World Sleep Day 15 March 2019

“As World Sleep Day approaches, spare a thought for those who did not sleep well last night, especially if that person is you. It is curious that only at this point in human history are we starting to take seriously that poor sleep is a mental and physical health problem, capable of causing terrible distress and lasting poor health consequences. At Good Thinking, we’ve started to understand better this silent, hidden epidemic and are trying to do something about it. We listened to some of those with poor sleep and what we found out was really interesting, but first let’s have a look at the issue.

What’s the problem with not sleeping?

“Many surveys show that up to 33% of the adult population have regular difficulty either getting to sleep or staying asleep. After depression, sleep problems are the third most common psychological reasons for appointments in general practice. Untreated, insomnia increases the risk of development or worsening of anxiety, depression, hypertension, and diabetes. Poor sleep doesn’t just make you feel bad, it actually impacts on your physical health and future.

33% of the adult population have regular difficulty either getting to sleep or staying asleep

Insomnia becomes a chronic problem when someone has difficulty either getting to sleep or staying asleep for at least three nights a week (not necessarily every night) for at least three months and is also distressed by their sleep symptoms. But how many people can talk about this distress and their sleep problem; not many we found out. It is easier to talk about anxiety and depression than it is poor sleep.

What do Londoners say about difficulties sleeping?

“Because at Good Thinking we wanted to learn from Londoners, we talked to them about their sleep and also listened to what they said online. For example, on Facebook, sleep problems were talked about by more people than anxiety or depression, but they didn’t say very much. We noticed that the poor sleepers had far fewer interactions with others about their problem; people could talk more easily about their anxiety problems, but not sleep.

We learnt that people would post comments online in the middle of the night when they were struggling to sleep. 53% of people talked of having occasional sleep problems, whereas 28% had persistent problems. Those with persistent problems talked of feeling stressed and lonely; the sleep problems didn’t just separate them from those who could sleep, but they talked less about them, even during the day. It was as if sleep problems were something we just couldn’t talk about. Yet tiredness was the most common mental health symptom discussed on Facebook. The frustration with yourself for not being able to sleep added to the loneliness, the suffering in silence, and may have been a barrier to asking for professional help; asking for professional help was much less likely than it was for anxiety or depression.

53% of people talked of having occasional sleep problems, whereas 28% had persistent problems. Those with persistent problems talked of feeling stressed and lonely

What’s the biggest cause of a sleepless night?

“Whilst being unemployed or not being in a relationship was linked to sleep problems, so was being a mother, and struggling with family pressures. Being part of a family was no escape from the loneliness.

What was so painful about our discoveries was that many people just didn’t know what they could do, or that could make a difference. Many young adults started to have occasional problems before they 35 years old, and if not helped the occasional sleep problems became persistent, chronic.

What can you do if a good night’s sleep seems an unlikely dream?

“At Good Thinking, we ensured that our service offered many opportunities for people to learn more about sleep problems, and no longer feel alone with theirs. We have different tools that allow someone to assess their sleep and even thoroughly check out whether there could be a physical cause for their problems. We also provide free to Londoners apps and online courses, such as Sleepio and Be Mindful, and if you follow their guidance, it really makes a difference.

Because people feel frustrated with themselves, self-help techniques often feel like the best way forward. And guess what? Good Thinking is a 24/7 online service and there when you need it, not by appointment. Why not check out what’s there, whether for you or someone important to you? We really have to break down the shame that haunts those who can’t sleep well and reduce their night-time loneliness, and with confidence say those words:

“I hope you sleep well”

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About the author

Dr Richard Graham is a Consultant Child & Adolescent Psychiatrist, former Clinical Director of the Adolescent Directorate at the Tavistock Clinic and Clinical Lead for Good Thinking. Over the last decade, his work has centred on the impact of technology on development and health. In 2010 launched the UK’s first Technology Addiction Service for young people at Nightingale Hospital in London. In June 2016, he was appointed the Executive Board of the UK Council for Child Internet Safety (UKCCIS is the British Government’s principal advisory body for online safety and security for children and young people) and Co-Chairs the Digital Resilience Working Group. He also works with the BBC, as Digital Well-being Consultant to the Own It App Project.