In 2006 in the US, the clinical gold standard for insomnia was controlled-release Ambien. Millions of prescriptions a year were and are written. Moving across the Atlantic, the situation is no less "impressive". According to the latest figures, there are around half a million people in England taking sleeping pills at any one time. The National Health Service records show 820,000 prescriptions are written every month. It is estimated that some 330,000 pills are taken every day. This would make insomnia the most common psychological condition in Britain.

Why is insomnia so common? One explanation is that we now live a 24/7 lifestyle. Television and cable transmit tempting programs into our homes round the clock. We can surf the net, talk or sms on our handphones. We drink too much coffee. We live in an overstimulated world. But why would that lead to what, in real terms, would have to be described as an epidemic? Perhaps it is an age thing. As we all get older, do we need less sleep?

A better explanation seems to be that we have changed our attitude towards sleep. The first step is to distinguish between insomnia as the inability to get to sleep when we want to and sleeplessness where something keeps us awake, e.g. a change in our biological clock after flying to a different time zone. This makes insomnia mainly a psychological condition with insomniacs significantly more likely to be depressed than ordinary sleepers. This means that the more anxious we get about "falling asleep" the more difficult it is likely to become.

Generations ago, people did not take sleep for granted. Indeed, they were often worried about appearing lazy if they slept too much — Leonardo da Vinci pronounced sleep a waste of valuable time, napping about fifteen minutes every four hours. Now we are indoctrinated with the idea that unless we sleep seven or eight hours a night, our worlds will end. Hence, the National Sleep Foundation in the US recommends eight hours, but it is a fact that 70% of the population get less than this. A range of between five-and-a-half and nine-and-a-half hours per night is probably normal. In The New Black: Mourning, Melancholia and Depression, Darian Leader suggests that insomnia is usually a symptom of anxiety. Rather than routinely prescribe ambien, he consistently seeks to identify and treat the cause of the inability to sleep.

We could enjoy the peace of the night-time world when everyone else is asleep. The phone does not ring. No-one disturbs us. But the sleep-deprived brain does not function well and, for the majority, nights cannot be used creatively or productively. People are simply too tired whatever time of the day or night it is. Go for long enough without sleep and madness waits for us. This creates a billion dollar/pound industry to produce medications to knock us out. We are not deterred even though there can be withdrawal symptoms to negotiate when we try to stop taking the pills. Ambien is better than no treatment. Cognitive behavioural therapy (CBT) is a good alternative but often not available. Other than CBT, we are into the self-help world of relaxation techniques. Perhaps this last option recognises that insomniacs are often too busy thinking about "stuff" to get to sleep. If they were bored, they might just drop off. One thing is certain, if you are not going to rely on ambien, the worst thing is to try to make yourself sleep. Like most things, the harder you try to do what should come naturally, the more unnatural you make it and the harder it becomes.