INSOMNIA

Napolean, it is said, scorned sleep and usually got by on only four hours sleep a day. Edison, too, railed against sleep, considering it a hinderance to his work. Almost everyone has experienced a sleepless night from time to time; but for all too many people sleeplessness is a serious condition affecting their moods, their relationships and even their ability to think and concentrate. Insomnia is rather easy to cause but difficult to cure, and it can unexpectedly affect anyone, young and old. As we discussed in an earlier article, it can also lead to clinical depression. While our busy modern lifestyle tempts many to miss a night of sleep, seemingly without serious side effects, the prolonged sleeplessness that is insomnia can be seriously debilitating. Tests done have shown that insomniacs have done very poorly on aptitude tests the day after missing a night of sleep. Studies at Carlton University in Ottawa showed nurses' ability to concentrate decreased by 50% during sleep disrupting shift changes. In cases of extreme sleep deprivation it has also led to hallucinations. Research at the University of Chicago shows adults who get fewer than seven hours of sleep are more prone to diabetes, high blood pressure and endocrine dysfunction. Your body needs sleep the same way it needs food, water, and shelter. Sleep is restorative, healing, and a great headache cure. It is impossible for one to lead a normal life without sleep.

There are three basic types of insomnia: difficulty sleeping, difficulty staying asleep, and early waking. Difficulty sleeping is the most common form of insomnia and the easiest to cause. Factors bringing this condition about include drinking alcohol, eating a large meal just before sleeping, exercise to soon before bed, and, of course, too much caffeine. Difficulty staying asleep can be caused by sleep apnea. In sleep apnea, a person may wake 100 times each hour (in severe cases) because the airway becomes blocked by the tongue, relaxed throat muscles, or excessive tissues. (Therefore, obese people are more likely to have this disorder.) The person does not "wake" per se; that is, they do not actually open their eyes and come out of sleep. However, this type of insomnia can disrupt the sleep cycle and cause the sleeper not to get the amount of "deep" sleep they need, thereby inhibiting their normal functions during the day. There are other sleep disorders, too, such as restless legs syndrome and narcolepsy. Restless legs syndrome is another sleep-inhibiting disorder in which the patient feels a crawling sensation in the legs that is annoying and goes away when one "walks it off." Narcolepsy is not a sleep-inhibiting disorder, but rather one where the patient falls asleep unexpectedly many times during the day. The person dozes on and off many times during a day, and may experience hallucinations just before or after sleep, muscle weakness, and extreme sleepiness. It is a nervous system disorder involving the REM phase of sleep.

Medical scientists are discovering, too, that biology plays a big role in insomnia. Teenagers who stay in bed until noon are not being lazy, they are at eh mercy of their unique biological rythems. Wild hormone fluctuations during menstruation, pregnancy and menopause can significantly impact on women's sleep. According to Toronto Western Hospital sleep researcher Helen Driver, just before menstruation there is a withdrawal of hormones resulting in poor sleep. Entering menopause doesn't make it better. Thirty-six per cent of menopausal women polled by the National Sleep Foundation said hot flashes interfered with their night's rest. Sleep investigators are becoming more aware of the effects of the female hormones, estrogen and progesterone. Progesterone, especially seems to interact with a receptor in the brain that has sleep-inducing qualities. Older people's rest becomes troubled by the disappearance of deep-sleep phases that occur at the end of the sleep cycle. Those biological changes, combined with the daily anxieties of life, shift work, some medical conditions and genetic tendencies that hamper sleep, are creating a community of stuporous Canadians stumbling lethargically through the day. Sleeplessness has become so chronic and disruptive that it is causing many people to make faulty, sometimes reckless, judgments, says Stanley Coren, a University of British Columbia psychologist and author of the best-seller Sleep Thieves. "We are," says Coren, "a dangerously sleep-deprived society."

Surveys by the Washington-based National Sleep Foundation show at least 70 million North Americans have sleep disruptions at some time in their lives. The Three Mile Island nuclear accident in Pennsylvania in 1979 and the Exxon Valdez oil spill off Alaska in 1989, for instance, happened, in part, because people desperate for sleep were in charge. At least 100,000 car crashes in the United States, and thousands in Canada, occur each year because of drowsy drivers at the wheel. "People," says renowned sleep specialist Dr. William Dement of Stanford University in California, "don't really understand how much sleep they need."

Insomnia also impacts on our ability to retain new information we may have worked hard to learn. Psychologist Carlyle Smith of Trent University in Peterborough, Ont., has determined that Rapid Eye Movement (REM) sleep increases after a new task is learned. But if REM sleep is disrupted, memory retention and motor skills suffer. In typical University fashion, students often take all their courses between Tuesday and Thursday. But if they drink Thursday night and stay up late, they'll lose part of what they've learned on Tuesday and Thursday. But, strangely, they will keep most of what they learned on Wednesday. A recent study by Dr. Robert Stickgold of the Harvard Medical School in Boston builds on Smith's findings. It shows that when new skills are learned, the information will not be properly retained in the absence of at least six to eight hours of sleep. But waking up in the middle of the night and then going back to sleep can be harder on cognition than not sleeping at all, according to University of Montreal psychiatrist Roger Godbout.

Sleeplessness is a serious problem for teenagers affecting their mood and behaviour in school. Teenagers who get little sleep have more truancy and are often late because they are too tired to go to school. Sleep loss may also be linked to depression in young adults with tired kids reacting less positively to positive things and more negatively to negative things--a syndrom known to every parent. Worse than this, a National Sleep Foundation study shows drowsy young adults between 15 and 24 are responsible for 50,000 automobile accidents a year in the United States.

Remember, Naploean did loose that battle at Waterloo, and researchers have shown Edison's successes may be the result of his discounting the many hours a day he spent napping in his laboratory.

 

Suggestions For A Good Night's Sleep:

* Have your evening meal at least three hours before bed.

*Try to go to bed and wake up at the same times each day. Even if you get to bed later some nights, make an effort to get up at your regular hour to make it easier to get to slee the next night.

* Remove the TV and computer from the bedroom. The light they emit provides a visual cue to the brain that can impede sleepiness. Even reading can be a bad idea for people with sleep problems, since it requires light and can set the mind whirling. Save the bed for sex and sleep.

* Try to eliminate caffeine from your diet. Smoking and alcohol are also problematic. Drinking alcohol may interrupt sleep.

* Wear socks. Cold feet can make it difficult to sleep.

* Take a bath before bed. Body temperatures drop after a warm bath, a signal to the body that it is time to sleep.

* Exercise regularly--but not just before bedtime. Being physically active during the day can induce drowsiness at night.

* If you can't sleep, get up and do something. Go back to bed only when you feel tired, then get up at your regular hour.

 

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(c) BER Fraser msw,rsw. (2000) Reprint only with attribution and, if on-line, with appropriate link..

 

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