The sleepless night that lasted a year

Lucy Cleland tried hundreds of tricks to get her full eight hours - including yoga, acupuncture and endless hot baths. After 367 miserable midnights, she turned to a clinic specialising in sleep disorders
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When my father said to me: "It's a gift, not sleeping - think of all the books you can read," I stared at him with bloodshot eyes, sighed and tried not to cry. Sorry, Dad - I know I should be reading Proust in the wee small hours but, quite frankly, I'd cut off my arm right now for some genuinely peaceful sleep.

When my father said to me: "It's a gift, not sleeping - think of all the books you can read," I stared at him with bloodshot eyes, sighed and tried not to cry. Sorry, Dad - I know I should be reading Proust in the wee small hours but, quite frankly, I'd cut off my arm right now for some genuinely peaceful sleep.

Not that I'm keeping track or anything, but yesterday was the 367th day in a row that I have not had a good night's sleep and I'm more than a little fractious. Everyone suffers bouts of insomnia - about 15 per cent of the population at any given time - but I feel cursed for having it so enduringly.

It's a hidden and very lonely affliction. Unless you're sharing a bed (and when you are, the sound of someone else's heavy, even breathing only makes you bitter), no one witnesses you lying there, acutely aware of the minutes ticking away and the all-too-early arrival of those infernal birds. Every morning my routine starts with staggering half-comatose to the bathroom, dousing my puffy face with icy water and doing funny eye-exercises until the face staring back at me in the mirror resembles something human. I can't remember the last time I didn't feel worn out, or woke up refreshed. I look haggard - and I'm only 28.

"But you must be getting some sleep, you don't look that awful," say my bright-eyed friends. Yes, otherwise I'd be dead. But there's sleep and then there's sleep. When I actually get some, it seems to fall somewhere between semi-conscious mental whirring and such vivid dreaming that I wake agitated and exhausted by my imagined exploits. My bed, the place where I should feel most comfortable and secure, has become the enemy and the day is spent subconsciously gearing myself up for battle. Sleep is my obsession, the buzz word that triggers incredulity when I hear or see reference to it. It's like when you think you're pregnant and babies seem to leap out at you from every direction.

And it's not as if I haven't tried remedies, but if anyone else suggests a nice cup of camomile tea and a hot bath, I'll punch their lights out. Advice has ranged from ionisers and magnetic bracelets, to my grandfather's well-meant suggestion of reading a very dull book. My bedroom resembles an apothecary's shop - lavender atomisers whirring, brown bottles of nameless herbal tinctures, melatonin, Nytol, valerian and contraband Thai sleeping pills. Books with titles such as Counting Sheep and The House of Sleep line my shelves, as if to comfort me that my condition is hardly rare.

I tried acupuncture, where they taped little beads over gouged holes in my ears, which I was to press hard at regular intervals. They were so painful that there was no chance of sleeping anyway. My hypnotherapist told me her daughter was a make-up artist who would love to "do me over". I stopped seeing her.

Counselling, massage and homoeopathy had no effect. I did a do-it-yourself feng shui job on my bedroom and created a calming oasis with candles and the sound of a babbling brook on the CD player, while I sat, legs crossed in a yogic position, concentrating on my breathing and visualising a beautiful garden. But then a flock of crows came swooping down, and weeds grew as fast as I could pick them, turning my delicate Eden into an impenetrable jungle. I was trying to trick my mind, and it was a formidable opponent.

I even quit my job last year and moved to the wilderness of Montana to work on a ranch for six months, thinking that, if anything would, the fresh air and active lifestyle would bring physical exhaustion to break the cycle. I got fit, I got happy, I got healthy - but I didn't sleep. In fact, while there I had a terrifying experience: a state called conscious paralysis, which was only explained to me recently. During REM (dream) sleep, the body is paralysed, but I became conscious, skipping a gear in the awakening process. I couldn't move a muscle. I thought I was dying. The God-fearing Montana folk thought I was possessed and attempted what I can only call a minor exorcism involving the Bible and much chanting. Needless to say, the demons stayed.

It was getting ridiculous. I was vaguely aware that periods of anxiety and stress had sparked my previous attacks and this was my body's way of alerting me to the problem - but a whole year? Sleeplessness was affecting my entire life. I was incapable of making any decisions. Depression struck so hard that I moved back to my mother's for a few weeks, although I could do little more than sit on a sofa, avoiding the outside world, and eventually succumbing to my GP's prescription of antidepressants and a month's worth of Temazepam.

A few weeks later, a friend informed me that she had found the perfect man for me. I was in no state for romance, I told her. But no - she meant Dr Irshaad Ebrahim, the head of the London Sleep Clinic, which was set up a year ago. His interest in sleep developed early in his student days when he realised that sleep and psychological symptoms were closely related and that the effective treatment of sleep could help to resolve the psychological disorder.

