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Monday
Apr302018

Are You Suffering From Insomnia?

In the past, I have talked about matters of sleep hygiene or ways that you can create the best possible chance of getting quality sleep.  However, none of this is particularly helpful in curing true insomnia and the number of sufferers is increasing.  So how can you tell if you might have insomnia?  The first step is always to rule out any underlying medical issues.  Fatigue may be a symptom of many medical problems and should always be addressed with your medical doctor. 

Additionally, there are diagnosable sleep disorders that can wreak havoc on your daily life.  Normally the way to determine whether you have insomnia or a sleep disorder is to consider two factors: your risk factors and the type of symptoms that are occurring.  Risk factors include a tendency to snore, high blood pressure, aged over 50, male gender, body mass index over 35, neck circumference larger than 17 inches (16 inches for women), and whether anyone has observed you stop breathing while sleeping before.  Symptomology is trickier to determine.  The main difference between insomnia and a sleep disorder is that those with insomnia express feeling tired and fatigued while those with a sleep disorder actually doze or fall asleep during the day.  If you suspect a sleep disorder you should seek professional assistance as soon as possible. 

Yet, if you have insomnia, there are many things you can do to work on the problem on your own.  There are two biological factors that work in tandem to help you have quality sleep.  One of those is sleep drive.  The more you are awake and active, the more sleep drive you build up throughout the day.  If you are waking up frequently, or too early in the morning, perhaps you are not accruing enough sleep drive throughout the day.  The answer may be as simple and easy as increasing the amount of hours you are awake or the amount of time you are spending active during the day. 

The other biological system at play is circadian rhythm.  This is the system in your body that notices when light starts to ebb and makes you sleepy.  It is easy for a body’s circadian rhythms to get out of sync when sleep and wake times aren’t consistent throughout the week.  Keeping a sleep diary can be a huge help to determine whether or not you have insomnia and what the underlying causes might be.  While there are many available templates for a sleep diary, the information should at least include what time you get into bed, what time you try to fall asleep, what time you actually fall asleep, how many times you were up and for how long total, what time you wake up for the day, what time you get out of bed, and how you would rate the quality of your sleep.  In order for this information to be useful, it is important to keep track of it for a period of at least a week.  Sleep diaries often help you determine bad habits that may be affecting your sleep and what is the best thing for you to change to improve the quality of your sleep. 

You may notice that you spend a lot of time in bed, but very little of it is time that you are sleeping.  A lot of people have the mistaken idea that every adult requires eight hours of sleep.  This is not always the case.  You may be waking up or not sleeping as well because you are spending too much time in bed.  In that case, you could try restricting the amount of time you are in your bed.  For instance, if you are noticing that you are only sleeping five hours a night, you would wait until you are sleepy to go to bed and allow yourself five and a half hours in bed before your desired wake up time.  Then as you start to see yourself sleeping the full time you are in bed you can increase the amount of hours you are in bed by a half an hour every few weeks until you begin to feel rested.  Note, however, that it is never safe to restrict your time in bed to lower than five and a half hours even if you are actually sleeping less than that.

Another problem you may encounter is that your sleep and wake up times may differ depending on the day.  In that case, you may have to work to try and pick a middle ground sleep and wake up time that would work for the full week.  Once you implement this it is important that you try not to go more than half an hour off of the times you have set for yourself if you truly want to see improvement. 

A final problem that is often encountered is that you may have developed worry about sleep that has caused your body to develop a negative association with your bed.  This may occur in people who have a tendency to be anxious and find themselves stressing while lying awake at night in bed.  A good indicator that this is your problem is that you may be falling asleep on your sofa watching TV but as soon as you are in bed you are wide awake.  The best way to deal with this is to create a “nest”.  The idea is to remove your mind’s negative association with your bed.  So when you cannot sleep, don’t just lay there tossing and turning.  Get up and go to a quiet and calming place.  Engage in a restful activity such as meditation, reading, knitting or even watching non-stimulating TV.  Once you feel sleepy, head back to bed.  Initially this may require you to go to your nest often, sometimes even more than once a night.  However, soon the nest becomes the place that you associate with wakefulness and worry instead of your bed and you will find yourself reclaiming quality sleep.

A combination of the techniques I have suggested may be necessary to solve your insomnia issues.  Also, the problem often feels worse before it gets better.  The first few weeks of change are the hardest, but if you stick with it the results of quality sleep will be well worth the time.  If you want more information about any of these ideas I highly suggest purchasing the book Quiet Your Mind and Get to Sleep by Colleen Carney and Rachel Manber.  Finally, if you notice your insomnia getting worse or have concerns about your ability to stick to any of these techniques, consult a professional and get the help you need.

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