Health Conditions

How to Cope with Insomnia and Reap the Benefits of Rest

Every day seems to bring more research and news coverage on the subject of inadequate sleep. It makes us accident-prone and slows down our reasoning. It drenches our sex drive and dulls our skin. Our memory, judgment and mood suffer, as well as our waistlines. It is enough to keep you up at night! For those who suffer from true insomnia, rather than simply a riveting novel or a riotous social life, advice to get more sleep is deeply frustrating. Insomnia requires a multi-pronged approach that addresses physical and mental health issues, lifestyle changes, possible medications and non-medication therapies that retrain and relax the mind.

Medically, insomnia is defined as short and poor quality sleep that affects your functioning during the day. Most of us require 7 to 8 hours of sleep per day in order to feel well rested. Interestingly people who routinely get insufficient sleep often feel that they have adapted to their schedule. They feel that they need less sleep than the average person. But when researchers test them on mental alertness and performance, it is clear that they are impaired more than they realize. Remember that lack of sleep can affect our reasoning – even our reasoning about lack of sleep.

Insomnia can present itself in different ways. Some sufferers have trouble falling asleep; they lie in bed waiting for sleep that does not come. Others fall asleep relatively easily, but wake frequently and can’t get back to sleep. Some wake up frustratingly early and others feel like they were awake all night.

Some insomnia is short-term and situational. Stressful events can knock us out of our sleep routines and occupy our minds at all hours. This acute insomnia generally resolves within a few days or weeks. Chronic insomnia is sleeplessness that plaques you at least 3 nights a week for more than a month.

Insomnia is an issue that presents itself more often to women than to men. Hormonal changes accompanying menstrual cycles, menopause and perimenopause can be sleep disturbing. Hot flashes and night sweats are not conducive to a good night’s rest. Insomnia also accompanies several other medical conditions that tend to affect women more commonly, such as anxiety, fibromyalgia, depression and restless leg syndrome. Pregnant women often report trouble sleeping. Leg cramps, frequent urination and general discomfort as they advance in the pregnancy are usual causes. We are also simply more prone to insomnia as we age. As women live longer, their chances of grappling with insomnia increase.

Insomnia can present itself as its own disorder or it can be a symptom of something else. Some people are prone to bouts of primary insomnia – meaning that they have no other condition that is causing the sleeplessness. Stressful or traumatic life events, disruptive travel or work schedules can throw them into a period of insomnia. Sometimes the insomnia resolves when the situation returns to normal, but sometimes it persists for longer.

Secondary insomnia is the more common type. It is a symptom of another condition. Menopause, depression, anxiety, arthritis, migraines, fibromyalgia, sleep apnea, heartburn, stroke and Alzheimer’s are some of the conditions that can result in insomnia. However, secondary insomnia is not always caused by a medical condition. A snoring bed partner, a caffeine, tobacco or alcohol habit, a too-bright or loud sleeping space can all seriously derail your sleep attempts. Medications for allergies, colds, asthma and some heart problems can also make sleeping difficult. With so many possible sleep disruptors it can be nerve wracking just to contemplate the next bedtime. Anxiety about insomnia can become its own destructive cycle. Worrying about anticipated sleep loss can keep us from sleeping. Similarly the connection between insomnia and depression can become a loop. Insomnia both increases our likelihood of developing depression and is also a symptom of depression itself. As each condition progresses it worsens the other.

If your insomnia is affecting your daily life it may be time to talk to your doctor. Prepare yourself for your visit by keeping a 2-week diary of your sleep, noting when you go to bed, when you wake up, how you feel during the day, any changes to your sleep routine, as well as stresses and medications. This will give you useful information to help your doctor assess your sleep situation.

Close up, woman asleep with hands beside her head resting on a pillow

Insomnia can be treated in many different ways. Mild situational insomnia may simply resolve on its own. Lifestyle changes such as reducing alcohol and caffeine at night can be a simple but effective change. Keep your sleeping space, cool, quiet and darkened. Exercise shows great promise in relieving insomnia. There is still discussion regarding the best time to work out when you want to improve your sleep, but most experts agree that it is best to avoid serious exercise in the few hours before you plan to go to sleep. Also, avoid late meals. Give yourself 2 to 3 hours to digest before bed. Keeping a consistent sleep schedule can be very helpful, go to bed and get up at the same time every day, if you can and avoid napping after 3 PM. This helps to train your body to a healthier sleep rhythm. For extra insurance add a relaxing routine, like reading, meditating or taking a bath to reinforce that bedtime feeling. Avoid using your bed to pay bills, watch TV, or do paper work. Use your bed for only sleeping and sex. You want to create a positively conditioned response to getting between the sheets. If sleep is simply elusive, don’t lie there and fret. If you are worrying, get out of bed and make a to-do list for tomorrow. If you simply aren’t drowsy, go somewhere quiet and read or engage in some other peaceful activity for a bit and then give it another try. Avoid the urge to go to the computer during this time. Research shows that the interactivity defining much of our computer use stimulates our brains in ways that may thwart sleep and the light from the screen may suppress the natural production of melatonin and confuse our biological clocks.

There are several other Cognitive Behavioral Therapy techniques used to combat sleeplessness. Cognitive control and psychotherapy can be used to corral the anxious thoughts or worries that keep you awake. Sleep restriction is a schedule that controls the time that you are in bed. You try to match the time that you are in bed to the time that you need to sleep, in an attempt to reduce the amount of time spent in bed sleepless. You go to bed later and get up earlier and then gradually increase your time in bed until you are sleeping through the night. Relaxation methods can be used to relieve stress and tension in the body, such as meditation, hypnosis and muscle relaxation. Biofeedback therapy uses electronic sensors to help a patient monitor body functions and responses that are usually automatic, such as heart rate and hand temperature. These responses change when the patient feels stress and allow the therapist and patient to measure the success of their relaxation techniques and create new habits. Lastly, you can try to relieve yourself of the stress of insomnia by remaining passively awake. Trying to lie in bed without the expectation of sleep can be helpful for those who find themselves up late, worrying about sleeplessness.

For some people a prescription sleep medication becomes necessary. These drugs have their own potential side effects that you need to discuss with your caregiver. They can be habit forming or cause grogginess and interact with other medications. Generally, these medications are used short-term, to give some relief to exhausted patients. But a Doctor may prescribe a longer treatment. Over-the-counter sleep aids generally utilize antihistamines to make you drowsy. If you choose to use them you should talk to your doctor to make sure that they will not interact badly with any other medications that you are taking. Like prescription medications, avoid combining them with alcohol and don’t take them when you have to drive or do any other activity that requires you to be alert.

In the quest for that elusive good night’s rest we can find ourselves tossing and turning physically and mentally. The more we understand about the importance of a rested body and mind, the more anxiety we can experience over our less than tranquil nights. Luckily there are plenty of tools and solutions to try. You do not need to surrender to insomnia. A good night’s sleep and all of its benefits can often be yours once again.

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Alison Relyea-Parr

Alison Relyea-Parr

Alison is the editor and contributor of A UW-Madison graduate, Alison is also an illustrator and educator.