Chronic insomnia can have devastating effects on mental and physical health. Leona O’Neill talks to three NI people about their condition and how they sought help.
Patricia Flanagan, from Londonderry, suffered so badly from insomnia that it led to her trying to take her own life. The 39-year-old, who lives in the Bogside with her husband Martin and their children, Sarah (29), Megan (23), Seana (22), Adam (19), Rebecca (14) and Gracie-May (10), says her bipolar disorder and insomnia go hand in hand.
"I am bipolar so if I go into an episode, either a hypomania or a low mood, I would get insomnia," she says. "So I would stay up for 72 hours and then I would crash for 10 hours, then stay up for another 72 and sleep for 10.
"I would get that maybe three times a year and it can last for weeks or months even. It can be quite serious, especially when you are experiencing hypomania, you just don't sleep. With the chemicals rushing through your brain, everything just feels so alive. There is just no possibility of sleep.
"You only crash after the 72 hours and by then you are hallucinating. It's no joke.
"Nowadays I get treated quicker with sleeping tablets and other medication and it might last for two or three weeks at a time, whereas before it might have lasted for months.
"The more the insomnia impacts on you, the worse your mental health is going to get. It is a vicious circle."
Patricia says going three days without any sleep has her feeling at first euphoric, before the crash hits.
"I would be elated," she adds. "If you don't sleep for one night and you have to go to work at 8am the next day you are going to have an adrenaline rush.
"And that is just your body's way of overcompensating for lack of sleep. So if I go 72 hours without sleep I am bubbling, and I go into a hypomania - which is an episode where I would feel like I am walking on air, everything is amazing, colours are beautiful, everything you see and touch is just great, but after this you drop and you are in serious trouble then.
"After insomnia and hypomania you can go into a deep decline into depression. The last episode I had last year, I tried to take my own life."
Patricia says that her insomnia has also led her to become diabetic.
"The worst thing about insomnia is that everyone else is going to bed and you are left downstairs by yourself for maybe 12 hours," she says. "It is so lonely.
"And because you are sitting up through the night, you eat. I went up to 17st because of it and I ended up with Type 2 diabetes. I would have snacks in the middle of the night and even a hot meal. I would be repeating my daytime routine at night also.
"I've lost four and a half stone since and I am now in remission."
Patricia says that she is trying everything to combat the condition and says others shouldn't be afraid to try medication. She says it's about 'finding what works for you'.
"I would have to get heavy doses of sleeping tablets," she explains. "I would normally go into hospital and they would medicate me in there. It takes a while to get me back into sleep patterns again.
"I feel good these days, I am on the right medications. I meditate at night time and do a lot of natural and organic things to help me sleep.
"If you need the sleeping tablets, take them. Insomnia messes with your brain.
"You are not going to be able to work properly or eat properly, so I would always advise people that if they do need them, take them."
Londonderry man Ryan Arbuckle says his insomnia left him suicidal. The 32-year-old Waterside health worker said he found himself turning to alcohol to try and get to sleep.
"My insomnia started just completely randomly," he says. "It was perhaps one of the scariest things to ever happen to me.
"It was in 2012 and I woke up one morning and everything was kind of tilted. I had tinnitus.
"I would go for a nap and I would usually fall over to sleep, no problem.
"But this day I tried to nap and I just rolled around and couldn't get over to sleep. And until this day I have never felt that I have my feet back on the floor again.
"I have been to the doctor numerous times. I have taken antidepressants and numerous sedatives. I'm currently on various medications, including a melatonin supplement.
"I would spend maybe three or four nights completely awake. It completely destroys you. I have no energy and I have missed days at work because of it.
"You can get in trouble in work, you can lose jobs. The fatigue is unreal. I don't have any motivation. I don't go out at the weekends any more. I found myself drinking a bit more than I should, just to get to sleep."
He says that although prescribed tablets helped him for a time, their effects wear off, leaving him in the same sleepless position.
"When I go back to the doctor they hand me a two-week course of sleeping tablets and after that two weeks I just go back to normal again, not sleeping," he says. "There is no permanent fix for it.
"My doctor changed my medication to Mirtazapine and it knocked me out for three days solid. I told the doctor what happened and he said my body must have needed that. I'm still taking it now, but as time goes on it gets less and less effective.
"I have gone through counselling therapies, reflexology and everything that they ask you to try and do to help it. But it is just a case of managing it.
"It's so tough. I could go home tonight and go for an early night. I would fall asleep at 8.30pm and wake up again at 10pm and that will be me up all night.
"It is a difficult thing to manage and I don't think people understand how much you need your sleep. It impacts on every other part of your body."
