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"The first thing I knew about it was from the woman downstairs, who was banging on the door of our flat and asking about the water pouring through her ceiling. I went into the bathroom, and saw that the bath was overflowing. I'd forgotten to turn it off, and, even worse, had no recollection of ever running it," says Louise, a copywriter and mother of two, who has been an insomniac since the age of seven.
You would normally put Louise's erratic behaviour down to a case of extreme forgetfullness due to lack of sleep, rather than a sign of mental illness, but a recent article in the New Scientist now raises the possibility that insomnia could actually cause mental illness.
Insomnia has long been linked to mental health problems, but they were always considered a side-effect. Now studies by American scientists suggest otherwise."It was just so easy to say about a patient, well, he's depressed or schizophrenic, of course he's not sleeping well - and never to ask whether there could be a causal relationship the other way," said Robert Stickgold, a sleep researcher at Harvard University. A whole host of psychiatric problems including depression, post traumatic stress and attention deficit disorder could be caused by sleep problems, the new research suggests.
Louise, now 38, from north London, is convinced there is a connection. "I'm sure the insomnia was the cause of my mental state, not a side-effect," she says. Louise had become used to coping on four hours of sleep a night, and resorted to watching old films on a loop to try to induce a state of sleepiness. But recently Louise's insomnia has spiralled into something altogether more sinister.
"I don't mind missing the odd night here and there, but sometimes it's night after night after night and then it becomes relentless. I can feel my sense of sanity slipping away, I see things that aren't there, I become preoccupied with things that don't matter, like checking my Facebook account constantly during the night, just to get communication from the outside world." she says. She was recently prescribed anti-depressants to manage the anxiety she is experiencing.
An American research study of patients suffering from sleep apnoea - a clinical condition in which the upper airway intermittently and repeatedly collapses, or closes over, leading to interrupted sleep - found that the condition doubled the chances of suffering from depression. Another study by Professor Matt Walker of the University of California, Berkeley, involved showing a set of increasingly disturbing images to people who had slept normally, and others who had been deprived of sleep for 35 hours.
"We found that the emotional centre of the brain, the amygdala, was about 60 per cent more active in people who had been sleep deprived, which was quite a frightening amount," says Walker. The connection between the amygdala and the frontal lobe of the brain had also been disrupted. "As the frontal lobe puts the brakes on the brain's emotional centre, it shows that when you're sleep deprived you're all accelerator and no brakes. You don't have control over your emotions."
Walker believes that at a "societal, medical and funding level we have neglected the importance of sleep and it's beginning to catch up with us". He is hopeful, though, that within the next five years we will understand "whether three per cent, five per cent or 50 per cent of people diagnosed with psychiatric problems are simply suffering from sleep abnormalities."
While he does believe in the importance of sleep, Britain's leading sleep expert is less convinced by these latest theories. Professor Jim Horne, director of the Sleep Research Centre at Loughborough University says: "I read the article and my eyes nearly popped out on stalks. In the great majority of people who have psychological problems a common finding is disturbed sleep, because in order to have a good night's sleep you need an untroubled mind. But simply treating the insomnia will not cure the psychiatric disorder. Will a hypnotic (sleeping pill) cure their mental illness? The answer is of course not. Mental illness is down to psychological factors, genetic factors - insomnia is a symptom."
Professor Horne believes that much of the evidence cited could be interpreted differently: "For example, people with sleep apnoea may be more likely to be depressed, but that doesn't mean it was the apnoea that caused it. A lot of these people are also likely to be obese and that is associated with depression."
Instead, he advises that those suffering from insomnia shouldn't worry about whether or not they're going mad, but concentrate on overcoming the problem. "Insomnia is not really a sleep disorder, but a disorder of wakefulness intruding into sleep. Sufferers need a professional to help them deal with their waking problems - most people know in their heart of hearts what those are."
"Insomniacs worry too much about their health, and sure as eggs is eggs some of them will now worry that they're going to get depression," says Professor Horne. "But you won't become mentally ill through lack of sleep. The biggest danger for insomniacs is being sleepy during the day and having an accident while crossing the road or driving a lorry. That's where the dangers lie."
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