SLEEP, LIKE THE weather, is one of those easy topics of conversation. People like to compare and contrast. It is estimated that around one in three people regularly experience insomnia, with the elderly particularly at risk. Insomnia can vary in how it presents; some find it hard to fall asleep, while some experience a broken pattern of constantly waking up. Others wake up early in the morning and are unable to get back to sleep.

It can leave you feeling unrefreshed next day – tired, irritable and unable to concentrate. For some people, insomnia comes and goes in episodes without causing any real problems; for others, it can have a serious impact on relationships and quality of life. It may even be a sign of illness.

Such illnesses might include obstructive sleep apnoea (OSA), where the upper airway keeps closing during sleep, causing loud snoring or even pauses in breathing that keep waking the person up. In the doctor’s surgery, the person might complain of morning headache or excessive daytime sleepiness. Unsurprisingly, OSA correlates with road traffic accidents because people fall asleep behind the wheel.

Other medical reasons for poor sleep include heartburn, thyroid problems, restless legs syndrome (an irrepressible urge to move the legs to avoid discomfort, often worse at night), any cause of significant pain, some types of medication, and various psychiatric illnesses such as mania, depression, anxiety disorders and post-traumatic stress disorder (PTSD). This is not an exhaustive list.

Not getting enough sleep can be frustrating and leave us exhausted the next day. Alamy Stock Photo Alamy Stock Photo

Sleep and psychiatry have been comfortable bedfellows for well over a century. The Austrian neurologist and founder of psychoanalysis, Sigmund Freud, wrote extensively about dreams being a form of “wish fulfilment” that expressed unconscious desires that were sometimes unacceptable or repressed in real life. Seeing dreams as the “royal road to the unconscious”, Freud did a lot of dream work with his patients, analysing the storyline or imagery of dreams (the “manifest content”) to........

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