It’s happening again. You lie in bed, wide awake in the middle of the night. You hit the bed three hours ago, but try as you might, there’s no way you can fall asleep. Your mind is racing a kilometer a minute, but the alarm clock next to the bed keeps ticking—ticking—ticking, and the minutes pass by like hours.
Insomnia ranks right behind common cold, stomach disorders, and headaches as a reason people seek a doctor’s help. “Insomnia is a persistent lack of sleep, which interferes with the normal repair work performed during the hours of partial unconsciousness,” writes Dr. Alan Moyle in Insomnia: End the Misery of Sleepless Night.
Unknowingly, insomnia is a symptom—“not a disease,” declares Dr. Isadore Rosenfeld, best-selling author of The Best Treatment. “No one is born destined to become an insomniac,” he explains.
Like any other symptom (pain, itch, cough, fever), there’s always a reason of your inability to fall asleep, the most common being something psychological—you’re either worried, anxious, fearful, depressed, or excited. Or, you may be perfectly content, but your sleep environment is at fault—your bedroom is too hot, too cold, or poorly ventilated; your bed is too short the mattress is bad for your back.
Or, you may have developed bad bedtime habits, like trying to catch up on your unfinished office correspondence before turning out the lights; working out on your rowing machine; smoking that last cigarette of the day (the nicotine will keep you awake); even your sex habits can cause insomnia—it soothes most of us, but over stimulates others.
In some instances, insomnia could be a sign of a medical problem. Among the wide variety of medical conditions that can produce abnormal sleep patterns include heart disease and vascular lesions, lung disease, kidney disorders, liver problems, diseases of the pancreas, disorders of the digestive system, endocrine and metabolic diseases, and nutrition problems.
The medicine you take is another reason for your sleeplessness. Some drugs stimulate and affect the central nervous system causing alertness and thus insomnia. These drugs include medications for weight loss, foods and beverages containing caffeine, adrenergic drugs of asthmatics.
Insomnia often starts with a few wide-eyed nights caused by, say, a minor emotional disturbance. “Those few sleepless nights create habits that can lead to a long-term problem like taking a nap during the day or a nip at night,” says Dr. Edward Stepanski, an American clinical psychologist at the Sleep Disorders and Research Center at Henry Ford Hospital in Detroit . “You watch television in bed or raid the fridge at 2 a.m. Before you know it, you’re doing these things on a regular basis and you’ve developed what’s known as behavioral insomnia.”
All of the things most people do to supposedly improve their sleep will actually worsen it. “The original problem goes away, but the insomnia remains,” Stepanski notes. “They’ve developed terrible sleep habits that wouldn’t allow anyone to sleep, plus now they’re watching the clock and they’re very fearful as bedtime approaches.”
Medical science call this serious sleeping trouble as chronic insomnia, which could have profound underpinnings, such as psychiatric disturbance, breathing problems, or unexplained leg movements during the middle of the night. Experts agree that if you can’t easily fall asleep or stay asleep throughout the night for a month or so at a time, it may be time to see a doctor.
Sleep is defined as “unconsciousness from which the person can be aroused by sensory or other stimuli.” A night’s sleep consists of four or five cycles, each of which progresses through several stages. During the night, a person alternatives between slow-wave sleep, also called non-rapid eye movement (NREM) sleep, and rapid eye movement (REM) sleep. The entire cycle of slow-wave sleep and REM takes about 90 minutes. The entire cycle of slow-wave sleep and REM takes about 90 minutes.
A good night’s sleep means waking up rested and energized. On average, a healthy adult needs between six and eight hours of sleep a night, according to Dr. Ravi Seshadri, a sleep expert and clinical director of MD Specialist HealthCare at the Paragon Medical Center in Singapore .
However, the amount of sleep it takes to achieve rejuvenation varies from person to person. “It’s not a fixed number,” says Dr. Patrick Gerard Moral, head of the sleep and snore diagnostic and treatment unit of the University of Santo Tomas. He adds that length is not the only important factor in sleeping but the quality as well.
Why so much ado about sleep? Experts say sleep is imperative to maintaining good health. Without it, you increase your susceptibility to an astonishing health problems, including heart disease, stroke, diabetes, obesity and depression.
“Sleep is a natural physiological phenomenon, but it’s also a learned behavior,” says Dr. Michael Stevenson, clinical director of the North Valley Sleep Disorders Center in California.
Don Hawley, author of the book Smell a Few Flowers, offers these tips to beat insomnia:
1 Exercise more. Increasing your activity during the day will make it much easier for you to fall asleep at night. Don’t, however, do anything strenuous just before retiring. A brief, leisurely stroll is usually beneficial.
2 Have a fixed time for going to bed. We are creatures of habit, and dropping off to sleep should be a comfortable routine.
3 Avoid late meals. Don’t eat anything during the hours just prior to retiring, and let the final meal of the day be light, perhaps fruit or soup.
4 Don’t nap in the evening. Avoiding a nap too late in the day makes one more tired and ready for sleep.
5 Take a warm bath. A warm bath soothes the nerves and is conducive to sleep.
6 Avoid stimulants. Remember that coffee, tea, cola and tobacco all tend to keep people awake.
7 Practice deep breathing. Breathe out through the nose, hold it for several seconds, and exhale through your nose as slowly as you can. Wait a few seconds, and repeat the process.
8 Learn to relax systematically. Consciously think about completely relaxing each part of your body, starting at the top—the scalp, the forehead, the eyes, the ears, the mouth, the neck, the arms, the trunk, the legs.
9 Think of peaceful things. Begin to unwind an hour or so before bedtime. Push away the worries and problems of the day, and occupy the mind with pleasant thoughts.
10 Open the windows. Treat your lungs to some fresh air. A cool room is more conducive to sleep than a warm one.
11 Keep out unwanted light. Pull the shades, or obtain a comfortable pair of eye covers.
12 Seek quiet. You may have to resort to ear plugs to cut out unwanted noise.
13 Try counting sheep. Don’t laugh; it works. Dr. Richard Wyatt, of the National Institute of Mental Health, explains: “It’s not so much the thinking about sheep, but doing a very repetitive and boring task. You know its outcome, so you can’t get anxious or excited.” Usually sleep eludes us because our mind is still actively milling over some problem; we need to slow down the mental processes, Hawley says.