I would have thought it was the other way round. Based on a system he calls the Sigma Approach, they tackle the problem from all conceivable angles: psychological, physical, scientific, social and holistic. It's basically a one-stop sleep shop, and I was very pleased to have found it. "We aim to hand the power back to you, the patient, so you can move from a place of fear to a place of calm. Most patients have preconceptions about sleep; most commonly, that they'll never sleep soundly again. We want to dispel those myths," Ebrahim explained.

At the clinic, I completed a lot of diagnostic questionnaires about my sleep behaviour and general mood. I had to wear an Actiwatch, which monitored my levels of nocturnal activity, and determined the quality of my sleep. I kept a sleep diary every day, recording caffeine and alcoholic intake, my going-to-bed and getting-up times, and how many times I woke up during the night, which was really difficult.

After analysis, I was diagnosed with chronic primary insomnia (basically, long-term inadequate sleep that's not due to any underlying condition) and prescribed anti-depressants and sleeping pills, although different ones from those prescribed by my GP. Ebrahim said it was vital to get my serotonin levels back to normal so I could cope with the strict sleep regime they were proposing. It was impossible to fathom whether depression was causing the insomnia or vice versa, so I was ready to try anything, glad that I no longer had to stab in the dark and trawl around alternative therapies; a frustrating, time-consuming and expensive pursuit.

Ebrahim referred me to Elizabeth Scott, a psychotherapist and cognitive analytic therapist, who is in charge of lifestyle and sleep management at the centre. It sounds very corporate and up to date, but it's basically a strict regime of reprogramming, which she said "worked categorically, without question".

Sleep restriction is the main element: I was to go to bed and get up at the same time every day, including weekends. This filled me with horror as I reserved those days for lolling in bed, playing catch-up. I was prohibited from doing anything in my bedroom: working, reading, watching TV. I should not eat anything too heavy or sugary in the evening and monitor my alcoholic intake, although she said a glass of red wine or two wouldn't do any harm. I should exercise, even just a little, every day.

And I must continue to keep my sleep diary. If I was awake for a prolonged period, I was to get out of bed and go into another room, the theory being that I was programming my brain to cotton on to the fact that when I got into bed, it was to sleep.

A lot of the advice seemed like common sense. Throughout my research, I found numerous websites recommending similar tips. The point is that you need the back-up, the verification and the demystification of your sleep disorder to help to combat the anticipatory anxiety - which, of course, is half the problem.

I took to my new regime with aplomb, rather like starting a new diet. You're convinced that this time it really will work. But, like a diet, you can come off the rails, and I found that by the time Friday night rolled around, I'd drunk too much, gone to bed too late and couldn't bear the thought of getting out of bed at 7.30am, so I allowed myself a little cheat. Because of the diary, which I kept faithfully, the next time I saw Elizabeth, she picked up my lapse immediately.

I vowed again to undertake the regime as rigidly as I could, knowing full well that this was my best shot at getting rid of my insomnia, so with the support of her weekly sessions, and a focused approach on my part, I made it my mission to comply. I started going to yoga once a week, and even joined a friend's belly-dancing class. I told my friends that they should not encourage my normal degree of alcoholic consumption, and that at midnight I would disappear, Cinderella-like.

It slowly occurred to me that I was starting to enjoy life again and doing things I couldn't have conceived of a couple of months earlier. Although I'm only four weeks into the regime, I can no longer tally my sleepless nights, nor do I resemble the walking dead in the morning. When people ask the inevitable: "How did you sleep last night?" I can, most of the time, say: "Fine, thanks" - and mean it. I stay up until my prescribed bedtime of midnight, amazed that I sometimes long to go to bed before that. At least now I can read Proust, even if I don't understand it, and listen to one of my favourite Beatles tracks, "I'm Only Sleeping", without bursting into tears.

The London Sleep Centre, 137 Harley St, London W1 (020-7725 0523; www.londonsleepcentre.com)

PERCHANCE TO DREAM: THE RIGHT WAY TO DROP OFF

Cigarettes and caffeine should be avoided four to six hours before bedtime; exercise just before sleep is a no-no, too.

Set an hour aside before bedtime to wind down.

Get into the habit of going to bed and getting up at the same time every day, including weekends, and don't nap during the day.

Make sure you have a comfortable bed and a quiet, dark bedroom.

Remove all electronic equipment from your room, including televisions, computers and radios.

Use your bedroom for nothing more than sleep or sex. That means no reading, working or watching TV.

Before going to bed, write down on a pad anything that might be worrying you.

If you don't fall asleep within about half an hour,get up again until you feel sleepy.

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