Overnight Treatment For Chronic Insomnia
- By Patrick J. Skerrett, Former Executive Editor, Harvard Health
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Each night, as millions of Americans slumber peacefully, millions more cant fall asleep or stay asleep. For some, its just a now-and-then hitch. For others, insomnia is a chronic problem that affects mood, daytime alertness and performance, and emotional and physical health.
Chronic insomnia often starts out innocently enough. Stress or trouble at home or work interferes with sleep for a few nights. But then the habits that come along with not sleepinglooking at the clock, lying in bed wide awake, worrying about not getting to sleepcan stick. Soon just the sight of your bed or the tick of the clock toward 10:00 pm can trigger anxiety and render you wide awake.
Loosening the grip of chronic insomnia can take time and effort. Some of the sleepless turn to medications. One widely used behavioral approach, called stimulus control therapy, aims to break harmful sleep habits and thoughts over the course of several weeks. A new approach that uses a 25-hour program called intensive sleep retraining may be enough to break the cycle in a day.
Quiz: How To Know If You Have Insomnia
I cant sleep at night. Do I have insomnia? Sleeplessness can affect anyone and it can be a huge problem for your daily routine and quality of life.
According to the Sleep Health Foundation, as many as 1 in 3 adults in the country have at least mild insomnia, and about one-quarter of those experience persistent symptoms. And though most people struggle occasionally with getting enough rest, chronic insomnia can be much more difficult to manage.
Find out more about this sleep disorder and how to understand if it is causing the difficulty you experience.
Challenging The Worries And Thoughts That Fuel Insomnia
Its also helpful to challenge the negative attitudes about sleep and your insomnia problem that youve developed over time. The key is to recognize self-defeating thoughts and replace them with more realistic ones.
|Challenging self-defeating thoughts that fuel insomnia|
|Self-defeating thought:||Sleep-promoting comeback:|
|Unrealistic expectations: I should be able to sleep well every night like a normal person. I shouldnt have a problem!||Lots of people struggle with sleep from time to time. I will be able to sleep with the right techniques.|
|Exaggeration: Its the same every single night, another night of sleepless misery.||Not every night is the same. Some nights I do sleep better than others.|
|Catastrophizing: If I dont get some sleep, Ill tank my presentation and jeopardize my job.||I can get through the presentation even if Im tired. I can still rest and relax tonight, even if I cant sleep.|
|Hopelessness: Im never going to be able to sleep well. Its out of my control.||Insomnia can be cured. If I stop worrying so much and focus on positive solutions, I can beat it.|
|Fortune telling: Its going to take me at least an hour to get to sleep tonight. I just know it.||I dont know what will happen tonight. Maybe Ill get to sleep quickly if I use the strategies Ive learned.|
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Whats Causing Your Insomnia
- Are you under a lot of stress?
- Are you depressed? Do you feel emotionally flat or hopeless?
- Do you struggle with chronic feelings of anxiety or worry?
- Have you recently gone through a traumatic experience?
- Are you taking any medications that might be affecting your sleep?
- Do you have any health problems that may be interfering with sleep?
- Is your bedroom quiet and comfortable?
- Do you try to go to bed and get up around the same time every day?
Favorite Insomnia Advocacy Groups
Project Sleep is nonprofit organization dedicated to raising sleep disorder awareness and providing help to those with sleep disorders. The group awards scholarships to support students with sleep disorders and hosts events to raise help raise awareness about sleep disorders and the importance of sleep health. The group also disseminates information about how to support sleep disorders research.
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Favorite Insomnia Blogs And Podcasts
The Sleep Doctor blog is run by Michael J. Breus, PhD, a clinical psychologist, a diplomate of the American Board of Sleep Medicine, and a fellow of the American Academy of Sleep Medicine. Find blog posts by Dr. Breus on new insomnia research, tips on managing the sleep disorder, and sleep hygiene recommendations to help prevent the problem to begin with. Breus also publishes a list of sleep devices and products he recommends.
Where To Start: Treating Insomnia Naturally
Most insomnia that is not caused by medications or medical conditions is whats known as a learned behavior. This means that your mind has learned to sleep poorly over time. But you can learn how to sleep better. For this reason, the American Academy of Sleep Medicine recommends people with insomnia first try non-medicated methods.
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Habits That Cause Insomnia And Disrupt Sleep
While treating underlying physical and mental issues is a good first step, it may not be enough to cure your insomnia. You also need to look at your daily habits. Some of the things youre doing to cope with insomnia may actually be making the problem worse.
For example, maybe youre using sleeping pills or alcohol to fall asleep, which disrupts sleep even more over the long-term. Or maybe you drink excessive amounts of coffee during the day, making it harder to fall asleep later. Other daytime habits that can negatively impact your ability to sleep at night include having an irregular sleep schedule, napping, eating sugary foods or heavy meals too close to bedtime, and not getting enough exercise or exercising too late in the day.
