Revisiting Our Relationship with Insomnia

Why Our Trouble Sleeping Is More Normal Than We Think

Mary Sykes Wylie

It's 3:00 a.m. Your eyes suddenly snap wide open and stare unblinking into the darkness. You try to remember the dream you were having, but it's gone, and anyway you're now as tightly tuned as a bowstring to the mysterious night noises of your house---pings, drips, rustles, hums, creaks---that send little electrical jolts zinging unpleasantly through your nervous system. You determine not to move, because that would be to admit you really are irrevocably awake. So you lie very, very still and clamp your eyes tightly shut again, though they fight back, quivering in the effort to reopen.

By now, your hyperactive brain is in full gear, a gazillion neural networks churning out a kaleidoscopic vision of every awful moment of fear, loss, frustration, fury, humiliation, and failure you've ever had, going back to college, to 7th grade, to kindergarten. (Now is also a good time to relive the really grisly part of that horror movie you watched years ago, still lodged permanently somewhere between your amygdala and prefrontal cortex).

Fostering Wakefulness

Insomnia. Almost everybody has it at one time or another. Some poor souls live (or barely live) with it. It's hard to know exactly how widespread it is—prevalence rates are all over the map. As many as 30 percent of the population, or as few as 9 percent (depending on the source of the statistic, or how insomnia is defined, or what impact it has), suffer from some form of it at least some of the time. Critics maintain the higher estimates are overblown, partly by insomniacs themselves, whose suffering leads them to overestimate the time they spend lying awake (10 minutes of lying wide-eyed in bed feels like an hour) and by the pharmaceutical industry (that all-purpose villain) in order to sell billions of dollars in sleeping potions.

Definitions of insomnia are loose to the point of inanity. DSM-IV defines "primary insomnia" as "a difficulty initiating or maintaining sleep or experiencing nonrestorative sleep that results in clinically significant distress or impairment in functioning."

Chronic insomnia is linked to a multitude of physical and psychological ills: increased risk of cancer, hypertension, heart disease, obesity, diabetes, infertility, miscarriage, depression, anxiety, irritability, dementia, impaired cognitive and reasoning skills, lowered immune-system function, heightened awareness of pain, and who knows what else?

Over the past century or so---roughly corresponding with the invention and worldwide adoption of electricity---the average time allotted to sleep in the industrialized world has shrunk by as many as four or five hours. The average North American now sleeps about six and a half hours a night. Thanks to technology, particularly the Internet, there's nothing you can do during the day that you can't do at night.

And we have a consumer industry to aid us in these pursuits. In all but the most godforsaken wilderness, it's possible to get in your car and find an all-night gas station that sells submarine sandwiches and any number of high-jolt, caffeine- and sugar-infused canned beverages with names like "Spike," "Fuel Cell," "Wired," and "Powershot." Here in the United States, where we work longer hours and take fewer vacations than citizens of any other Western nation, sleeping more than is absolutely necessary seems to be regarded as a form of sloth: you aren't really serious about your career unless you show up for work at 6:00 a.m. with bags under your eyes and don't leave until 9:00 p.m.

Beyond the Need to Sleep

In studies conducted at the National Institute of Mental Health during the '90s, psychiatrist Thomas Wehr and colleagues found that when research subjects were deprived of artificial light and restricted to a dark room for 14 hours a day (closely approximating the natural light-dark conditions of winter) for several weeks, their entire sleep pattern shifted dramatically. They didn't sleep solidly for 8 or 10 or 14 hours, but first lay quietly in bed for two hours, then slept in two sessions of about four to five hours each, separated by one to three hours of calm, reflective, wakefulness. Instead of having the stress hormone cortisol streaming through their bodies---like insomniacs have when they can't sleep---these subjects exhibited heightened levels of prolactin, the pituitary hormone that stimulates lactation in mothers and permits chickens to brood contentedly on their eggs, during their periods of nighttime wakefulness. Their brain-wave measurements at these times resembled a state of meditation.

Some researchers are drawing the conclusion from this material that midnight or early-morning insomnia is possibly more "natural" than the pattern of eight hours straight sleep that we've come to expect, but often fail to achieve. Perhaps, the implication is, we ought to accept the reality of those hours awake and cultivate a better attitude toward the inevitable---we should accept and make friends with those wakeful hours in the middle of the night. According to sleep researchers, lying quietly and peacefully awake can be as restful and restorative as sleep. And it's undoubtedly true that expending much anxiety on insomnia just makes the problem worse.

This blog is excerpted from “Sleepless in America." Read the full article here. >>

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Topic: Anxiety/Depression

Tags: brain science | ACA | amygdala | chronic insomnia | depression | DSM | dsm-iv | ED | HEAL | insomnia | loss | meditation | mental health | national institute of mental health | psychiatrist | psychotherapy | sleep disorders | technology | TED | therapist | therapy | Psychotherapy Networker | sleep | Mary Sykes Wylie

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