Ryan says the lack of sleep has led to him becoming depressed and even having suicidal thoughts.
"Insomnia led me to depression," he says.
"I mean suicidal depression. I was really down at rock bottom. When you are depressed you take a bit of comfort in your sleep. You can escape for those 12 hours and your worries are away. It's a different story when you are not able to sleep and you're awake for the whole 24 hours in the day. I went through battles, I was at clinics about drinking because I was so desperate to get to sleep.
"In 2012 I was very, very low due to the insomnia. I was suicidal. I know there is a stigma around asking for help, but I have a really great mum and dad who I could go to with everything and they helped me, thankfully."
Ryan says insomnia still impacts his daily life. "Once you have insomnia I don't know if there really is any way out of it," he says.
"Some people sleep for 12 hours and some people sleep for one. Unfortunately I am one of those people who gets the lesser amount. And it leaves me feeling like I don't want to do anything, anymore.
"When I come home from work I just climb into bed and watch TV, whereas I could be going out with my friends and doing things. But I don't have the energy.
"I have tried everything at the health shop. I have tried Night Nurse, beta blockers, sleeping tablets and sedatives. I am on Circadin - a prescription tablet containing melatonin - at the moment, which seems to be helping a little. On a really good night I will get four hours' sleep, and on a normal night I maybe drift off just as the alarm clock goes off.
"Every morning, when I get up I feel awful. I nearly have to be dragged out of bed. It is so tough. I think a lot of people suffer from insomnia and it leads to depression, drinking, drugs and that whole unhealthy road.
"It really is a bit of trial and error with this. I'm still not there six years later, but I'm trying to get on top of it.
"And there are always people there to help. I have always felt supported by my family. I think that it's really important to let your family know that you are struggling with sleep."
If you, or anyone close to you, is affected by any issues in this article, please contact the Samaritans free on 116123 or Lifeline on 080 8808 8000
North Belfast woman Hollie Patterson is a health care provider. The 25-year-old says that she has turned her insomnia around by working through the night and sleeping during the day.
"I have had insomnia since I was around 18 years old," she says.
"It literally just came on. I couldn't sleep at night. I was a health care assistant, working day shifts. I came home from work and couldn't sleep. Initially I put it down to being busy at work.
"At that time I was working in a cancer ward, so I thought maybe it was my mind over-processing stuff, I thought maybe it was a culture shock. But then there was no let-up with it. So I went to my GP.
"He linked it to depression and I was treated for that, then I was diagnosed with fibromyalgia. Sadly it is all tied into one.
"I tried sleep hygiene programmes, cognitive behavioural therapy (CBT), yoga - everything really - and nothing worked. It was chronic insomnia and I thought there was nothing I could really do."
Hollie says that her insomnia impacted on her work, and she had to change to night shifts in order to get any sleep at all.
"I wouldn't get any sleep at night and I would maybe get a few hours during the day," she says.
"That's why I had to go on night shifts for the past year and a half. I could never sleep when I'm supposed to sleep - at night - so I'd be awake and doing whatever needed to be done around the house. My neighbours became quite accustomed to me vacuuming at 4am.
"I do permanent nights now. My manager has been so good with me, because they know that it is a problem for me. That support is fantastic.
"I sleep during the day and I work all night, it just suits me. I have absolutely no issues sleeping during the day. As soon as I get into bed, that is pretty much me fast asleep.
"I go home at 8am and I'll sleep until 5pm, get up and go to work. I think now that is my routine now and that is what works for me."
How much sleep do you need?
On average, adults require from seven to nine hours, children nine to 13 hours and babies and toddlers 12 to 17 hours.
The most common causes of insomnia are:
Ways to treat insomnia yourself:
Only go to bed when you feel tired, and try to go to bed and wake up at the same time every day.
Relax at least one hour before bed - you could take a bath or read a book.
Think about your bedroom environment: make sure it is dark and quiet, and use thick curtains, blinds, an eye mask or ear plugs.
Take regular exercise during the day.
Make sure your mattress, pillows and covers are comfortable.
Don't smoke or drink alcohol, tea or coffee at least six hours before going to bed.
Don't eat a big meal late at night.
Avoid taking exercise at least four hours before going to bed.
Don't watch TV or use devices just before bed.
Try not to nap during the day.
Keep to your regular sleeping hours even if you have a bad night's sleep.
For non-urgent help, see a GP if:
Your insomnia is not improving despite trying to change your sleeping habits or if your insomnia is affecting your daily life significantly. Sometimes you will be referred to a therapist for CBT.
Source: www.nhs.uk/conditions/insomnia. For more information and advice, visit the NHS website and charities such as www.mind.org.uk