Not only can poor daytime habits contribute to insomnia, but a poor nights sleep can make these habits harder to correct, creating a vicious cycle of unrefreshing sleep:
Oftentimes, changing the habits that are reinforcing sleeplessness is enough to overcome the insomnia altogether. It may take a few days for your body to get used to the change, but once you do, youll sleep better.
If youre having trouble identifying insomnia-causing habits
Some habits are so ingrained that you may overlook them as a possible contributor to your insomnia. Maybe your Starbucks habit affects your sleep more than you realize. Or maybe youve never made the connection between that late-night glass of wine and your sleep difficulties.
What To Do When You Cant Fall Asleep Or Cant Go Back To Sleep
One last little thing to mention here. Insomnia is different for different people. Some people have no problem falling asleep, they just cant stay asleep. In my case, it was both. After hours of praying sleep would come, Id roll over and wake myself up and repeat the process. Not good!
There are different schools of thought on this one. Most of the things Ive read say to get up and do something for a little bit and try to go back to bed. You can try that, I do that from time-to-time. Honestly, I use it as time to pray. Its amazing how much ground I can cover while Im laying there. At times I wonder if it is the Lord keeping me up so I can pray for people and situations.If I still dont fall asleep, then I get up and read the Wordusually Psalms or Proverbs.
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Insomnia Really Is Torture
Sleep deprivation truly is torture.
Weve all heard stories of war camps that deprived prisoners of sleep. Yep! I felt like a prisoner of war in my own home. My prison of insomnia that never seemed to get better.
Regardless of what is causing your insomniastress, depression, anxiety, hormonal imbalance, busyness, or some other unknown factorthere are things you can start doing today to help you start getting more sleep.
Is There Something Wrong With Me
When I first found out that I had paradoxical insomnia, something bothered me about it.
If I cant even tell the difference between being awake and being asleep, surely there must be something wrong with me?
Being someone prone to anxiety, its perhaps unsurprising that Id find a way to worry about the fact that I apparently had nothing to worry about.
If this is something that concerns you too, the short answer is not to label yourself as a hypochondriac just yet.
Clearly, something isnt quite right if your sleep time causes you significant distress. But it doesnt necessarily mean something is wrong with you, or that its all in your head either.
The long answer is, of course, more complex. And I think its helpful to start with how sleep researchers point out that its not a condition to trivialize or dismiss.
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Research And Statistics: How Many People Have Insomnia
Roughly 25 percent of the population experiences at least one bout of acute insomnia each year, according to a 2018 study from the University of Pennsylvania. That same study also found that about 1 in 4 of these folks will develop persistent or chronic insomnia.
The National Sleep Foundation reports chronic insomnia may be much more prevalent with research finding prevalence rates as high as between 10 and 30 percent.
Statistics on short sleep, meaning those who sleep less than seven hours each night, find that men are very slightly more likely to get insufficient sleep than women. Also, people who are obese, as well as those who smoke or who do not exercise, are much more likely to sleep less than seven hours compared with people who do not check those boxes, according to the CDC.
Some of the latest research on insomnia has looked at its connections with other diseases or disorders, and especially diseases of the nervous system and brain. For example, theres evidence that insomnia is both an early warning sign and a possible contributor to brain diseases like Alzheimers, notes the National Sleep Foundation.
Theres also research that suggests sleep helps you learn, even when it comes to muscle-memory related tasks like playing the piano.
Favorite Products And Tech For People Who Have Trouble Sleeping
The Better Sleep Council is the consumer-education arm of the International Sleep Products Association . BSCs purpose is to provide education for consumers about sleep, health, and the products that are involved . BSC is run by bedding and sleep experts across the mattress and bedding industry. Find resources on the site about how to pick out a mattress, mattress upkeep, what else in your bedroom promotes a good nights sleep, and more.
Pzizz is a noise machine app that personalizes a mix of music optimized for sleep, voice narrations, and sound effects for each user. Your unique playlist is developed according to clinical sleep interventions and psychoacoustics research. The audio sequence you hear is intended to help quiet your mind and help you sleep.
This hypnosis and meditation app was created by the self-help audio author Glenn Harrold. The app features hypnotherapy and meditation recordings designed to alleviate stress and anxiety and help you get to sleep. The app was ranked as one of the top sleep apps by the American Sleep Association.
With additional reporting by .
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Lull Yourself To Sleep
Others told us that they make themselves sleepy by listening to audiobooks, Gregorian chants, BBC Radio, sleep apps like Calm, or the tranquil, underwater sounds of whales. Whales talking at low volume seems to do the trick for me, one reader told us. Another said he prefers classical music. If I lay awake, at least I get a little taste of culture, he said.
You can also try breathing exercises to help you get relaxed. One popular exercise is the 3-4-5 technique. It involves breathing in for three seconds, holding your breath for four seconds, and then slowly exhaling to the count of five.
