Not sleeping is awful beyond belief, but I can't imagine life without my insomnia

Sleeplessness is difficult to cope with, and can result in dizziness, paranoia and hallucinations. But chronic insomnia sufferer Nicky Woolf reckons he'll see the sunrise more times than you will.

I am writing this at half past four in the morning.

I usually work at night. I'm not asleep. Not because I am panicked about the deadline; no extraneous worries or gnawing doubts trouble the calm waters of my mind tonight. But I'm still not asleep. “I never sleep”, I joke to friends. It's not true – I do sleep, sometimes – but it's never easy. It's always a fight to push my brain under, as if I am drowning it. Sometimes, much more often than I would like, I simply lose; lie there listening to the white noise in my mind, snatches of songs playing over and over, meaningless words and phrases and images for hours on end until it's time to get up again un-rested; or, like tonight, give up entirely and get on with some work.

Sometimes, if I have something I really need to be well-rested for, like an exam or an interview, I will keep myself awake the couple of nights before, just to slightly increase my chances of sleeping the night directly before. Even this doesn't always work. My brain has an uncanny ability, no matter how tired I may be physically, simply to refuse to go to sleep. Sometimes I can trick it into relaxing. Rarely, but triggered seemingly by nothing, I have a particularly bad insomnia attack. During these, I can go days – very occasionally even weeks – without any satisfying sleep at all, leading to dizziness, paranoia and hallucinations; crackling or popping noises at the edge of hearing, and smoke or flashes in my peripheral vision. It is practically impossible to for anyone who hasn't experienced it to understand quite how awful it feels to operate on that little sleep.

Insomnia is not, in fact, an illness. It is a symptom – sleeplessness – with a wide variety of potential causes both physiological and psychological. General stress or worry, lifestyle changes, new work hours and so on can cause acute (in the medical sense, meaning short-term or temporary) insomnia, which can often also be a side-effect of other illnesses like those that affect the respiratory tract. About the causes of chronic, psycho-physiological or “primary” insomnia like mine, less is known. In about fifty per cent of cases it can often be linked to deeper-rooted psychological issues including depression. There is also a condition called somniphobia or hypnophobia, which is a chronic insomnia caused by an irrational fear of sleep after nightmares or trauma early in life.

But some people just don't sleep sometimes, with no visible links to previous trauma or current depression – and while there are behavioural changes and medication that can be used to ameliorate the problem, there isn't really a cure.

“People say things like, 'have a bath', or they ask 'have you tried having camomile tea before bed', says Clare*, who has suffered from insomnia since her early teens. “All obvious questions to which you obviously know the answer. They're well-meaning and sympathetic, but it kind of illustrates how very little they know about it. Because... there's an insanity that comes to you after a long time [without sleep] where your mind is stretched very nearly to breaking point, and no-one is going to assume when you're ratty, or crying, or having a weird reaction to anything it's because of insomnia. But it is. Because not sleeping makes you mad. It casts a shadow over the whole day. And because sleep is something everyone has and doesn't have a lot, it's something everyone thinks they can relate to. Everyone thinks they get it. But they don't.”

“About a third of the population has a tendency towards insomnia,” says Professor Adrian Williams, of the London Sleep Centre. “There are many potential causes – perhaps body clock problems, psychiatric issues around depression: probably 50 per cent of insomnia is linked overtly or subtly to depression. Then physical disturbances which cause patients to wake; most commonly, sleep apnea – snoring-related problems – restless legs. These are symptoms that the patient may not be aware of; they say 'I wake up and can't go back to sleep'. Then there's psycho-physiological insomnia, which used to be called Primary Insomnia, and the current thinking is that this occurs in a physiology which allows poor sleep.”

The human brain is a terrifically complex machine, and the subtlest changes in brain chemistry can have far-reaching effects on our lives. Sleep is regulated by a family of neurotransmitters produced in the hypothalamus; the most prominent one is gaba, (which stands for gamma-aminobutyric acid and interacts with the pontine tegmentum to initiate REM, or deep sleep), and in 1999 a neurotransmitter called “hypocretin” was discovered to act as a switch to regulate wakefulness, and is notably absent in narcoleptics.

About the physiological causes of insomnia in the brain, Professor Williams tells me, not much is known. Considering how common the problem is, and how numerous its variations, there have been very few studies ever done on human subjects. One, Webb and Bonnet, 1979, concluded that sleep deprivation carries “no ill effects” - but in that study participants had their sleep reduced no further than to four hours in every 24; the same amount, in fact, that Margaret Thatcher recommended for a productive life. The record for monitored sleep-deprivation is held by 17-year-old Californian high school student Randy Gardner, who stayed awake for 11 days in 1964, reporting hallucinations, problems with short-term memory and paranoia, and no long-term ill-effects were noted, though the experiment was conducted with the little scientific rigour. Harder-pushing sleep denial studies with animals – rats and dogs – do lead eventually to death.

“There are concerns about the physical consequences of poor sleep, and they're under investigation now,” says Professor Williams. “The textbooks would not talk about this stuff at the moment – textbooks being ten years out of date – but we in the field feel that insomnia is not as benign as it might seem. It's more than just an irritation, and should be taken seriously.”

