I Couldn’t Sleep at All Last Night

By John Thurman M.Div., M.A.

Link to the National Sleep Foundation

These words from an old song from the ‘50’s seem truer today than when they were first sung.  

Getting a good night’s sleep is a major challenge for millions of Americans.

Have you noticed the television ads for prescription sleep aids? The Luna Moth, Abe Lincoln and the talking beaver or the man or woman tossing and turning in bed are some of the current visuals used to promote prescription sleep aids.  It seems that our culture is having a hard time falling to sleep, staying asleep and feeling rested.

The National Institute for Health reports that nearly 70 million Americans struggle with sleep issues. I know, I have my struggles with sleep from time to time. My wife, on the other hand, usually sleeps as sound as a baby.

So what is insomnia? Simply stated, it means not getting enough sleep. People with insomnia have one or more of the following classic symptom:

• Trouble falling asleep
• Waking up often during the night and having trouble going back to sleep
• Waking up too early in the morning
• Unrefreshing sleep
• Insomnia will usually lead to some problems during the day such as sleepiness, fatigue, problems with concentration and irritability. A person with insomnia may also have another sleep disorder such as sleep apnea, narcolepsy, and restless legs syndrome.

According to data provided by the National Institutes of Health, the number of people with sleep disorders - and the alarming number of undiagnosed cases - is nearly epidemic.

• Approximately 70 million Americans struggle with sleep problems and nearly 60 percent of those situations are chronic.
• Sleep is particularly challenging for the older population, with more than half of those 65 and older suffering from a sleep problem.
• Because sleep disorders occur more frequently in the older population and because of the growth in numbers of those 65 and older, it is estimated that 80 million Americans will have a sleep problem by the year 2010, an increase of 15 percent.
• Although sleep disturbances occur most frequently with advancing age, it is estimated that 25 percent of American children experience difficulty sleeping.
• Approximately $15.9 billion is added to the national health care bill as a result of sleep disorders.

Current research suggests that approximately 60 million Americans suffer from insomnia on an annual basis, which can lead to serious sleep deficits and problems. Insomnia tends to increase with age and affects about forty percent of women and thirty percent of men.

Individuals can have primary or secondary insomnia. Primary insomnia simply means that the person is having sleep problems that are not directly related to any other health condition or problem. Secondary insomnia means that a person is having sleep difficulties because of something else, such as a health condition (like depression, heartburn, pain, medication, or a substance they are using). Insomnia can vary in how long it lasts and how often it occurs. Short-term insomnia is called acute insomnia can last a few nights to a few weeks. This type of sleep loss is usually directly related to:

• Significant life stress (job loss, new child, death of a loved one, moving)
• Sickness
• Environmental factors like, light, noise, extreme temperature changed
• Jet lag
• Work shift changes, changing both to and from Daylight Savings Time

Chronic (long term) insomnia is when a person has had a break in their normal sleeping pattern for at least three nights a week for one month or longer. It can be caused by many things and often occurs along with other health problems. Common causes of chronic insomnia are depression, chronic stress, and pain or discomfort at night.

The good news is that there are a number of ways to get your sleep back on track. In the last section of this article you will receive several ideas about what you can do. We will look at how insomnia is diagnosed, how it can be treated, and we will close with some tips on sleep hygiene.

If you think you have insomnia, talk to your health care provider. An evaluation may include a physical exam, a medical exam and a sleep history. You may even be asked to keep a sleep diary for a week or two, keeping track of your sleep patterns and how you feel during the day. Your health provider may also want to interview you spouse or roommate about the quantity and quality of your sleep. In some instances, you may be referred to a sleep center for special tests.

Acute or short-term insomnia may not require any medical treatment and may be helped by some small lifestyle changes. (See sleep tips below). But if your insomnia makes it hard to function during the day because you are sleepy and tired, your health care provider may prescribe sleeping pills for a limited time.

Treatment for chronic (long-term) insomnia includes first treating any underlying conditions or health problems that could be causing the insomnia. If the insomnia continues, your health care provider may suggest some behavioral therapy or medication. Most medications that are used for sleep have side effects and must be used with caution. It is not recommended to use over-the-counter medications for chronic insomnia. Small life changes can go a long way in helping re-establish sleeping patterns.

An ancient Proverb says, “You can lie down with out fear or anxiety and your sleep will be sweet.”Here are several general sleep tips that you can use to promote better sleep patterns:

• Try to go to sleep at the same time every night and get up at the same time each morning. Try to avoid naps during the day because they may make falling to sleep in the evening more difficult.
• Avoid caffeine, nicotine and alcohol late in the day. Caffeine and nicotine are stimulants and can keep you from falling asleep. Alcohol can cause wakening in the evening and interferes with sleep quality.
• Exercise regularly. Try not to do major cardiac exercise close to bedtime because it may stimulate you and make it hard to fall asleep. Stretching and other light exercise may actually help you sleep.
• Avoid heavy meals late in the day a light snack, not a bowl of your favorite ice cream may help you sleep.
• Make you bedroom a comfortable place. Be sure that it is quiet, dark and not too warm or cold. Avoid having your television in your bedroom. If light and noise are a problem try earplugs, a fan, or a “white noise” machine to cover up the sounds.
• Develop a routine that will help you relax and wind down before you sleep, such as reading a book, listening to music, or taking a bath.
• Avoid working and emotional, stressful activity in the bedroom.
• Avoid using your bed for anything other than sleep and lovemaking.
• Relaxation breathing and meditation are great ways to relax before falling to sleep. Reading a few of the Psalms from the Old Testament of the Bible can get a person off to a great sleep.
• If you cannot fall asleep and do not feel drowsy, get up and read or do something that is not overly stimulating until you feel sleepy.
• If you have trouble lying awake worrying about things, make a to-do list before you go to bed.

            In addition to medical treatments for sleep, there are alternative treatments such as teas, nutritional supplements, relaxation training, lifestyle changes, and oriental medicine.