Another suggestion: Make sure your bedroom isnt too warm. Keeping your space fairly cool, ideally between 60 and 68 degrees Fahrenheit, can promote better sleep.
What To Do When Insomnia Wakes You Up In The Middle Of The Night
Many people with insomnia are able to fall asleep at bedtime, but then wake up in the middle of the night. They then struggle to get back to sleep, often lying awake for hours. If this describes you, the following tips may help.
Stay out of your head. Hard as it may be, try not to stress over your inability to fall back to sleep, because that stress only encourages your body to stay awake. To stay out of your head, focus on the feelings in your body or practice breathing exercises. Take a breath in, then breathe out slowly while saying or thinking the word, Ahhh. Take another breath and repeat.
Make relaxation your goal, not sleep. If you find it hard to fall back to sleep, try a relaxation technique such as visualization, progressive muscle relaxation, or meditation, which can be done without even getting out of bed. Even though its not a replacement for sleep, relaxation can still help rejuvenate your mind and body.
Do a quiet, non-stimulating activity. If youve been awake for more than 20 minutes, get out of bed and do a quiet, non-stimulating activity, such as reading a book. Keep the lights dim and avoid screens so as not to cue your body that its time to wake up.
Relaxation techniques that can help you get back to sleep
Mindfulness meditation. Sit or lie quietly and focus on your natural breathing and how your body feels in the moment. Allow thoughts and emotions to come and go without judgment, always returning to focus on breath and your body.
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What Are The Types Of Insomnia
Insomnia can come and go, or it may be an ongoing, longstanding issue. There is short term insomnia and chronic insomnia:
- Short term insomnia tends to last for a few days or weeks and is often triggered by stress.
- Chronic insomnia is when the sleep difficulties occur at least three times a week for three months or longer.
Prescription Options For Treating Insomnia
If youve been trying CBT-I for several weeks without improvement, or you feel your insomnia is unbearable, now is the time to make an appointment with a healthcare provider. Due to the concerns surrounding COVID-19, many providers are conducting virtual visits for mental health issues. During your appointment, they will most likely ask you questions about your typical night. They may also choose to prescribe you one of the following:
Most providers will have you return to their office a few weeks later to see how youre feeling. They may ask the same questions from your first visit to see if your sleep has improved at all. They may also ask you if youre having any side effects and how often you needed to take the medication.
Some of these medications are better for helping you fall asleep, while others are better at helping you stay asleep. So make sure you let your provider know which is more troubling for you when it comes to catching those zs.
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How Is Insomnia Managed Or Treated
Short-term insomnia often gets better on its own. For chronic insomnia, your healthcare provider may recommend:
- Cognitive Behavioral Therapy for Insomnia: Therapy : CBT-I is a brief, structured intervention for insomnia that helps you identify and replace thoughts and behaviors that cause or worsen sleep problems with habits that promote sound sleep. Unlike sleeping pills, CBT-I helps you overcome the underlying causes of your sleep problems.
- Medications: Behavior and lifestyle changes can best help you improve your sleep over the long term. In some cases, though, taking sleeping pills for a short time can help you sleep. Doctors recommend taking sleep medicines only now and then or only for a short time. They are not the first choice for treating chronic insomnia.
Stress Caused My Insomnia
I truly believe that my insomnia journey started when I started experiencing more stress in my life.Around 1998, I started experiencing a lot of strain in key relationships in my life. I started feeling alone and depressed. I started gaining weight which fueled my old eating disordercompulsive over-eating. Luckily, I was still really active, so my weight gain wasnt as bad as it could have been . But the weight gain made me start getting more self conscious and triggered old baggage. Baggage. Gotta love old baggage. Ugh! So, I was experiencing stress on many levels.
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Dietary Supplements For Insomnia
There are many dietary and herbal supplements marketed for their sleep-promoting effects. Although they may be described as natural, be aware that sleep remedies can still have side effects and interfere with other medications or vitamins youre taking. For more information, talk to your doctor or pharmacist.
You’re Just A Spectator
“I was 6-7 years old and one day I got rushed to the hospital by my parents because they heard me breathing really loud and hard. The last thing I remembered were faces of the doctors and nurses above me while I was lying on my back. Then I flatlined.
The weirdest, unexplainable thing happened then and there I suddenly could see the whole scene as a spectator, like I was a floating spirit in that room. I could see myself getting revived, saw my mom crying and my dad comforting her. Then, I saw a white entity shaped like my body, falling through the ceiling and slowly, like a leaf on the wind, falling down to eventually land inside my body. That’s when that experience ended.
I was put in a medically induced coma, and I woke up after some days, I don’t remember. I had stuff plugged into me, an IV, red glowing elastic ring on my finger etc. Anyway, I later mentioned to the doctors that I saw it all, I saw them using the defibrillators, my parents etc. No one really believed me and told me that I was probably dreaming and biasing my memories due to watching tv, but I know what I saw!”
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