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Post No.: 0329insomnia


Furrywisepuppy says:


Your ‘sleep onset latency’ is the length of time it takes for you to fall asleep from the moment you tuck into bed and switch off the lights. A time of around 15-20 minutes is considered fine. If it’s much shorter then it may indicate that you have been sleep deprived, and if it’s much longer then it may indicate that you have insomnia.


Your ‘sleep efficiency’ is the percentage of time you’re actually asleep compared to the total time you’ve been in bed. An efficiency of 85% or more is considered good.


If you are sleep deprived then you’ll have built up a ‘sleep debt’, which is the cumulative effect of not getting enough sleep. This might either be because of losing a bit of sleep each night for several nights or weeks in a row, or because of not sleeping for over 24 hours (e.g. due to an all-nighter studying… or partying!)


Now we cannot bank sleep in advance, or can only do so slightly and not to the same extent that we can build up a sleep debt. (It’s very loosely similar to the way that eating a large meal can make us feel like we can skip the next meal, but people who bank a lot of food (i.e. who store a lot of fat inside their bodies) can still feel hungry before they’ve spent all of that fat (energy) they’ve previously banked.) If it feels possible to bank some sleep then it’s probably because you’ve been routinely sleep deprived and you think that this sleep-deprived state is normal, hence why that extra sleep feels like a beneficial bonus rather than the healthy or ideal normal way to feel and operate.


Your ‘sleep reactivity’ is the ease in which you manage to fall asleep during a particularly stressful or arousing time, such as the night before you have a crucial meeting, the night before going on an exciting holiday, or the night after a distressing experience. And if you find it hard to fall asleep under these conditions then that’s a strong predictor of whether you’ll suffer from insomnia.


You can have sleep onset insomnia because you find it hard to fall asleep when you first go to bed, and/or sleep maintenance insomnia because you find it hard to stay asleep for long enough once you have been to sleep.


So some people with insomnia have trouble getting to sleep, some struggle to stay asleep, and some both. This insomnia can in turn lead to or exacerbate depression – insomnia can perpetuate a depressive episode long after the original underlying stress event or condition that triggered the depressive episode has been over, removed or cured/solved. For instance, a physical back injury triggered a depressive episode, as well as insomnia because you couldn’t find a comfortable position to sleep in, and now after several months of this, you now associate your bedroom and trying to get to sleep as a stressful experience itself – these types of stresses about struggling to sleep can themselves perpetuate a case of insomnia and/or depression, even though the original physical injury or pain has healed or ceased. This thus results in a vicious cycle of insomnia and/or depression. In short, stressing about sleeping can keep us awake!


Insomnia is often a symptom of some other underlying root cause, such as PTSD, anxiety or chronic stress. The mind is constantly, consciously and/or unconsciously, whirring and ruminating on something like a loss or trauma, perhaps from years ago – and it’s really this that needs to be broached first before the insomnia can be solved. There are different root causes hence there is no ‘one size fits all’ solution to insomnia.


As in most cases that concern one’s health, insomnia involves an interaction between both one’s genes and one’s environment. The stressors or underlying conditions that can affect our sleep can be environmental (e.g. what’s in our bedroom), psychosocial (e.g. a divorce) or medical (e.g. some health conditions or medications). So insomnia sufferers may have a genetic/biological predisposition, they may then face a precipitating factor or stressor, and then they may face a perpetuating factor that perpetuates their insomnia even though the precipitating factor has passed.


Poor ‘sleep hygiene’ includes eating too close to bedtime, or alternatively too far from bedtime (which leaves an uncomfortable rumbling tummy), consuming caffeine too close to bedtime, exercising too close to bedtime, trying to use alcohol to fall asleep, using electronic devices in bed (sometimes for the very reason of not being able to sleep and looking for something to do whilst awake in bed) or doing other sleep incompatible activities such as watching TV in bed. Spending too much time in bed (e.g. being in bed when it’s not bedtime) is also a bad habit – the bed, and ideally entire bedroom, must only be associated with sleeping (and maybe sex) so get out of bed if you cannot sleep or are not tired, and restrict the time you are in or on your bed. One of the worst things is an irregular sleep schedule. Psychological matters might include unrealistic sleep expectations, such as stressing over the notion that you must have 8 hours of sleep if you happen to feel okay with less or better with more, or, again, feeling anxious about not being able to sleep itself. (Post No.: 0219 looked at how much sleep people of different ages need.)


Perpetuating any of these above kinds of habits can also prolong insomnia or a bad relationship with sleep. So one of the best strategies if you have insomnia is to follow those sleep hygiene tips. Go to bed at the same time each night but if you cannot sleep within 15 minutes of tucking into bed then get out of the bedroom and do something that is calm until you’re tired again. And most of all, always get up at the same time each morning (don’t use that snooze alarm!) and immediately open the curtains to get some daylight. Some experts suggest strictly getting up at a consistent time every single day but only going to bed whenever you’re feeling tired, whatever time that may be because no one can be forced to sleep at, say, 11pm every night if they’re not tired at that time. Woof!


Being exposed to enough bright light (preferably sunlight) as soon as you get up, and minimising the amount of light you get before you go to bed, is one of the keys for sleeping well when you want to sleep, and feeling awake when you want to be awake.


The first days you get up at a fixed time even though you need more sleep will feel horrible, but your body should soon learn to adapt to sleeping at that fixed time you should be in bed each night. Some sleep experts allow or even advocate taking naps during the day, but if you are trying to adjust your sleep routine then don’t take any naps during the day – only sleep during the 8-hour or so window you’ve set yourself for sleeping.


If you’re really tired or it’s getting late but you’ve still got some work left to do, you’re highly likely better off going to bed at your usual time and finishing the work the next day if possible. This is because your productivity rate when you’re tired could be half of your normal productivity rate so you’ll take twice as long to complete it in this state, and you’ll feel terrible while doing it too, plus it could get even worse if you make mistakes for being tired. You may then believe that this level of performance is ‘normal’ and all you could ever be. Meanwhile, if you do get some sleep and then pick up the work the next day when you’re at optimal productivity levels again, you’ll get more work done or you’ll get it done in less time, plus you’ll feel mentally better for the sleep too, and fewer mistakes will likely be made.


All this is true regarding productivity when we work overly long hours – working longer or later doesn’t necessarily mean that people are getting more work done or getting better quality, more creative, work done. For sacrificing breaks in general, you might feel chronically stressed, your eyes are getting wrecked, you’re skipping meals and/or you’re not getting up from your chair frequently enough, which all harms your mental and physical health and therefore long-term productivity potential. Sometimes it’s easier to understand something than to make it happen though, as one might stress about the unfinished work when lying in bed, which might then keep one awake anyway. Well if working beyond expected hours becomes a pattern then it either means the work is unhealthy or one needs to learn to start it earlier.


If you still struggle with insomnia or have other types of sleep problems, such as loud snoring (which could be a sign of sleep apnoea) or night terrors, then it’s best to go see your doctor. He/she might prescribe you cognitive behavioural therapy or something else. Cranial electrotherapy stimulation (CES) might help some people with insomnia, or alternatively any activity that is ultimately calming such as listening to calm music.


Woof. If you have any other tips that have worked for you for getting a good night’s kip then please reply to the tweet linked in the Twitter comment button below. Counting an endless stream of fluffy sheep doesn’t work for most people – but I guess you could give it a try if you want? For me, it keeps me even more awake because all I see are lamb chops(!)


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