A Sleep Anxiety Wake Up Call

A tall elderly man, shrouded in a pale blue cotton blanket is being wheeled to a nearby ambulance. Squinting through the evening’s gloom, I stop to watch as he is gently manoeuvred in to the back of the ambulance and driven away.

Relieved and moist eyed I trudge up the hill to retrieve my car. I have just watched my Dad leaving hospital following five days of treatment for pneumonia. He is on his way home despite not being well enough to sit up in a wheelchair. I tried to persuade the doctor to keep him until morning – when he’d have more energy for the journey – they were sympathetic but resolute; they needed the bed.

Four nights before, Dad had arrived in Accident & Emergency with breathing difficulties, the lack of nursing staff and five-hour wait to see a doctor were clues that he wouldn’t be transferred to a ward any time soon.

I stayed up all night with Dad and caught three hours sleep in the middle of the next day before going straight back to the hospital. I’m not complaining, I was happy to do it and the staff did their best – they seemed overwhelmed by the number of patients, many of whom were elderly. It’s that time of year. But let’s not get distracted; this blog is about sleep anxiety.

I overheard one of the nurses telling a colleague she only gets one or two hours sleep at a time. It reminded me I would normally be worrying by now about how I would cope the next day; thinking I’d probably succumb to a cold and so forth.

Why then had my normal panic about missing a few hours sleep, never mind a whole night, not surfaced? I put this change down to the simple exercise I recently picked up in a self-help book Say Good Night Insomnia by Dr Gregg D. Jacobs.

A few weeks back, I followed the advice to make a note of the following

  1. the time I got in to bed
  2. went to sleep
  3. length of periods of wakefulness in the night
  4. time I woke up
  5. how many hours I allotted for sleep.

It only took me a few minutes each morning to complete the grid and tot up my total hours of sleep.

After a week I could see I was having at least six hours sleep – granted its not the longed for eight hours I’ve always believed I need. However, realising my overall average over the week, was seven hours plus a night, really surprised me. For the first time I felt less anxious about how much sleep I am actually getting. Perhaps you know that feeling … It bubbles up at you whenever you can’t get straight off, wake in the night or wake too early?

Noticing the thoughts occupying my mind, such as ruminating over lack of sleep; negative thinking how will I cope if I’m tired sometimes made me fearful before I even got in to bed. What hope was there of sleeping! The diary of sleep hours was a wake up call, excuse the pun, because feeling reassured I am getting enough sleep has stopped me waking up in the night! And staying up all night with my father really brought that home to me.

Yes, I have looked tired this week, not surprising given the worry over my dear dad. As far as the missed night is concerned though, I’m not panicking, I know I can go to bed a little earlier over the next few evenings and my body will take what it needs. After all, I’m not a teenager – I’m not growing!

Writing this also prompted me to re read a blog I wrote back in November 2103 Sleep Solutions and reminded me of some of my own advice. Oops, bad habits can creep up on us …

Here are those sleep tips with a few new ones added. I hope you find them useful. Please share any you may to have to add in the comments box:

  • Take advantage of your natural body clock – the circadian rhythm, and if possible reinforce it by keeping to a regular sleep pattern, even at weekends.
  • Thinking; are you leaving all your thinking time until you are lying in bed? Try giving yourself some space to back track over the day and process your thoughts before you need to go to sleep. A good way of letting go is to work through your day, what you remember and how you felt until bedtime.
  • Ruminating and worrying; if you’ve got something gnawing away at you, try talking it through with someone or keep a journal and write down how you feel. This should give you a sense of having shifted the problem and provide perspective. Night time waking can be linked to people having ‘a lot on their mind’, as the body’s subconscious uses the sleep phase, typically between 2:00 and 4:00 am, to process problems. Studies have shown that people who talk about their problems are less likely to wake up regularly in the night.
  • If issues are beyond your immediate control or influence, focus on why it matters to you to shift resentment and angry feelings.
  • Most people find they sleep better on days when they are physically active. We know that exercising releases feel good hormones that help relieve stress, so this in turn will help you sleep.
  • Depression; if you are suffering from emotional difficulties and they have lasted more than a few weeks, you may be depressed. This is something I have experienced and wrote about in my memoir An Inconvenient Posting. The book includes a Do’s and Don’ts of Depression section. It is recommended you consult your doctor if you suspect you are depressed.

