Coping with insomnia and simple tips to get you to sleep
ANJIRA ASSAVANONDA
Sleep is important to everyone. Sleep helps one's concentration, memory and helps you feel refreshed.
But not everyone can sleep like a baby. There are a number of people who stay awake all night, some wake up in the middle of the night and cannot go back to sleep. As a result, some spend their days in drowsiness, trying hard to fight sleep while working.
If you are experienced these symptoms, you may suffer from insomnia, says Assoc Prof Chakrit Sukying, of the Department of Psychiatry, Ramathibodi Hospital.
Who suffers from insomnia?
About 30 per cent of the Thai population suffers from insomnia.
A recent study found that more women, for an unknown reason, suffer from insomnia compared to men. Contributing factors are age, gender, lifestyle, environment, psychological factors and medical illnesses.
Types of insomnia
1. Transcient insomnia: A person is unable to sleep well for a few nights, usually because of excitement or stress.
Children, for example, may toss and turn before an important exam or sports event.
Adults often sleep poorly before an important business meeting or after an argument with a family member or close friend.
2. Short-term insomnia: Periods of on-going stress at work or at home can result in up to one month's of poor sleep.
When the stressful situation eases, or when a person adjusts to it, sleep usually returns to normal.
3. Chronic insomnia: A person under the following conditions are diagnosed with chronic insomnia:
- Unable to sleep for at least three nights a week, for a month.
- Has difficulty initiating sleep or in maintaining sleep, or wakes up early in the morning.
- Feels the sleep is not enough and does not feel refreshed after waking up.
- Unable to sleep despite all a supportive environment.
- Sleeplessness affects daily functioning.
What causes insomnia?
1. Primary insomnia: A sleeplessness that is not attributed to a medical, psychiatric, or environmental condition. In some cases, primary insomnia is a result of brain alert. The persons' brain is hyper aroused, keeping them awake day and night.
Dr Chakrit explains that sleep actually relates to body temperature. When the body temperature drops, we'll feel sleepy. Normally, the body temperature drops three times daily - early at night, between 3 and 4am and from 2 to 3pm.
However, for people whose brains are hyper-arousal, their body temperature will not drop as normal. As a result, they have problems getting to sleep.
2. Secondary insomnia: Sleeplessness caused by medical illnesses.
Dr Chakrit says more than one-third of people with chronic insomnia suffer from a psychiatric disorder, mostly involving depression.
These patients will wake up in the middle of the night and are not able to go back to sleep.
Other illnesses that cause insomnia include period limb movement disorder and breathing disorders, such as the severely disrupted breathing during sleep (sleep apnea).
For secondary insomnia, treatment of the medical illnesses will help the insomnia.
Guidelines to help you sleep better
- Beware of the importance of sleep. Don't let your body suffer from sleep deprivation.
- Maintain a regular schedule to wake up, so that the sleep period follows your biological clock.
The biological clock or "circadian rhythm" will tell you when to sleep and wake up. The circle of this clock is a little more than 24 hours. This means if you get up late, you tend to sleep later and later in the night.
People at different ages have unequal sleep needs. Adults need about eight sleep hours per day. Ageing people may need shorter hours of sleep.
- Don't force yourself into sleep. If you cannot fall asleep in 30 minutes after going to bed, get up and relax by doing something to get your body move a little.
- Don't take daytime naps. If you really need it, try to do so for no more than one hour in the afternoon, no later than 3 pm.
- Exercise regularly. Exercise is internal heating. When your body temperature rises and drops, you will feel sleepy. But pay attention to timing. Do heavy exercises in the morning, and mild exercises in the evening, at least four hours before bedtime.
- Immerse yourself in warm water that has an essential oil, and soak for 20 minutes before bedtime. It will help you sleep.
- A warm glass of milk before bedtime is also a good remedy.
- Eat light at night, but don't starve. Hunger also puts you at risk of insomnia.
- Avoid substances like nicotine, alcohol and caffeine. They will stimulate your brain and keep it awake.
"Alcohol will make you asleep in the first three hours after drinking, but after that it will get your brain alert," said the doctor.
- Consult doctors if you're unable to sleep for over a few weeks.
- Sleeping pills can help in some cases, but they should be taken under doctors' orders.
Life of an insomniac
Nat (name changed), 26, was diagnosed with chronic insomnia three years ago.
"When I go to sleep, I don't feel sleepy, and even if I do fall asleep, it's never a deep sleep. I may sleep for just two or three hours, then I wake up. Sometimes there are two to three nights in a row that I don't sleep at all, and the weird thing is I still do not feel sleepy during the day," said Nat.
"It's so frustrating. I feel I would have been much quicker and able to come up with much better ideas at work, if I did not have insomnia," he said.
"My doctor said it's probably because I worry too much, but I don't agree. Even if I'm not stressed, I'm still wide awake," said Nat.
"As a teenager, I've never had insomnia. It was not gradual. It just happened overnight and remains that way," he said.
His cycle of insomnia is unsteady. Sometimes he sleeps well for a whole month and then has insomnia for two to three months.
"Actually, a full night's sleep is rare for me. Usually, only a maximum of five hours a night is good enough," said Nat.
Even the strongest dose of sleeping pills does not help Nat.
Alternative medicine like acupuncture works at certain level, but the effect was not long lasting for him.
"I felt much better in the first month of therapy, but after my body got used to it, everything returned to the way it was," he said.
Since there have been no effective remedies, his solution is to maintain a healthy lifestyle, including avoiding caffeine after noon, and practicing meditation for 15 to 20 minutes every night.
When he is unable to sleep, he tries to keep his eyes shut even though he's consciously awake. That helps him to get through the day.
"Meditation helps a lot. It calms my nerves and has helped my sleep pattern improve, " he said.
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