Insomnia has long been known to make people miserable, but researchers have discovered that it can also increase your risk for serious conditions such as high blood pressure, heart disease, diabetes—and even increase your risk of dying.
Important recent finding: People with persistent sleep problems were three times more likely to die (of any cause) over a 19-year period than those who slept well.
So what’s the best way to eliminate sleep problems? For years, doctors have prescribed sleeping pills for people who are plagued by insomnia despite the drugs’ potential side effects, such as next-day grogginess, dizziness, nausea and confusion.
Latest development: Many sleep experts now say that a nondrug approach—cognitive behavioral therapy for insomnia (CBT-I)—is the “gold standard.”
In fact, CBT-I, which involves counseling sessions to help insomnia sufferers change how they think about sleep, is considered to be more effective than medication for long-term relief, according to the American Academy of Sleep Medicine.
The majority of insomnia sufferers attempt to deal with sleeplessness by adopting routines such as watching TV in bed or napping during the day. However, napping answers the body’s desire to sleep at the wrong time. Unfortunately, these practices actually perpetuate insomnia, and it becomes a habit. The good news: Insomnia can be overcome. Key components of CBT-I…
You can’t make sleep happen. But you can let it happen by cooperating with your body to “catch the wave” of sleep.
Here’s why: Your body needs and wants to sleep—it’s a natural drive, like hunger and thirst. The longer you go without sleep, the stronger the drive becomes.
Your body also goes through a daily cycle. Though it may seem surprising, alertness builds throughout the day and peaks in the evening just before sleep. As alertness then winds down, sleep drive ramps up.
When these mechanisms work together, a night’s sleep satisfies our sleep need. We stay asleep as long as our alertness cycle remains low, and as the cycle begins to rise, we wake up refreshed.
With insomnia, the rhythms fall out of sync. To best address this problem…
CBT-I teaches insomnia sufferers that it becomes a self-fulfilling prophecy if they believe they can’t sleep. Thoughts to counter…
Thought 1: I need my seven (or eight or whatever) hours, or I’ll be a wreck tomorrow.
Fact: While people feel and perform better after a good night’s sleep, most function surprisingly well after much less—the first three hours of sleep are the deepest and most restorative.
Thought 2: I can’t stand lying awake endlessly like this.
Fact: Insomnia is unpleasant but hardly unbearable. You’ve survived it before and can do it again.
People who undergo CBT-I are also advised to follow well-known insomnia-fighting strategies, such as not consuming caffeine in any form, including coffee or tea, after early afternoon and not drinking alcohol in the evening, which leads to problems staying asleep later in the night. Other steps include going to bed at the same time each night, following a relaxing routine (no stimulating TV programs or Web surfing at least one hour before bedtime)… and using the bedroom only for sleep and sex.
Also helpful…
Do not nap in the evening, even if you’re exhausted. This interferes with your sleep drive. If sleepiness peaks too early in the evening—for example, your eyes start to close while you’re reading or watching TV—get up and walk around.
Get up after 20 minutes in bed if you’re not yet asleep. Stay up (read or do chores) until you feel drowsy. If you return to bed and still can’t sleep, get up again.
If your sleep problems don’t improve, consider seeking professional help to treat your insomnia and evaluate whether other sleep disorders, such as obstructive sleep apnea (in which breathing is interrupted several times during sleep) or periodic limb movement disorder, are playing a role.
An evaluation may involve a consultation with a sleep specialist (he/she should be certified by the American Academy of Sleep Medicine) and possibly an overnight sleep observation. A sleep center is usually the best place to receive such an evaluation. To find one, go to www.SleepCenters.org. Insurance typically covers the cost.
To locate a therapist trained in CBT-I, consult the Association for Behavioral and Cognitive Therapies, www.abct.org. Four to eight sessions are typical, and in some cases, they are covered by insurance.