For myself, I have no idea who or what I would actually be if my insomnia was cured tomorrow. Sleeplessness has been such a constant in my life that I'm not sure I'd know what to do if I could just lay my head on the pillow and switch off the way others can. If I'm under pressure, I can easily work 48 hours or even more without sleeping if I really need to; I've had plenty of practice.

On top of that, there is a strange and strangely wonderful community of the sleepless with whom I often share the connection of being online, awake, sleepless, frustrated, at past five on any given weekday morning. Oh yes: and I'll bet my last valium that we've seen the sunrise more times than you ever will.

In fact, the sun is just rising now.

*Names have been changed to protect identity

Sunrise over London. Photograph: Getty Images

Nicky Woolf is a writer for the Guardian based in the US. He tweets @NickyWoolf.

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Is defeat in Stoke the beginning of the end for Paul Nuttall?

The Ukip leader was his party's unity candidate. But after his defeat in Stoke, the old divisions are beginning to show again

In a speech to Ukip’s spring conference in Bolton on February 17, the party’s once and probably future leader Nigel Farage laid down the gauntlet for his successor, Paul Nuttall. Stoke’s by-election was “fundamental” to the future of the party – and Nuttall had to win.
 
One week on, Nuttall has failed that test miserably and thrown the fundamental questions hanging over Ukip’s future into harsh relief. 

For all his bullish talk of supplanting Labour in its industrial heartlands, the Ukip leader only managed to increase the party’s vote share by 2.2 percentage points on 2015. This paltry increase came despite Stoke’s 70 per cent Brexit majority, and a media narrative that was, until the revelations around Nuttall and Hillsborough, talking the party’s chances up.
 
So what now for Nuttall? There is, for the time being, little chance of him resigning – and, in truth, few inside Ukip expected him to win. Nuttall was relying on two well-rehearsed lines as get-out-of-jail free cards very early on in the campaign. 

The first was that the seat was a lowly 72 on Ukip’s target list. The second was that he had been leader of party whose image had been tarnished by infighting both figurative and literal for all of 12 weeks – the real work of his project had yet to begin. 

The chances of that project ever succeeding were modest at the very best. After yesterday’s defeat, it looks even more unlikely. Nuttall had originally stated his intention to run in the likely by-election in Leigh, Greater Manchester, when Andy Burnham wins the Greater Manchester metro mayoralty as is expected in May (Wigan, the borough of which Leigh is part, voted 64 per cent for Brexit).

If he goes ahead and stands – which he may well do – he will have to overturn a Labour majority of over 14,000. That, even before the unedifying row over the veracity of his Hillsborough recollections, was always going to be a big challenge. If he goes for it and loses, his leadership – predicated as it is on his supposed ability to win votes in the north - will be dead in the water. 

Nuttall is not entirely to blame, but he is a big part of Ukip’s problem. I visited Stoke the day before The Guardian published its initial report on Nuttall’s Hillsborough claims, and even then Nuttall’s campaign manager admitted that he was unlikely to convince the “hard core” of Conservative voters to back him. 

There are manifold reasons for this, but chief among them is that Nuttall, despite his newfound love of tweed, is no Nigel Farage. Not only does he lack his name recognition and box office appeal, but the sad truth is that the Tory voters Ukip need to attract are much less likely to vote for a party led by a Scouser whose platform consists of reassuring working-class voters their NHS and benefits are safe.
 
It is Farage and his allies – most notably the party’s main donor Arron Banks – who hold the most power over Nuttall’s future. Banks, who Nuttall publicly disowned as a non-member after he said he was “sick to death” of people “milking” the Hillsborough disaster, said on the eve of the Stoke poll that Ukip had to “remain radical” if it wanted to keep receiving his money. Farage himself has said the party’s campaign ought to have been “clearer” on immigration. 

Senior party figures are already briefing against Nuttall and his team in the Telegraph, whose proprietors are chummy with the beer-swilling Farage-Banks axis. They deride him for his efforts to turn Ukip into “NiceKip” or “Nukip” in order to appeal to more women voters, and for the heavy-handedness of his pitch to Labour voters (“There were times when I wondered whether I’ve got a purple rosette or a red one on”, one told the paper). 

It is Nuttall’s policy advisers - the anti-Farage awkward squad of Suzanne Evans, MEP Patrick O’Flynn (who famously branded Farage "snarling, thin-skinned and aggressive") and former leadership candidate Lisa Duffy – come in for the harshest criticism. Herein lies the leader's almost impossible task. Despite having pitched to members as a unity candidate, the two sides’ visions for Ukip are irreconcilable – one urges him to emulate Trump (who Nuttall says he would not have voted for), and the other urges a more moderate tack. 

Endorsing his leader on Question Time last night, Ukip’s sole MP Douglas Carswell blamed the legacy of the party’s Tea Party-inspired 2015 general election campaign, which saw Farage complain about foreigners with HIV using the NHS in ITV’s leaders debate, for the party’s poor performance in Stoke. Others, such as MEP Bill Etheridge, say precisely the opposite – that Nuttall must be more like Farage. 

Neither side has yet called for Nuttall’s head. He insists he is “not going anywhere”. With his febrile party no stranger to abortive coup and counter-coup, he is unlikely to be the one who has the final say.