.
It’s a marathon, not a sprint. While some notice improvements within a few weeks (I pace), the average recovery time (during which patients continue the program without assistance) is six to 18 months.
But as I wrap up my final session, I notice that I’m now sleeping an average of six hours (up an impressive hour and a half) and for the first time in years I feel in control.
Dr. Mistry says, “Adequate sleep is the amount that makes you feel good the next day.” That’s what you strive for. And I’m feeling better already.
- Dr. Mistry (sleeppsychiatrist.com) charges from £445 per consultation.