“It was associated with me splitting up with my wife. Prior to that I wasn’t sleeping very well and after we split up the sleep deprivation really kicked in,” explains Keith, 45, who works as a government scientist.

He was sleeping on average between four and five hours a night, but sometimes as little as two hours. “When I first split up with my wife I went to counselling for six weeks and everything they suggested I put into place. I changed my diet and got myself fit and lost about two stone. I was exercising at least seven days a week and eating healthily but the sleep still wasn’t there.”

Despite lifestyle improvements, the insomnia persisted. “I’ve met a new partner and been very happy now for a couple of years but that hasn’t resulted in me sleeping any better. I was getting to sleep okay and then I would wake up in the middle of the night and couldn’t get back to sleep again. Just when you are getting back to sleep, the alarm clock goes off in the morning.”

As a scientist at the Health Protection Agency, Keith needed to be on the ball for his job. “I wouldn’t say I was permanently tired, it was more the mental anguish of not feeling as though I’d had a proper night’s sleep.”

The father of three never went to his GP and says that the idea of sleeping pills was never appealing. It was only after he heard an advert for the Sleep Centre that he sought help. He took part in a six-week sleep clinic which involved one hour-long session a week where he learned relaxation techniques and cognitive behaviour therapy (CBT).

“When I was going to sleep my mind was still racing, going over the different aspects of my life. One of the techniques was to try and clear your mind so that when you are going to bed you aren’t really thinking about anything.” He was also advised to keep a sleep diary to work out the average amount of sleep he was getting each night and only go to bed for that amount of time, even if it was only four hours. Keith saw results after two weeks and now sleeps for seven hours a night.

Colin Espie, professor of clinical psychology at Glasgow University, is the director of the Sleep Centre, a research facility based at the Southern General hospital in Glasgow which is run entirely on research funds. Most of the people who sees have been suffering for between 12 and 15 years. He argues that coping strategies, not medication, are the answer to long-term insomnia although he acknowledges that often GPs feel it is the only option. The CBT techniques he uses have around a 70% success rate.

“There is a place for sleeping pills as a contribution to coping with acute short term problems but that is where the evidence stops.

“The alternative that is evidence-based is cognitive behavioural therapy (CBT) which is used widely now for anxiety and depression. It’s an approach which focuses on changing behaviour, thinking and attitudes so that you can resolve the problem using coping strategies. The problem is that these treatments are not available. They work but they are not available.”

CBT for insomnia involves elements of anxiety management and relaxation to try and re-establish a pattern of good sleep by encouraging bad sleepers to approach sleep as if they are a good sleeper.

“In CBT, we teach a completely different model which is much more relaxed about wakefulness. Don’t catastrophise it but if you’re not getting to sleep within a normal period of time, say 15 minutes, accept it and get up and stop the bedroom environment being a place of angst and negative conditioning and go back to bed when you feel sleepy and don’t make a big deal of it.

“We also encourage people to reduce the amount of time they spend in bed rather than to increase it. We ask people to keep a diary and to calculate how much sleep they are actually getting, on average. If it is five and a half hours, then you go to bed for five and a half hours.”

Once continual sleep is achieved, sleepers extend their time in bed by 15 minutes per week. “Very quickly, their whole cognitive profile has changed

radically. The reason is very straightforward; it’s that our sleep is not a commodity, not an optional thing. Sleep is a biological essential, it’s part of the rhythm of life. People discover that they haven’t lost the ability, it’s not something magic but something they can rely on. That’s what good sleepers do, they don’t think twice about it.”

Sleep hygiene is a phrase which is commonly used with regards to the sleep environment but Prof Espie is not convinced of its relevance. “There are a very small proportion of people who have got insomnia because of excessive coffee drinking or bedrooms which are too bright but very seldom are these the causal or the contributory factors to the insomnia.

“When you compare sleep hygiene with CBT it doesn’t work – it is no better than a placebo. The caveat to that is that if there are people whose sleep hygiene is very, very bad it would work for them.”

A good night’s sleep is not only integral to our physical health; it has a significant effect on mental wellbeing. Until recently, the traditional medical view was that bad sleep was simply another symptom of mental ill health. “This is a very important point because our perspective on that has changed considerably over the last 15 years. There is a traditional view which people are trained in medical school that insomnia is merely a symptom of mental illness. Therefore, for example, depression causes insomnia or worry causes insomnia, but in fact the evidence from scientific research shows that the firmer relationship is that sleep disturbance lays people open to developing mental health problems. Even more reason to address it early, or at the same time.”

For people like Keith Bulloch, addressing his insomnia has turned his life around. “In the last few weeks, I feel as if I’ve done a 360-degree turn because I’m exercising a lot more again and I’ve been eating healthily so I’m back to where I was. I feel like it’s all been linked. Getting a full night’s sleep helped me to lose two stone. I feel a lot happier now and have a bit more energy about me. I feel like I’m in a better place.”

The University of Glasgow Sleep Centre is looking for volunteers to take part in a study on the transition from acute to chronic insomnia. If you are interested, email sleep.gaps@clinmed.gla.ac.uk or call 07554 080 450.

TIPS FOR A BETTER NIGHT’S SLEEP

Consider your sleep hygiene: ensure your bedroom is not too bright and your bed is comfortable; deal with any immediate distractions before you go to bed and don’t drink too much coffee or other caffeinated drinks during the latter part of the day.

Try not to worry too much about the fact that you can’t sleep. Accept that you may wake several times during the night.

Observe the 15-minute rule: if you haven’t fallen asleep within 15 minutes get up again and return to bed when you feel sleepy.

Improve your sleep efficiency. Sleep restriction increases the proportion of time that you are asleep in bed. If you go to bed for five-and-a-half hours and sleep for that amount of time you have 100% sleep efficiency, as opposed to going to bed for eight hours and sleeping for five-and-a-half hours. It’s the same amount of sleep, but the sleep is consolidated.

Once you manage to sleep through a shorter period, increase it but stop once you find you are lying awake. You may not need eight hours sleep.

Seek help earlier rather than later – generally, the more ingrained a bad sleeping pattern, the harder it can be to correct.