When going to bed:

  • Turn off blue light emitting devices such as TVs, tablets and Smartphones, which cause the brain to be alert. Kindles and some e-readers do not emit blue light.
  • Avoid reading or watching anything upsetting or unsettling on the run up to bedtime.
  • Over stimulation from caffeine is a reality. If you are particularly sensitive to its affects watch out for chocolate as well because of the caffeine in cocoa beans.
  • Exercising is good but not after 8:00 pm when it may rev up your system.
  • Eating heavy or sweet food near bedtime will also hamper your levels of comfort and over stimulate your body.
  • Distractions; got a noise you can’t block out? Invest in some good earplugs. I have friends who swear by them.
  • Be comfortable; cool, dark and quiet. Have anything you need close at hand; water, eye shades etc. If something is not right (itchy clothing for example) sort out the problem straight away.
  • Do not dwell on getting to sleep; focusing on the fear of not being able to sleep is the trademark of the insomniac. Negative thoughts and self-talk are guaranteed to keep you awake. Try techniques below.
  • Imagine you are a night watchman and you are not allowed to go to sleep! Use the power of the paradox…

You might like to try some relaxation techniques:

  • Just breathe… gently in through your nose and out through your mouth. Focus on your natural, deep breaths low down in your abdomen. This will help your mind step away from thinking and as you become the observer, switch off. If you find your mind keeps skipping on to other thoughts just notice this and gently come back to focusing on your breathing.
  • Relaxation CDs and downloads; there are many different ones to choose from; some include guided relaxations which will help relieve tension in your muscles.
  • Sleep aid CDs and downloads; many work on a similar principle to the relaxation aids, some include hypnotic, positive messages to help improve how you think and feel about sleep.  Most also aim to benefit those who wake in the night and would like something to help them get back to sleep if they do. I tried Paul McKenna’s I can Make You Sleep which comes with a book, DVD and CD and found it helpful.
  • Herbal Remedies and Bach’s Sleep Remedy; some people find Valerian is helpful for sleep disturbances and Bach’s remedies for balancing the body’s resources. You will need to mention any herbal remedy you are taking to your doctor if you are taking prescribed drugs.

Revisiting Singapore & Repatriation Blues

It was the holiday I’d been waiting for all year – the family mid summer break. But this year it felt more significant. Twelve years ago we repatriated back to the UK from Singapore, and now, after a decade of anticipating a return, we would go back, albeit briefly. The air miles stash had been plundered and South East Asia beckoned.

Even as we left Sing all that time ago, I knew I would want to return one day. Writing in my memoir An Inconvenient Posting, I recalled the scene as we took off:

“… the tiny island with its stalagmite skyscrapers being sucked away beneath me like a misshapen pebble.”

In the weeks before our holiday memories were rekindled of the time when we left Singapore to come ‘home’. I am one of those people who can’t help but plan ahead and wonder how things will pan out. Both ‘a blessing and a curse’ scenario planning seems helps me to feel ready for what life may throw at me. The downside is over-thinking can be energy intensive and result in poor sleep patterns.

My concerns back in 2003 had focused on:

  • Would we settle back easily, how would we pick up the threads of our former life?
  • Would the children be happy/fit in at their new schools?
  • How would I cope on the mid winter school run with a new baby in tow and without the domestic help I’d grown used to relying upon?
  • Would the town I’d lived in seem parochial after our Asian experiences?

I the event I discovered so-called ‘re-entry’ does have its own challenges. You expect to gel with people at home; you imagine they will feel comfortable and familiar with you and you to them. After all, it’s your homeland you are returning to. What I discovered was that I had changed while I was away, not surprising given I had learned to adjust to a different culture. Now, like a poorly fitting shoe, everyone and everything looked familiar, but it hurt as I moved around. It would certainly take time to adjust.

Thankfully, having only been in Singapore for three years, we weren’t forgotten. Although I do remember a couple of people seemed to look straight through me in the supermarket and others hadn’t realized I had even been away! Clearly, I needed to try harder with those ‘friends’.

Most people weren’t particularly interested in our foreign adventures and after a few sentences began to glaze over. Endeavoring to put myself in the mind of those that had stayed behind, helped me to cope with the apparent absence of curiosity. In my experience, the ‘I’ve lived abroad T-shirt’ is best worn with those who have had the experience.

Acknowledgement of how it feels to be back and some expression of appreciation for their continued friendship helped smooth the transition. Lillian Hellman’s words from Toys in the Attic come to mind.

