You will recall how in a previous blog entitled “Stress can be good for you”, we discussed the need for ‘waves of recovery and growth’. Well the simple truth is that sleep is directly implicated in arguably the most important and resourceful “recovery wave” of all. Every single point made throughout the course of tletters about human functioning and coping will be of little or no avail unless we attend to the crucial need for sleep. Let me also at the outset of this particular blog, attempt to clarify a major point, which I attempted to make in my most recent blog.

Imagine if you will, a substantial self-contained factory, the output from which – let us say – is a wide range of products demanding skill and precision to the nth degree in manufacture. There is keen competition for employment on the workforce of this factory and only the very best and most skilled of workers can be expected to prevail. Basically, two shifts are employed, i.e. a day shift and a night shift. The day shift – comprising workers possessing differing skills appropriate to the task – work on output, using ‘state of the art’ machinery, materials and methods.

Once the day shift has ended, the factory is taken over by a night shift. Their task is to service and check every facet of machinery and materials in order to ensure a continuing flow and standard of output of the highest order. So skilled and so highly paid are certain key workers of the night shift and so heavily do they rely on other workers making their contribution that they “clock in” late and depart well before the rest. So long as the night shift complete their servicing tasks satisfactorily, the day shift will return and output will continue. If not…!

Although this above analogy is, like most analogies, flawed and inadequate, hopefully it serves to clarify the point about the importance and value of a good night’s sleep as the basis for all satisfactory daytime coping. Now two questions: how much sleep do we need? And what, if anything, is there that we can do to maximize sleep’s rich potential? Response to the first question – whether it concerns you personally, a new born baby, or world-class athlete – is simple and always the same; and that answer is, “Enough”. So wide and complex are the individual differences appertaining, that this is the only really meaningful answer to give. Moreover, if you are being awakened from sleep each morning by an alarm clock or some other unnatural device or whatever, you are unlikely to be receiving sufficient sleep. As to the second question the answer is, “yes there are” and I shall take much of the remainder of this blog to outline something about them to you and why.

If you think about it, you will I am sure, readily agree that worry is a formidable ‘toxin’ to sleep. Hopefully, some of the coping strategies suggested throughout these letters will already be helping, both to increase self-control and to reduce the impact and effect of worry and concern. However – and not withstanding all of that – we all know how easy it is, especially in the early hours, to awaken from sleep, only to be roundly ‘set upon’ by the ‘dogs’ of worry persisting. If it’s not about what went wrong yesterday, then it is likely to be in anticipation of what might go wrong tomorrow; I’m pretty sure you know the sort of thing. One patient who I very well remember from some years back now had made great progress in coping with her daytime concerns. Nor did she experience any problem with falling asleep upon going to bed at night. No: her difficulty was that around 2am when the house was still and her husband and three daughters were presumably sleeping peacefully, she would awaken and – as she described it to me “be simply swamped with almost every imaginable kind of worry”.

Often, after lying tossing and turning for a while, she would get up to do some sewing or knitting or even ironing. (The rising from bed was, as we shall see, by no means an unreasonable thing to do if only to prevent her tendency to worry and inability to sleep from becoming ‘paired’ or associated in the “conditioning” sense with the bed and bedroom environment). Nevertheless, this chronic problem began, not surprisingly, to wear her down. Her sleep-loss steadily and inexorably mounted and – well – desperate times call for desperate measures. (C) SB.