Thursday 18 January 2018

How a sleep disorder keeps Caomhan Keane awake all night

Ever since he was a baby, Caomhan Keane's sleep patterns have been somewhat unorthodox. A self-confessed night owl, the 33-year-old is starting to consider how staying awake all night, and sleeping in until the afternoon, is affecting his health

Caomhan Keane (33), tries different gadgets to get him to sleep at night Photo: Steve Humphreys
Caomhan Keane (33), tries different gadgets to get him to sleep at night Photo: Steve Humphreys

Benjamin Franklin, one of the founding fathers of the United States, is reputed to have said that 'early to bed, and early to rise, makes the man healthy, wealthy and wise'. For those of us who consider ourselves night fowl, James Thurber's twist on the maxim rings more truly: 'Early to rise and early to bed, makes a man healthy, wealthy and dead.'

Around 10pc of the population are early risers. Twenty per cent more are night owls, and the rest fall somewhere in between. Sure, the ways we live our lives aggravate our leanings. But research shows that early larks and night hawks are born that way, each possessing structural brain differences that account for their taste in wake-up times.

"Night owls show a reduction in the integrity of white matter in the brain," says Dr Jessica Rosenberg of the Institute of Neuroscience and Medicine in Jülich, Germany, who has conducted groundbreaking research in the area. "This indicates that the speed of transmission of nerve signals are compromised compared to that of morning larks."

Forced to dance to a beat that's counter to our natural rhythm, we night owls suffer a type of jet lag every morning as we struggle to adapt to the time zone of our (studies show!) less intelligent opposites.

We are better lateral thinkers, earn larger mean incomes, and are more likely to have a comfortable home, according to the University of Southampton. Yet the school system works against us, which accounts for us doing less well in State exams. Is it any wonder, so, that we nocturnal animals are said to be more prone to depression and possess less stable moods - as well as less flexible personalities - than our worm-catching kin?

I've always flown with the birds of the night. When I was just 11-months-old my father threw my cot out into the landing of our one-bed apartment as my blabbering resulted in his sleep deprivation.

In my teens I read The Diaries of Adrian Mole by bog light when the rest of the household dozed peacefully, contributing to my now terrible eyesight.

And by the time the Leaving Cert came around I was studying into the wee hours, turning morning time into a Lynchian grotesquerie.

It was workable while I lived with my parents and my mother could enter my bedroom like a black ops unit, dousing me in sunshine, profanity and -when all else failed - water.

But in the past 18 months an increase in shift work during regular hours - and the moaning of a partner whose hours differ from my own - has forced me to sort out my sleep. My brain is no longer able to handle the late nights it's endured for years and still turn in as competent a day's work.

"Sleep deprivation is cumulative," says Dr John Faul, consultant sleep specialist at the Bon Secours Hospital. "You should actually need less when you get older, but you have amassed what we call 'sleep debt', and the more you fall in debt, the harder it is to remember what a proper night's sleep is actually like."

As sleep debt mounts, the health consequences increase, putting us at growing risk for weight gain, diabetes, heart disease, stroke, and memory loss.

"It's a conditioned reflux and it's very difficult to break these habits. You build your life around your late sleep habits and think 'maybe I should work at nights' and 'maybe my friends should all be night owls', and soon your whole life is worked around this sleep schedule. Your body clock adjusts."

This internal alarm clock is said to regulate periods of sleepiness and wakefulness throughout the day. Known as the circadian rhythm, it adjusts to our environment using external cues, like light and heat, and regulates sleeping and feeding patterns, alertness, core body temperature, and brain wave activity accordingly.

Perhaps most importantly, it regulates hormone production.

Your circadian rhythm controls the release of melatonin to cause drowsiness and to lower body temperature. It also releases cortisol to sweeten our system with blood sugar to temper stress.

Disruptions to it have also been shown to lower leptin, an appetite-suppressing hormone, produced at night, and increase ghrelin, a hormone released by the stomach that stimulates hunger. So we are royally pissing it off by riding the information highway last thing at night.

Dr Elaine Purcell, of the Sleep Disorders Clinic at the Mater Private, has seen an increase in parasomnias such as sleepwalking and night terrors, due to the proliferation of such light, and of delayed sleep phase syndrome, a chronic dis-regulation of a person's circadian rhythm.

