How many times during the night do we toss and turn, check the clock, and find it ticking away and tell ourselves, “If I could fall asleep right now I would get at least five hours of sleep”? But, sleep doesn’t come so we continue to toss and turn. This happens to many people and may suffer from a disorder known as insomnia. People who suffer from this disorder have many complaints, and many have similar symptoms. Symptoms can vary from stress to pain to always feeling tired. Insomnia is a very difficult disease to have to live with. It is hard for both those that suffer from it and their family members.
According to Linde and Savaley’s, The Sleep Book, (1974), “the person who has trouble sleeping is not alone” (p. 9). They also claim, “An estimated thirty million people suffer from chronic insomnia” (p.9). Many non-insomniacs have occasional periods when they wonder if they’d make it through a sleepless night. Many insomniacs can’t fall asleep because of pain and discomfort. Those that can fall asleep but can’t stay asleep might be caused from depression, or too many things to worry about. In Ernest Hartmann’s The Sleeping Pill (1978) some causes of insomnia (p. 113). He states that pain and discomfort do indeed play an important part in the difficulty remaining asleep. For those having difficulty remaining asleep might be because of depression or having too much to worry about.
In Linde and Savary’s, The Sleep Book (1974), Dr. Dale C. Friend claims, “insomnia can be classified by four causes: tension, fatigue, discomfort, and in and out insomnia” (p. 100). Tension insomnia occurs mostly in executives or people who worry about their businesses. Tension builds up inside during the day and is still inside at bedtime, it won’t come out, so they tend to worry and are not able to go tot sleep. Fatigue insomnia happens when people who get tired during the day and then they take a nap in the early afternoon and as a result they cannot go to sleep at bedtime. People suffering from discomfort insomnia often complain of stomach upsets, such as ulcers, toothaches, or arthritis. This causes them to wake up during the night, which gives them discomfort. In and out insomnia occurs when patients feel that they didn’t sleep at all during the night when they really did, but only stayed in the first stages of light sleep and woke up frequently throughout the night.
Dr. Allan Rechtschaffen states in Linde and Savary’s The Sleep Book, (1974) “Insomniacs spend less time in REM sleep than normal sleepers” (p. 110). REM sleep, or rapid eye movement sleep is the final stage of sleep reached in a normal sleep cycle. To better understand this cycle of sleep scientists have used an electroencephalogram to measure brain waves during sleep. A normal sleep cycle consists of five distinct stages with paradoxical, or REM stage being the final stage. REM sleep is what is commonly known as deep sleep.
There are many other causes of Insomnia such as the many environmental causes said by Ernest Hartmann’s The Sleeping Pill (1978). Hartmann states, “any loud noise or sounds that can irritate or aggravate can disrupt a persons sleep” (p. 116). When trying to sleep, the littlest things can bother someone’s sleep whether hearing the bathroom water faucet dripping or even the heater coming on during the night. All these things can keep a person up all night when they are suffering from insomnia. He also claims, “there is a condition sometimes called ‘habit insomnia’” (p. 116). Habit insomnia is when something caused the insomnia in the past so when the sufferer associates it into habit. For example, when the see the bed that they have difficulty sleeping on, they condition themselves to think that they can’t sleep because of the bed, therefore they don’t sleep.
In Mendelson’s Human Sleep and It’s Disorders, (1977) Incidence of insomnia was found by doing a sampling of 1,645 persons and it was found that 14% of those tested had trouble getting to sleep, (Karacan, et. al., 1973). The results tended to be higher for women than men and as age increased. Tiller, studied 83 healthy office patients of 60 years or more and found that 21% of them complained of insomnia at some point (1964). He also states that for the two kinds of insomniac’s people under the age of fifty, can’t fall asleep and those over fifty had no difficulty falling asleep but can’t stay asleep for the duration of the night. In Human Sleep and its Disorders, (1977) McGhie and Russell (1962) questioned 2500 persons in Scotland representing a cross section of the country. They found that women generally sleep less than men. Some of this may be due to the constant hormonal fluctuations females have. In another study Weiss, Kasinoff and Bailey (1962) questioned 100 general medical outpatients, 100 psychiatric clinic out patients and 100 healthy patients all of similar age. The psychiatric group had four times the sleep problems as the healthy people and medical patients. It is also very ironic that married people tend to sleep less than single people.
