Tips for Dealing with Insomnia

 Vijai P. Sharma, Ph.D

Insomnia is rarely diagnosed as a disorder in its own right, so it's impact on our society is not fully noticed.

Insomnia is generally seen as part of some other disorder. Chronic insomnia can decrease productivity at work, impair concentration and attention, and may cause accidents while driving or operating machinery. Insomnia affects twenty to forty percent adults. Women and elderly are more likely to be the victims of insomnia.

There are three types of insomnia: 
1. "Initial" insomnia, that is, after turning out the lights, it takes longer than 30 minutes before one can fall asleep. 
2. "Middle" insomnia, that is, after going to sleep, one has difficulty in maintaining sleep and remains awake for more than 30 minutes before the morning waking time. 
3. "Late" or "terminal" insomnia, that is, premature awakening in the morning with less than 6.5 hour of sleep. 

A minimum of 6.5 hours of sleep is considered standard requirement because two thirds of adults report between 7 to 8.5 hours of sleep per night. However, some people may need more or fewer hours of sleep. 

One third of adults are either "short sleepers," needing 4 to 5 hours of sleep or "long sleepers" needing 9 to 10 hours of sleep. 

We first determine how much sleep one requires and how much sleep he or she is actually getting. A person with insomnia may have one or all the three problems, the initial , middle, and late insomnia or, a combination of any two.

Insomnia is also evaluated by the "sleep efficiency." Sleep efficiency is computed by the number of sleep hours over the total hours in bed. The sleep hours should be 85 % of the total time in bed. If a person was in bed for eight hours, of which he was awake 2 hours, his sleep hours filled only 75 % of the total time in bed. Sleep efficiency in this case was poor.

Insomnia is treated inadequately and generally limited to a prescription of sleeping pills.
Sleeping pills work for a short time as the patient develops a tolerance for the pills and requires more and more medication. Other factors, such as, a physical or a mental disorder, family, health, and work-related stress, divorce, separation, and grief, may cause insomnia, and need to be dealt with first.

Treatment of a long-term insomnia, includes giving up faulty sleeping habits and developing good sleeping habits. Faulty habits that contribute to insomnia:
1. Going to bed when you are wide awake and your body and mind do not want to do anything with sleeping. 
2. Staying in bed awake too long, even though you can't fall sleep. Occupying the mind with problem solving, thinking, worrying, etc. , makes mind more awake. 
3. Lying in bed awake and trying harder and harder to go to sleep only increases anxiety and frustration which makes the sleeping problem worse. 
4. Oversleeping in the morning hours on weekdays or weekends may not be a problem for others but it has a harmful effect on a person with insomnia. 
5. Reading a book or watching TV in bed induces sleep in some people, but if you do not fall asleep in 30 minutes, it can make your sleep problem worse. 
6. If you fall asleep in places, other than bed, you get out of the habit of sleeping in bed.

Good sleeping habits induce sleep. 
1. Avoid caffeine and alcohol in any form, four to six hours before bed time. 
2. Avoid nicotine near bedtime and upon awaking during night. 
3. Avoid a heavy meal in the evening. On the other hand, a light snack before bed time may be sleep inducing. 
4. Avoid vigorous exercise within 3-4 hours of bed time. On the other hand,
regular exercise in the late afternoon may deepen sleep. 
5. Minimize noise, light, excessive temperature during sleep by using ear plugs, window blinds, electrical blanket/ air conditioner, etc. 
6. Spend no more than 8 hours in bed per night. 
9. If you must take a daytime nap, keep it less than an hour and complete it before 3 p.m. 
10 Go to bed only when sleepy. 
11. Get out of bed when unable to fall asleep for more than 30 minutes and return to sleep within 30 minutes. During this time, do only a manual activity or count your breaths while breathing abdominally. 
12. Repeat this procedure as often as necessary. 
13. Arise at the same time every morning. 
13. Practice relaxation technique 
14. Do not use your bed and the bedroom for non-sleeping activities, such as eating, paying bills, talking on phone, etc. Bed/bedroom should be used for sleeping purposes only. 

I need to clarify something here real quickly. When I ordain this last rule, I am not suggesting celibacy is the cure for insomnia. I mean, with reasonable exceptions, use your bed and bedroom for sleeping activity only!

* This is an educational article for general information and not professional advice. Consult a professional for your specific case.

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Copyright 1996, Mind Publications 


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