Depression and insomnia can be a chicken-and-egg problem: anxiety keeps you awake; lack of sleep increases your risk of developing full-blown depression. Many people with physically treatable sleep issues show significant emotional improvement once the apnea or restless leg syndrome is dealt with. Yet there are those who lack medical excuses for lying awake, who go to bed for eight hours every night, and who still have chronic insomnia and chronic depression.
While we associate sleep deprivation issues with staying up late working, anxiety-based insomnia can deprive one of sleep even when, strictly speaking, one does everything right. Medical science actually recognizes both sleep onset insomnia (difficulty falling asleep) and sleep maintenance insomnia (difficulty staying asleep). A significant number of people with clinical depression manifest both forms.
Personally, I’d need five figures to count the nights I’ve gotten into bed at 10:00, spent the next 60-90 minutes churning my brain over what needs doing tomorrow, finally fallen asleep only to wake two or three times with high-adrenaline dreams, and ended the night by drifting in and out of shallow-and-stressful dreaming from 3 to 5 a.m., then lying awake for another 60-90 minutes before forcing myself to struggle out of bed with a “You’ve got things to do!” guilt trip. Total amount of sound sleep for those eight hours in bed: about four to six hours.
Part of the problem is that my brain’s neurochannels are already conditioned to associate the physical action of climbing into bed with the mental action of turning on high-adrenaline thoughts. The other part: my OCD-oriented, Type A personality that fears fully tuning out the world lest I miss or lose something vital. Some people are worse off: they suffer from genuine somniphobia, a terror of sleep that is usually rooted in performance anxiety over sleep itself; a perceived lack of security in one’s home or neighborhood; frequent nightmares; or unnerving experiences with apnea or sleep paralysis.
While some species are wired to function well on the light-sleep approach, humans aren’t. Although precise time needed varies from person to person (and too much sleep can do damage as well), nearly everyone requires seven to nine nightly hours of real sleep — not staring at the ceiling, not repeatedly “dreaming oneself awake,” not listening to the radio or audiobooks in bed.
Of course, many people insist that setting the radio or an audio clip helps them fall asleep and it well may, if it uses soft and relaxing sounds exclusively (no commercial or news interruptions allowed). With or without audio assistance, most experts agree that the classic “counting sheep” approach is overrated, and that the best fall-asleep technique is to visualize a relaxing scene, such as a beach, garden, or campfire.
Other helpful techniques:
- Keep the room as dark as possible.
- Set the thermostat around 65 degrees Fahrenheit.
- Use your bed only for sleep or sex.
- Invest in a high-quality mattress. Turn it every six months and replace it every 10 years.
- Eat a light supper (or, if you finish supper more than four hours before bedtime, a light evening snack) of whole grains and low-fat proteins.
- In your last two to three “waking” hours, avoid: TV, computer devices, adrenaline-inducing work or reading, vigorous physical activity, and caffeinated drinks.
And if you’re a “don’t want to let go” type like me, find reasons for wanting to sleep well. Visualize the advantages of having more energy and functioning more effectively. Remind yourself that the world can get along without you for a while. If you’re genuinely afraid of “danger in the night,” consider asking your local police or fire department for a home safety check.
Most of the above tips also help with sleep maintenance insomnia, where you sleep shallowly and wake multiple times before morning. Especially where this has a physical cause such as apnea, the patient may not even sustain conscious memories of waking, nor understand why he or she feels so tired in the morning. Being unable to wake without an alarm is a red flag — a sign that your body needs to be bullied into violating what it instinctively knows is good for it. Don’t brush this off because you seem to function acceptably once you get up; like the person who “feels perfectly sober,” you may be suffering from impaired judgment brought on by the sleep deprivation itself.
If you have a chronic “can’t go to sleep” or “can’t wake up in the morning” problem, and the basic techniques are getting nowhere, talk to your doctor — not only to see if your insomnia has a definite physical or mental cause, but to discuss possible life changes should the issue prove more general. If you’re a chronic worrier, or always in rush mode — or if you’ve been highly sedentary and spending most of your time indoors — the solution may be better stress management, more daytime exercise, or even changing jobs or other major aspects of life.
Finally, beware of guilt or performance anxiety over sleep. Nearly 70 years ago, Dale Carnegie, in How to Stop Worrying and Start Living, noted that “Worrying about insomnia usually causes far more damage than sleeplessness.” Even if sleep deprivation and insomnia went extinct, different people would fall asleep at different times, wake at different hours, and stir at different times during the night. Actually, there’s historical and scientific evidence that humans may not be made for eight hours of unbroken sleep; many cultures have considered it normal not only to wake after four hours, but to then get up for an hour or two before returning to bed for the second half of one’s eight hours. So, waking in the middle of the night may actually be a sign of healthy sleeping, while not stirring for eight hours may warn that the body already has a sleep debt. Don’t make insomnia worse by obsessing about how well you fit the accepted pattern.
Most healthy sleepers go to bed at the same time every night and get up at the same time every morning (yes, even on weekends). To find your best going-to-bed time, set your getting-up time and then be strict about going to bed 7.5 hours before, every night, for a week or two. If you then wake regularly just before the alarm sounds, you’ve probably found your ideal bedtime. Otherwise, adjust your bedtime backward or forward (depending on whether you wake long before the alarm or only when it sounds) by 15 minutes each week following, until you find the balance point that coincides with your best waking time.
Remember, sleep is not a waste of time. It is a vital part of making the best use of your full time allotment.
References
The Claim: Counting Sheep Helps You Fall Asleep
Carnegie, D. (1990). How to Stop Worrying and Start Living. Pocket Books: Revised edition.
The Myth of the Eight-Hour Sleep
10 Things to Hate about Sleep Loss
Why Am I So Tired All the Time, Even after a Full Night’s Sleep?
Insomnia photo available from Shutterstock
from Psych Central http://ift.tt/22o3QmK
No comments :
Post a Comment