Dr Thomas Stuttaford
Attend an evening with Andre Agassi

Even when the City is enjoying a bull market and generally cheerful trainloads of bankers make their way each morning to their offices, a third will claim that they suffer from insomnia and a fifth will have discussed the problem with their doctor. City executives are used to the cyclical nature of the economy and often have personalities that thrive on excitement and challenge.
Their clients, the ordinary millions of mortgage and pension-holders, don't have temperaments that blossoms when challenged by extreme pressure and buoyed up by thrills. They don't have the ability to shrug their shoulders, commenting on a similar situation in the 1980s. Older City workers remember the crash of the 1970s, and even that there was a little trouble in the 1990s.
Conversely, today's Charles Pooters, the salaried nobodies of the Grossmiths' diary, are ever conscious of the short-term mortgages that need renegotiating and rising prices. They don't, and can't, console themselves, as they lie awake at 3am, with thoughts of the lesser troubles of the financial markets at the end of the 20th century. But they may recall the slump of the 1930s when many Pooters were left destitute.
Anxious people who have mortgages, overdrafts and a hard-earned lifestyle to maintain are likely to be in for months of disturbed nights' sleep and drowsy, lacklustre days. Insomnia, the conviction that someone has that he or she is not getting an adequate amount of sleep, is not just a modern problem. Until comparatively recently, the prevalence of insomnia was not, as it is now, determined by the would-be sleeper's level of anxiety, but by the temperature, humidity and with it the fecundity, appetite and number of bedbugs, lice and other forms of insect life. People then rarely slept alone: in smaller houses, several often slept in the same room, even in the same bed. That may have been great for warmth, but it was paradise for hungry insects. Even those who managed to sleep despite itching skins would then, as now, be kept awake by snoring, whether their own or others in the room.
A recent weekend conference at the Welcome Foundation on sleep had, as one of its central themes, the premise that anxiety is now among the important causes of insomnia in the Western world. Another factor is snoring. No one doubts the damage, including an increased incidence of strokes and heart attacks, that snoring can do to the snorer if he or she has the crescendo pattern of snoring. This type grows louder and louder until the noise is interrupted by a short phase of apnoea, during which breathing is interrupted, and a momentary wakefulness - too short to recall - before the cycle starts again.
Few people consider the damage to the partner. They may not only be kept awake in bed, but one in three is woken up regularly every night, and one in two frequently, by partners' snoring. More than half the partners of snorers admit to feeling tired, stressed and edgy the next day. One in five describes his/her daytime condition as drowsy, over-emotional and spoilt by lack of concentration and poor memory.
Most speakers at the conference seemed to agree that regularly taking sleeping pills to correct insomnia was a mistake. Although some pills retain their tranquillising powers longer than their sedative capacity, the latter potential rapidly wears off. The agreed opinion was that cognitive behavioural therapy was an under used treatment. Sleeping pills can be taken sometimes for a good night's sleep but not so often that it becomes a habit and results in a tolerance to the drug's sedative action.
A suitable sleep regimen is essential. Bedrooms should be dark and quiet with a humidity and temperature that the sleeper finds comfortable. The bedroom must be a sanctuary providing privacy and seclusion. Bedtime is neither the time nor the place for discussions about finances, job insecurity, children's school performance or credit-card debt. Even bedtime reading should be suitably boring. Also your routine should not be disturbed by exercise or overindulgence in alcohol or coffee.
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