“People change and forget to tell each other.”

Moving back inevitably required a period of adjustment on the part of the children too; being young they did not have the advantage of remembering living in their homeland. For them England was a country they visited in the summer for a month, chiefly to meet up with relatives. Unused to the cool climate, it took them an age to see the necessity of sock wearing and warm sweaters – a particular source of concern for me having spent my early years growing up in chilly North East of England.

In the first weeks and months I sometimes felt a little isolated, but I also recall the kindness of friends. One neighbour pre-empted my difficulties and organised for a friend of hers to swoop in and help me with school runs. Having a young baby who loved her afternoon naps, this felt like a gesture of life saving proportions. I barely knew Angela, but by chance I recently met up with her one evening, it was so nice to express my gratitude to her after all this time.

Enough of re-entry dilemmas, finally it was the day to take our holiday flight to Singapore. I was excited to see our old home and looking forward to immersing myself in the unique atmosphere; the vibrant bustle of the city, tower blocks rising up from the lush earth, bougainvillea adorning the bridges and overhead walkways, turning endless metres of ugly concrete into a cerise and purple flower show.

However, I had been warned Singapore has changed a lot so I wasn’t quite sure what to expect. Arriving at Changi Airport I was immediately struck by (wait for it) the airport carpet. The person who selected the enormous swirls of brown and orange shag pile clearly had a sense of humour; surely long haul passengers, starved of sleep, feel queasy enough. In my mind I recalled Changi Airport as a state-of-the-art environment. Seeing it now, it felt more homely – to the extent that any vast building can.

As we picked our way through the traffic to our hotel near the shopping district in Orchard, I could not stop smiling to myself. It is difficult to sum up exactly why it is good to be back somewhere once so familiar; my eyes were hungry to see what I recognized and what had changed. There were many new residential blocks along on the East Coast Road, leading into the city. Singapore felt even more full, made possible by more land reclaimed from the sea, something I always find improbable. The amazing green houses of Gardens by the Bay and the triple block towers of the colossal Marina Bay Sands Hotel (see pic) both new to my eyes were certainly not to be missed, literarily or metaphorically.

If I’m honest my nostalgic delight was not a shared experience; my husband travels to ‘Sing’ a couple of times a year on business, meanwhile our girls didn’t seem to remember anything! The older two were four and seven years old when we left, so perhaps my hopes of enthrallment were unrealistic. With a severe storm moving through South East Asia the backdrop to our arrival was also a rather dark and wet one

Once we had got over our jet-lag and started to adjust to the time zone (I had forgotten how bad it feels to be awake all night) equilibrium was restored. Walking around our old condominium, our eldest squealed with glee as she recognised the monkey bars by the condo pool. Afterwards, I suggested we all walk to the Botanic Gardens, but had underestimated the length of the walk. There was a chorus of, “how much further Mum?” – I had forgotten what it was like pounding a pavement in the equatorial heat – oops.

Singapore Orchids Botanic Gardens

Singapore Orchids Botanic Gardens

As we left Singapore and moved on, my husband asked the children what was most memorable for them about Singapore? They all agreed that aside from the tasty food, seeing the maids hanging out on their day off; Sundays at Lucky Plaza shopping mall had made an impression. The lifestyle difference of the maids surprised them, with little time for themselves and then seeing them huddled in groups for picnics taken on the verges and sidewalks of Orchard Road, one of the busiest shopping areas on the planet, this was something completely new. For all Singapore’s fantastic architecture and sight-seeing opportunities, what impacted their young minds most was the women living away from their families in servitude, and having such a different, more limited lifestyle to what they know.

So, what did I take from returning to our old home? To crystalise so many memories, good and bad, was restorative for me. It was the place where a younger self experienced a first, mind expanding posting and where I gave birth to my third, and last baby. I think we leave a little part of ourselves in each place we live and take something with us too; a connectedness with the place and the people. It felt right to go back. Ideally I would like to have do so much sooner; had there been some of the people we knew when we lived there to visit, it would have made the experience richer.

I am a little embarrassed to admit the Singaporean woman in Holland Village, who still runs a nail bar there, remembered me without any prompting, “I know you, you used to live here, you brought your friends”, she smiled. My girls thought this was hilarious as I usually do my own nails, to discourage them from doing the same and wasting money (ironically). My retort, “Well, I had more time on my hands back then and it was cheaper in Singapore.” Sadly, neither of those things are true nowadays!