Insomnia

"Let her sleep, for when she wakes, she will shake the world." ~ Napoleon Bonaparte

Sleep is vitally important to your health, both mental and physical. There is a massive amount of evidence showing that lack of quality sleep negatively affects mental health. And quality is an important word here, because not only is quantity of sleep an important variable, but, above a certain minimum point, quality may be even better than just quantity. For example, it’s better to get seven hours of quality sleep, than nine hours of broken, disrupted sleep.

 

Sleep problems are widespread. Insomnia specifically is one of the most common reasons people see their primary care doctor. Many factors cause bad sleep. All kinds of stressful events in our lives can cause it. 

 

Several medical conditions can cause or add to insomnia, so, as with many health conditions, it’s usually helpful to explore and aim to rule out possible physical causes with one’s doctor. Mental health and psychological factors, though, often play a major role. Anxiety broadly is one of the top causes. Depression is also closely associated with insomnia, as are several other mental health disorders. In this way, insomnia is often considered a secondary-disorder. That is, it is often the result of some other issue. And working on that other issue (again, commonly anxiety, but also other things) will then likely help the insomnia as a consequence.

 

If you have some intense stressors, and life comes with stressors, no matter who you are, you have to assess how those might be affecting your sleep. However, insomnia can become a problem by itself, even when there are no other significant issues in sight that could be contributing to it. This would be called primary insomnia. What makes primary insomnia different is that if you keep having sleep problems long after the stressful event has ended or settled or resolved, then you now have a primary insomnia issue.  In other words, the sleep problem has taken on a life of its own. Plus, as you know if you’ve struggled with this issue, insomnia can also cause other things to be worse, and therefore can itself be a cause for other mental and physical health problems, as mentioned. It can become a vicious cycle.

 

Either way, whether primary or secondary, insomnia can be improved with the right interventions. Learning tools to sleep better and to deal with insomnia, can help you better deal with the stressful and challenging things you experience when you’re awake, which will then in turn likely help you sleep better, and so on. So it goes both ways. The vicious cycle can become a virtuous cycle. The more successful tactics you can implement the better.

 

Thankfully, there are several approaches that can help. Here’s a sample of some things that you may discuss with a mental health professional to see if they are right for you, and how to go about making changes in this area. One is having better sleep hygiene, which means having a calming routine around sleep, that avoids exposing yourself to bright light or stimulating activities (including not consuming stimulating substances like caffeine too close to bedtime.). Another is stimulus control, where you keep other activities and stimuli out of the physical area where you sleep, so that when you go to bed, your mind has come to automatically associate that setting with sleep, rather than watching Netflix on your phone, for example. And therefore sleep itself becomes more of a habit. Also, there is sleep compression, where you limit (only above a minimum point) the amount you sleep so that you can get better quality sleep, rather than a night of broken segments of sleep. In other words, while most adults need seven to eight hours of sleep, and as described above, it’s better to get six solid hours of sleep than to be in bed for nine or ten hours and to sleep poorly and inconsistently.

 

Trying to catch up on sleep during the day by taking naps can also backfire, because it then can be harder to sleep again at night. (Reverse these if you are a night-shift worker. The same points apply, though.) Having a consistent bedtime and wake-time can help to keep sleep in one solid block, without frequent awakenings. And this keeps your daily, circadian rhythm in a more reliable pattern. It’s the waking up and falling back asleep over and over that is very disruptive to your brain. (That’s also why the snooze button is the worst thing ever! It’s typically better to either wake up completely when the alarm goes off, or to have slept a bit more in the first place without being disrupted.)

 

Besides these things, general stress management and working on one’s overall level of anxiety in life can absolutely make a big impact on sleep, as well. Or, if you have other mental health conditions and/or symptoms that are contributing, working on those can help.

 

Again, these are not specific recommendations, but rather a general idea of what types of things can be done. If you’re struggling with insomnia, please seek help, because there are likely multiple things you can do starting today to improve your sleep. From there you can start to focus on the rest of your life again.

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