"Sleep disorders are on the rise, globally," says Dr Faul. "We don't know why. There could be medical causes that are undiagnosed as of yet, like there was in the 1920s when there was an epidemic called encephalitis lethargica, a type of hypersomnia that survivors of the Spanish flu got, that meant they had to sleep for up to 20 hours a day, though we didn't know why at the time.

"There have also been incidents where the swine flu vaccine caused narcolepsy, and other specialists have said food additives contribute."

Many people ingest booze, pills, and caffeine to tackle the issue, replacing one problem with multiple ones.

"People want one answer to an issue like sleeping, when it's actually something that is quite complex and personal," says Dr Dilis Clare, a leading authority on herbal medicine in Europe. "There isn't a miracle drug. You have to figure it out yourself.

"Any ritual you do before bed that gives you the expectation of going to sleep has an effect. It tells your brain that that is the next step and it starts unwinding."

She recommends meditating throughout the day or sipping on herbs, like chamomile flower heads, two to three times per-diem, to curb anxiety.

"Valerian is good for a sleep disorder related to anxiety. Verbena affects the liver, tackling that melancholic mood that affects over-thinkers. Motherwort is good for issues relating to the menstrual cycle and menopause. While hops - more commonly associated with beer - can help the over-sensitive not to spin out," she says.

The most common problem for people who have issues falling asleep at night is that they haven't done enough exercise. "I'm not talking about running 10k on a treadmill. Just stick on some Freddy Mercury and dance around your room by yourself, work up a sweat."

Just be careful not to do it too late at night. "People shouldn't exercise within three hours of bedtime," says Dr Purcell, "as cardiovascular work pushes up body temperature. Your body has to cool below normal temperature for you to fall asleep."

I tried most of the above. Which worked for putting me to sleep.

Unfortunately my subconscious has a tongue that could uncork a wine bottle, and no matter how early I got into bed, once my alarm went off it soothed me back to sleep, until the morning, if not most of the afternoon, was gone.

A desperate need to pee couldn't move me. A raging thirst. Even the UPS guy banging on my window couldn't stir me. What I needed was a replacement mother.

First I tried the Sleep Cycle Alarm Clock, a patented state-of-the-art sound analysis technology that records sleep patterns.

During sleep, our movements vary with each sleep phase. When in deep sleep you move less, and when in light sleep you move more. Sleep Cycle uses the phone's microphone to identify these phases and wakes you during your lightest sleep phase, using a predefined 30-minute alarm window.

The problem for me was that while it may be waking me during my light phase, it's no match for my subconscious luring me back to a world where Chris Pratt has just emerged from the shower. And it's yogi-inspired alarms gently eased me awake just long enough to put it back on snooze.

Where it excels was in giving me accurate information about my sleep, such as when I went to bed, when I actually slept, and for how long, as well as the quality.

This made me more conscious of the issues that affected me, such as the air quality in the room, how active I was during the day, and the moon cycle. With this information I could thus adapt my routine.

Next I tried the Step Out of Bed app, which only stops blaring when you step out of bed and keep walking for a pre-ordained period of time.

The first morning it accused me of cheating and reset the countdown, getting louder and waking up the whole house. The next night I stayed over in my partner's and while descending from his mezzanine I got into an argument with the app, which didn't recognise the stairs and reset itself, causing me to scream profanity, miss a step, and land on my face.

Finally, I tried the Sonic Boom Alarm Clock, which was designed by a company that makes products for the deaf. It has an 113dB extra loud alarm and a bed shaker that makes you feel like you're waking up during the Blitz.

The first time I used it it gave me such a shock I shot up out of the bed so fast I slammed my head off the low ceiling. But it proved way too easy to turn off. Placing it in another room in the house meant I had to again physically get my ass out of the bed to turn it off.

It takes time, effort and a lot of patience to figure out what will send you off to the land of nod.

"People come back to me and say they tried it for two to three nights and it didn't work," says Dr Clare. "You have to do it for six weeks. You are trying to change all your brain chemistry. An occasional cup of chamomile tea is not going to turn the freight train around."

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