One who’s never had trouble sleeping will never understand how exhausting sleep deprivation can be. Insomnia now affects at least 30% of humanity – that’s over 2.4 billion people!
Not every sleepless night heralds insomnia
It’s surprisingly difficult to come up with one coherent definition of insomnia. It’s a sleep disorder that can be explained by the inability to fall or stay asleep.
Based on this categorization there is onset insomnia (inability to fall asleep) and maintenance insomnia (difficulty staying asleep). But insomnia can be divided also by how long it affects one’s health. So on this level, insomnia can be acute (short-term) or chronic (long-term). And finally – insomnia can be described as primary or secondary. The first, meaning that someone is having difficulty sleeping, but is not suffering from any other illness. The second means that insomnia is covering some underlying condition.
When to start worrying
Acute insomnia can strike you when your stress levels are over the roof. Any time you’re having some trouble at work or at home, or have to deal with a difficult life experience like losing a loved one, you may be prone to an insomnia-like disorder.
To be diagnosed with chronic insomnia, you’d have to suffer from sleep deprivation at least 3 nights a week for over a month.
Who is more vulnerable to insomnia?
For some reason, almost twice as many women report having sleep issues as men. Scientists don’t have a reasonable explanation – at least yet – as to why insomnia affects one gender more than the other.
Causes of insomnia:
- Depression and/or anxiety
- Environmental factors (too hot, too much light, too loud)
- Some medication
- Emotional discomfort
It’s mostly in our heads
A century ago, we slept 20% more than today. A century ago, our world was smaller, less connected and we didn’t take work home. I’m not saying the world a century ago was better – it was just different. Now, information not only rules but overloads our minds. And it’s nearly impossible to rest when your mind is still processing events – future or past.
Meet the sympathetic nervous system
Since our minds are occupied with processing more and more information – and often stressful ones – it’s causing our sympathetic nervous system to be in an “always on” position.
The sympathetic nervous system is one of the defense mechanisms that evolved to protect us in stressful situations. It’s responsible for the fight or flight response, and it manifests itself in increased heart rate, blood flow, metabolic rate, cortisol (stress hormone) level, and higher brain activity. If you know what stress is, you’re familiar with these symptoms. Such mobilization of your body is necessary in dangerous situations. But today, we’re overloaded with information and stress, so more too often this defense mechanism is left “always on,” causing trouble sleeping.
Think about it – it’s virtually impossible to catch some shut-eye if your brain is convinced you’re in danger.
Insomnia under the MRI
This inability to “shut-down” can be clearly observed in an MRI machine. Healthy sleepers and insomniacs were invited to participate in a study. Both groups were placed in an MRI machine, where they slept. Researchers proved that healthy sleeper brains were slowly falling asleep, and area by area, their brain activity decreased. That wasn’t the case with people suffering from the sleep disorder. In their brains, one area was especially reluctant to go into slumber – the amygdala, responsible for strong emotional reactions.
Where to seek help
Your first line of help is your healthcare provider. You will be asked about your sleep routine and medical history. A doctor will decide which treatment method will be best for you.
How to treat insomnia
There are many ways of treating insomnia, including pharmaceutical and non-pharmaceutical.
The National Sleep Foundation, aware of the increasing problem of an underslept society, recommends not pills, but a therapy called CBT (I’ll explain it later on). An alternative to therapy is medication. Sleeping pills, prescribed by doctors, are still a popular-but-not-that-healthy way of inducing sleep (I will also elaborate on this later). Before you go to a doctor, make sure you’ve tried available (and free) solutions first.
Free solutions for insomnia
You probably heard a bunch of “good advice” on how to ensure healthy sleep, but it seemed too simple or too cliche to work. That’s why I will break some of it down for you scientifically.
- Take a warm bath – “clean” doesn’t make you sleepy, but “warm” does. After a hot bath or a shower, your blood vessels are dilated. That’s why you gain color. Dilated blood vessels also help with our inner thermostat – you start to lose heat, which is necessary for stage one of sleepiness.
- Don’t drink coffee (or anything with caffeine) at least 6 hours before you go to bed. Caffeine can be a lifesaver in the morning, but when bedtime is approaching, that’s the easiest way to delay your ability to sleep. It works like this: sleepiness in terms of chemistry is the work of adenosine – a nucleoside, high levels of which make you sleepy. Caffeine works by blocking adenosine’s receptors in the brain. Adenosine still builds up, however, you just don’t feel the sleepiness – at least for as long as caffeine is active. A recent study showed that caffeine can still impact your ability to sleep consumed even up to 6 hours before bedtime.
- Stick to a sleep routine – I don’t know, which part is more difficult to achieve – a strict sleep routine or giving up caffeine. But our bodies (and minds) love order. If you live by the clock, sleep, eat and go to work at the same time, they thrive. When you don’t, there’s a high chance you’ll deregulate your circadian rhythm.
- Try to exercise more – the more you move, the more tired you are at the end of the day. Nowadays, however, we tend to work with our brains way more than our bodies. In effect, it’s harder for us to drift off to sleep. Tiredness makes us lose focus and attention and that’s conductive to sleep.
CBT therapy for insomnia
CBT stands for “Cognitive Behavioral Therapy.” Sometimes you’ll see CBT-i, which means it’s a specific kind of therapy, dedicated to fighting insomnia.
As you remember from a few paragraphs above, insomnia is often caused by the restless sympathetic nervous system. CBT is a psychological way of putting it at ease. Generally, it’s a set of techniques and tools a patient can use to overcome negative emotions, behavior, and thoughts.
You can either join a therapy group, attend individual sessions or sign up for online guidance. If done personally, it requires regular, often weekly, visits to a clinician who will give a series of sleep assessments, ask to complete a sleep diary and work with the patient in sessions to help change the way they sleep.
CBT therapy is an effective and a recommended way of treating insomnia. But the downside is, it’s expensive. A 6-12 visit therapy can cost up to $3300.
The dark side of sleeping pills
The reason doctors all around the world are starting to be reluctant with sleeping pills is that the sleep they induce is not natural. It doesn’t give all the benefits a healthy sleep provides.
Sleeping pills and alcohol target the same mechanism in our brains. Both substances are sedatives – they don’t put you to sleep, they just knock out the higher regions of your brain’s cortex. There is also some highly disturbing research, linking sleeping pills to excess mortality.
Insomnia was declared a global epidemic by the World Health Organization. Since our lifestyle switched from farming crops to farming ideas, we’ve created an environment that just doesn’t support healthy sleep – or time for it, for that matter. But as we acknowledged the importance of sports and healthy food and have incorporated them into our lives, it seems it’s time to make one more step. This time towards healthy, uninterrupted sleep.