In terms of survival, the rule of three serves to guide you in situations of maximum risk. It is said that human beings can go a maximum of three minutes without breathing, drink water for three days, and three weeks without eating. When it comes to sleep, some experts say that the maximum is also three days without sleep. Within 72 hours of total rest deprivation, you can be at risk of death. “I spent eight days in which I barely managed to sleep one or two hours at most. I took up to six benzodiazepines in a row, but they didn't do anything for me. “It was like I was drinking water.”
Raimon S. suffered from a severe insomnia episode for several months. When he got into bed, tears of helplessness came to his eyes, as this had never happened to him before. “Just thinking about going to bed gave me terrible anxiety. “The closer the night got, the worse I felt.” Of course: he has managed to recover. The solution, he says, was not in pressing any magic button. “They prescribed me a very strong sedative. Thanks to that, I began to sleep a few more hours continuously, until I stopped to incorporate melatonin. Thanks to that, and following strict routines, I now get used to having several days of sleep a week.”
One of the references on sleep in Spain is Dr. Eduard Estivill. In his clinic in Barcelona – Clínica del Son Dr Estivill – he has managed to resolve even the most complex cases of insomnia. “We must understand that not being able to sleep should be classified as a symptom. That is to say, most of the time it has a cause.”
The reason, he adds, can be anything from a pathology or illness to a lifestyle habit. “People who drink stimulant drinks excessively, drug users and those who work at night tend to have more problems sleeping. Diseases such as Alzheimer's, psychiatric problems, thyroid disorders and chronic pain also lead to sleep problems. Most cases, he highlights, "have their origin in the exhausting pace of life we lead."
According to the Spanish Society of Neurology (SEN), between 20 and 48% of the Spanish adult population suffers from difficulty initiating or maintaining sleep. In the case of children, the percentage is 25%. In total, nearly 12 million Spaniards do not enjoy good quality sleep. Of these, 4 million have chronic or serious disorders. Less than a third seek professional help to solve it.
For the expert, if you want to maintain good sleep hygiene and start treatment to overcome a period of insomnia, it is essential to have good habits during the day. “What we do during the day will determine how we rest at night. And sleep, in turn, conditions our day. When we are aware of this, we will begin to understand the importance of a good rest.”
Depending on the diagnosis, the type of treatment to follow must obey some rules or others. In all those who come to your consultation, there is a common denominator: they want to resolve it immediately. “Many tell me yes, following these routines is very good, but, today, what do I do? How do I sleep?” It is, he says, a disorder that does not have an immediate solution. To achieve this, one of the most important rules is to follow, as strictly as possible, a series of routines during the daytime. Eat healthy, follow meal times – 8am for breakfast, 1pm for lunch and 8pm for dinner are the most appropriate, according to Estivill – practice sports, expose yourself to sunlight during the day and reduce activity before Going to sleep is essential. “Sports are also preferable in the morning, since sunlight helps to generate melatonin naturally at night.”
Albert C. is another example of improvement. For him, what triggered a terrible period of insomnia was his romantic relationship and the pressure at work. “I was already sleeping badly since I turned 18, but after I was 45 a horrible stage began.” He says that he had to take up to five benzodiazepines to sleep two or three hours a day. When he got up, he had to drive to work. From Barcelona to Vilafranca del Penedès: almost an hour. “There were days when it seemed like a miracle to have arrived. Once there, the stress he suffered increased as the hours passed.”
In his case, the solution was based on making several decisions. The first, solve your most urgent problem: getting divorced and leaving home. Then, follow a doctor-controlled regimen of anxiolytics with antidepressants. The latter, as a side effect, also caused drowsiness. Lastly, and what stands out as most effective, follow a strict routine. “Although I overcame the severe insomnia, I continued to have trouble sleeping. In the end, it's about trying methods, trial and error. Always following the same routine before going to bed has helped me a lot.”
Although he knows that screens are not the best ally, one of the routines he has adopted is reading articles on the electronic tablet. “I reduce the brightness and try to make the songs nice and calm. Nothing that talks about topics that could leave me feeling bad.” Podcasts and audiobooks also help you fall asleep.
Sleepwalking, which consists of getting up during the night and wandering around the house without being fully aware of it, is also another cause of poor rest. Although it is usually overcome during childhood, some people carry it with them for years or even their entire lives.
Ignasi E. had episodes until he was 30 years old. “It affected the whole family. There was a moment when the situation was unsustainable: I opened my eyebrow in the middle of the night against the door frame.” In his case, the therapy consisted of taking very low doses of paroxetine – used to treat depression and anxiety – for a few months, combined with a complete change of routine. One of the aggravating factors, he confesses, was stress at work.
“I started eating a lighter dinner, playing sports in broad daylight, trying to sleep a minimum of seven hours a day and avoiding movies, series or stimulating situations in the hours before going to sleep.” Thanks to this, Ignasi has not suffered episodes of sleepwalking that affect his rest for more than 20 years. “Now, the more the years go by, the stricter I have become with the habits. It changed my life completely.”
We spend, on average, a third of our lives sleeping. A person who turns 90, for example, will have spent about 30 years resting. “Although for some people it may seem like a waste of time, without those 30 years of rest the remaining 60 years of vital activity could not exist,” says Estivill. Furthermore, the expert also points out that in Spain people sleep, on average, 40 minutes less than the European average.
“The important thing is that, in the vast majority of cases, something can always be done to improve the situation. Taking certain medications, always under medical supervision, can temporarily resolve the discomfort. But the definitive solution is to change habits and routines. The bed can and must stop being our enemy,” he concludes.
