How to deal with Insomnia Part 1

Why we have it and what we can do about it

How should you deal with Insomnia? Are you tossing and turning in the middle of the night, trying desperately to sleep because you know if you don’t you’ll be dead tired the next day? Most of us know that worrying about not sleeping does not induce sleep. But how can we NOT worry about not sleeping when poor sleep seems to cause so many health problems? Heart disease, diabetes, autoimmune disease, anxiety and depression are just a few of the possible outcomes of chronic Insomnia that permeate the news these days. But trying too hard to sleep actually puts us in a catch-22. Worry causes more insomnia and insomnia causes more worry, which, in turn, can cause us not to sleep.

How to deal with Insomnia: Diagnosis

Depending on which study you review, approximately 10% of Americans actually qualify for an Insomnia diagnosis. Given how much we hear about short sleepers these days, that doesn’t seem like a lot. However, if we consider people who don’t meet the criteria for a standard diagnosis of Insomnia, but struggle with these symptoms intermittently, we are looking at about 25-30% of Americans. That’s a hefty statistic. What do you have to do to meet a diagnosis for Insomnia? You must have trouble falling asleep, staying asleep and/or waking too early with a significant negative effect on your subsequent functioning. This must occur at least 3 nights a week for 3 months. If it occurs for a shorter period of time, it is designated as “Brief Insomnia.”

How to deal with Insomnia: Different Types

So why do people suffer from “brief” or chronic Insomnia? Sleep researcher and co-investigator of the Shut i program, Charles Morrin, Ph.D., cites the following predisposing factors: a genetic predisposition to hyperarousal (that is when the autonomic nervous system is in a perpetual state of activation), family history, life stressors, environmental factors, personality traits, physical conditions, and psychological conditions, particularly a bidirectional relationship with anxiety and depression. (People with depression and anxiety tend to sleep less and insomnia causes anxiety and depression.) While there is little research on one’s history of interpersonal attachment, according to Laura Pagliani, Ph.D. of the University of Pisa, it looks like insecure attachment styles may be a risk factor for Insomnia as well. I will be delving into all of these factors over time as each deserves its own entry.

Some people have acute symptoms of Insomnia, related to a particular life event, while others struggle to sleep their entire lives. If you suffer from acute symptoms of Insomnia, an intervention would be worth your while. Studies indicate that acute symptoms can become chronic if not treated. If you are a chronic sufferer, don’t despair, there is hope!

How to deal with Insomnia: Modern Culture

Number one: research indicates many of the precursors to Insomnia are preventable. Recently, Jerry Siegel, Ph.D. conducted a study that looked at primitive cultures vs. modern American culture and sleep. What he found in 3 groups of primitive cultures (that is people living in the bush in Namibia, Bolivia and Tanzania with no electricity, running water, internet, or what we would call “comforts of home”) is that these people have virtually no Insomnia! While we have a significant amount to learn here, we may want to hone in on how we are handling (or not handling) stress, how we regulate light (do we get enough of the right kind at the right time), whether we exercise and when we exercise and our diet (are we eating healthy foods and using caffeine, sugar and alcohol sparingly?) These and other variables that our common to our culture, (but not to theirs) may shed some light on the prevalence ofInsomnia in America. If our modern culture boasts sleep inhibiting variables, it seems that we may have created our own beast…one that costs us physically, psychologically and economically, but one that we can, perhaps, individually or collectively conquer.

Insomnia Interventions

Number two: Once struggling with sleep, there are interventions we can run. Cognitive behavioral interventions for Insomnia have proven repeatedly to be effective. Researcher Jack Edinger, Ph.D., for one, has conducted several studies on CBTI and found them to be successful, particularly with chronic sufferers. Mindfulness based interventions for Insomnia look promising (see Dr. Jason Ong’s work on Mindfulness and Insomnia in SLEEP, Vol. 37, No. 9, 2014) and Depth Psychotherapy (while not on the National Institute of Health’s list of recommended interventions) can certainly address the attachment styles, personality traits and mood components that seem to put people at risk for Insomnia. Last, there are good old meds. While this is the least desirable intervention, given short and long term side effects of sleep medications, benzodiazepines in particular have proven successful in getting people to just go to sleep! Charles Morrin, Ph.D. indicates medications are particularly useful for acute Insomnia, but, “they are not as effective in the long-run because people may not invest as much time in changing sleep behaviors if they have a medication.”

How to deal with Insomnia: Conclusion

So where do you start? I recommend that you start with a simple Mindfulness approach in order to observe your sleep habits and get more acquainted with yourself. Observe yourself without judgment. Are you using technology right up until you turn out the light? Are you getting enough natural light during the day so your melatonin is working for you? Are you preoccupied and worried? Are you overly focused on trying to sleep? Is your sleeping environment too hot or too cold or uncomfortable in any way? What are you thinking and feeling before you go to bed? Pay attention and observe your behaviors, habits, thoughts and feelings. For the purpose of understanding your Insomnia, keep a log of these observations. While paying attention without judgment in itself may very well be an intervention, we’ll talk further and in more detail about Mindfulness and how it relates to sleep as well as about the other aforementioned interventions.

• Chromosome Telemores
• Insomnia and the Shared Bed
• Why Do We Sleep?