There are many different kinds of treatments for insomnia. Treatments can vary from going to see the doctor, taking sleeping pills or just by doing little things to help ease the mind and body to be able to sleep. In The Sleep Book by Linde and Savary, (1974) she gives us a few rememdies for insomniacs. She gives a list of 22 ways to help insomniacs rest. Some of those include going to bed the same time every night, establishing a routine and ceasing to take afternoon or evening naps. One of the best suggestions is to limit the amount of stimulants you take. Stimulants include anything containing caffeine, such as coffee or soda’s. Stimulants, as most people know, keep you awake. For insomnia sufferers limiting caffeine intake can be crucial to establishing better sleep. It is best if people go to bed at the same time every night and follow a daily or nightly routine. This helps to condition the body so better sleep habits can be established. Linde stresses the importance of following a daily routine and to discontinue afternoon or evening naps. Following this advice could be all the help a person needs to overcome insomnia. She refers to this as, “sleep hygiene” (p.106-9). She uses this term in comparison to the way we establish physical hygiene routines such as taking a shower every morning or brushing our teeth before bed. Establishing good sleep hygiene is simply doing the same routine at bedtime every night at about the same time, at least until the insomnia subsides.
Ernest Hartmann states, “The first step in treating insomnia is careful medical and psychiatric evaluation” (p. 123). Specific treatments can be given to insomniacs according to what kind of insomnia they have. Doctors will evaluate and learn what is wrong with these patients and then devise a plan of action to follow. In “Ten Steps For Better Sleep” (2000), Shauna S. Roberts suggests some more advice for those suffering from insomnia. Avoiding alcohol within several hours of bedtime is important, although many believe alcohol can relax them so they can get to sleep. However, alcohol can actually cause a person to wake during the night more often, or to toss and turn all night. Another important bit of advice she suggests is to avoid exercise at least three hours before bedtime. The reason for this is that when a person exercises, endorphins are released into the blood and can cause a person to be unable to fall asleep for many hours. She also advises people suffering from insomnia to discontinue watching television or reading while in bed. This is important because a person needs to condition their body to associate the bed with sleep, not with television or reading.
For many an obvious and easy solution for insomnia would be to take sleeping pills. However, most doctors do not suggest this method of treatment unless in extreme cases where a patients overall health is compromised. The reason for this is that the risks associated with addictive medications are more difficult to treat than the insomnia itself. When medication is prescribed, it is often only given for a maximum of four weeks to lessen the chances of dependency (Eddy & Walbroehl, 1999).
It is known also, that one of the biggest causes of insomnia is depression. The Harvard Health Letter states that a big problem with insomnia is that patients continue striving to treat the insomnia but do nothing to treat the depression. The insomnia may subside for a brief period but will generally return and may be worse than before. If patients seek treatment for their depression first and then work on establishing better sleep habits, then the whole problem of insomnia may completely go away (1998). The difficulty many patients have when dealing with both depression and insomnia is determining which is causing the other. For instance, if a person is suffering from insomnia, the lack of sleep may also cause some feelings of depression. At the same time if a person is suffering from depression they have insomnia as a result of that depression. It is important to seek medical advice when having feelings of worthlessness or overwhelming sadness.
Insomnia is not a laughing matter. Many people suffer through a lot of pain and loss of sleep because of this disorder. Family member have to deal with their loved ones being sick. It is said in all the books that I used that more and more each year they are finding more causes of insomnia and more people suffer from it. I have learned from doing this research paper that insomnia really is a difficult disorder to have to live with. By doing this paper I learned more things I never thought I could learn about insomnia. The research that I’ve done has opened my eyes on what is wrong and how it can be treated. We need to take care of our bodies, our minds and ourselves. We need to exercise right, at appropriate times, sleep at the right time and never get ourselves so stressed out that we can’t sleep at night. Insomnia can affect a person really fast and it’s hard to get rid of this disorder without a lot of effort. If we follow the advice given here, we will have an easier life.
Eddy, M.; & Walbroehl, G. (1999) Practical therapeutics : insomnia. American Academy of Family Physicians [Online] Expanded Academic Index. Available www.web6.infotrac.galegroup.com
Hartmann, E. (1978). The sleeping pill. New Haven and London: Yale university press
Linde, S.; & Savary, L. (1974) The sleep book New York NY: Harper and Row
Mendelson, W.B. (1977). Human sleep and it’s disorders New York NY: Plenum Press
President and Fellows of Harvard College (1998, Dec. 1). Insomnia: Get a good nights sleep. Harvard health letter [Online] Expanded Academic Index Available.www.web6.infotrac.galegroup.com
Roberts, S. (1999, April 1) Ten tips for better sleep. American family physicians p.1911(1). [Online] Expanded Academic Index. Available. www.web6.infotrac.galegroup.com