Healthy Beginnings

Problems with Falling or Staying Asleep? Let Go of the Insomnia Struggle

Do you have problems falling or staying asleep, or feel that your sleep is impacting your daytime functioning? We all struggle with poor sleep from time to time, but if struggling with sleep has become a way of life, you likely have chronic insomnia. If so, you are not alone as insomnia impacts one in three people in their lifetime.1 You may have to ask yourself, “What has insomnia cost me?” Are you exhausted during the day, moody or feel you have no energy for work or friends? Have you cancelled social events because you were too tired or have anxiety about how you are going to sleep on any given night?

Insomnia is not only about nighttime sleep, but how you live your life day to day, as well. Currently, more Americans are reaching for sleeping medications (i.e., Ambien, Lunesta, etc.) than ever before, often becoming dependent on them. Sleeping aids should generally be used for short-term use (a few weeks), but people are often using them for years. But increasing research is now showing that long term-use may be associated with other health problems such as increased risk for developing cancer, dementia and premature death compared to those who don’t take sleep aids.2,3

Further, in some cases, medication may only work slightly better than a placebo or pill with no active drug. For example, Ambien and Lunesta have been shown to help people fall asleep only about 20 minutes and 19 minutes faster, respectively, than a placebo and only adding 3 to 34 minutes to total sleep time.4 Their effectiveness is so limited that they are no longer the recommended choice of treatment for insomnia by the National Institute of Health (NIH), but rather a treatment called cognitive behavioral therapy for insomnia (CBT-I).

CBT-I is a non-medication approach that goes beyond general sleep hygiene such as avoiding alcohol, not watching television in bed, etc., and addresses the key behaviors and thoughts that can interfere with sleep helping people learn how to sleep again naturally. If you have struggled with insomnia for a long time, you may have developed some behaviors to try and cope. For example, you may stay in bed longer periods of time hoping for more sleep, or you may have worried thoughts about sleep (I wont be able to sleep tonight without my medication), and worry about the outcome if you sleep poorly (I am going to be a mess to- morrow if I don’t get some sleep). These thoughts and resulting behaviors (i.e., staying in bed trying to sleep) are normal given your struggle with insomnia, but over time they make insomnia a longstanding problem. We try to force a lot of things in our fast moving society, but sleep is not something we can force.

If you remain in bed trying to force sleep you may have to teach your mind to notice when this is occurring, and when the e ort related to sleep is not working. You will have to learn to drop this struggle and actually be present with the discomfort of not trying to make yourself sleep. To stop the spiral of chronic insomnia, we have to be willing to go through some short-term discomfort in order to reach longer-reaching goals. Successful sleep is possible as research on CBT-I shows it is more effective when compared to medications over time. As a result, often people no longer need medications following treatment, thereby eliminating all potential drug side effects. All the components of CBT-I treatment share the goal of helping people learn how to sleep again naturally by helping people reconnect to the natural rhythms of the body. Our relationship with sleep is life-long and not built overnight, but over time through consistent practice and willingness to let go of our own struggle so that we can learn to sleep again.

Our choices today will not only impact our sleep, but our relationships, work and overall quality of life. If you are still asking yourself how to stop the cycle of insomnia and finally feel rested; first, look at your behaviors, as it may be time to learn new sleep habits so you can wake up rested day after day. It is possible to learn how to let go of the insomnia struggle and sleep again.

Ruth Gentry, Ph.D., is a clinical psychologist at Integrated Sleep and Wellness. For more information, call 775-826-6218 or visit www.RenoSleepWell.com.

References

  1. National Institute of Health. (2005). National Institute of Health State of the Science Conference Statement on Manifestations and Management of Chronic Insomnia in Adults. Sleep 28:1049-1057.
  2. Kripke, M.D. et; al. (2012). Hypnotics’ association with mortality or cancer: a matched cohort study BMJ Open 2012;2:e000850. doi:10.1136/bmjop- en-2012-000850
  3. Billlioti de Gage, et; al. (2014). Benzodiazepine use and risk of alzheimer’s disease: case control study. BMJ 2014;349:g5205.
  4. The Truth About Sleeping Pills. What’s Safe, what Isn’t and how to get a good nights sleep (March 2015). http://www.consumerreports.org/cro/2015/03/ the-truth-about-sleeping-pills/index.htm