On average, we sleep one and a half hours less per
night than our ancestors did 100 years ago and with
today’s fast pace and lifestyle, nearly 50%
of the adult population in the US is sleep deprived.
This is partly due to longer working hours, increased
commuting times, or looking after babies and young
children but is also due to insomnia.
The most common result of being sleep deprived is
a public health issue and that is the risk of falling
asleep behind the wheel. It is estimated that one
third of all drivers will fall asleep while driving
at least once in their lifetime. The monetary and
human cost is tremendous. And it is not only the drivers
of motor vehicles that can be affected but also those
who fly planes, sail boats and operate trains and
other public transport.
Another consequence of insomnia is that we
build up sleep debt.
This sleep debut is created when we don’t get
enough sleep each night so that it accumulates, builds
up quickly and does not decrease spontaneously. To
repay this sleep debt, you need to sleep longer each
night until the deprivation resolves. If you cannot
make up sleep, then you are in danger of becoming
dangerously sleep deprived to which your body reacts
by having serious daytime drowsiness.
If you are suffering from insomnia and the consequences
of insomnia, it is important (a) to find out what
is causing your insomnia whether it be psychological
factors, substance abuse, the side effects of some
drugs, medical conditions such as asthma and others
or a stressful life and (b) to practice good sleeping
habits and lifestyle changes so that you can overcome
this condition when it is mild to moderate.
However, chronic or severe insomnia should be referred
to your doctor for help and guidance and to rule out
any medical or psychiatric condition. He or she will
perform a physical examination and certain laboratory
tests while special investigations may be necessary
in extreme cases. If you can keep a sleep diary with
a record of how long and when you sleep, this can
be very helpful to your doctor. It may even be necessary
and helpful for you to have an assessment at a sleep
clinic.
Some of the more unusual methods used to treat insomniacs
are listed below:
• In some patients with extreme insomnia, behavioral
therapies may be used such as relaxation therapy with
special techniques to calm you and relax your muscles.
• Cognitive therapy is a useful technique for
sufferers that often display unrealistic sleep expectations.
These expectations can lead to performance anxiety
due to excessive effort at trying to control the amount
and quality of sleep. Cognitive therapy identifies
these beliefs about sleep by replacing them with more
adaptive and realistic beliefs and shifting of attention.
• Progressive muscle relaxation is a technique
in which you are instructed to tense and relax different
muscle groups throughout the body one by one to reduce
the muscle tension that is often observed among insomniacs
at night and during the day.
• Biofeedback is a method of providing visual
or auditory feedback to you to help you control certain
physiological factors such as muscle tension, ultimately
encouraging you to become more inclined to sleep.
• Imagery training is a visualization used to
focus on pleasant or neutral thoughts in order to
diminish cognitive arousal.
• Sleep restriction is another method that initially
allows only a few hours of sleep per night while gradually
increases the nightly sleeping time. The amount of
time in bed is shortened to match the amount of time
asleep.
• Reconditioning is a method that teaches you
to associate your bed with sleeping and not daytime
naps. Called stimulus control, this is a technique
where you are trained to re-associate your bed and
the bedroom with rapid sleep onset.
• Drug treatment or medication may be effective
in preventing physiological insomnia when all other
methods are unsuccessful but it is important to diagnose
any underlying medical or psychiatric condition and
treat this too as the prolonged use of medication,
without addressing the root cause, may result in dependency.
Hypnotic or sleep inducing medications should only
be used for a few days at a time in order to try and
break a pattern of sleeplessness while addressing
any underlying problem.
• If depression has been diagnosed, then antidepressants
can be effective in helping you to overcome the depression
and so sleep better.
Some of the methods of treating insomnia described
in this article are rather different and some may
consider almost experimental. However, everyone is
unique and it may well be that a more unusual treatment
will work for you if you are suffering from severe
or chronic insomnia and your condition has not responded
to the more usual lifestyle and environmental changes
that can often make all the difference to an insomniac’s
condition.
Whatever the method used, the most important fact
is to ensure that you are getting a good night’s
sleep.
