Monday, Oct. 12, 2015


The Waking Nightmare


The waking nightmare

It is estimated over 70 million Americans suffer from difficulty falling or staying asleep, also known as insomnia. Although most experience the occasional night with difficulty sleeping, to many the problem persists that becomes a chronic daily affair. Chronic insomnia has been shown to cause difficulty concentrating, behavioral problems, fatigue, decreased job efficiency and increased stress. It not only interferes with life and the ability to function during the day, but it also increases the risk of heart disease. Many persons suffering from insomnia have tried to make adjustments in their sleep habits to no avail; many resort to over the counter sleep or prescription medications. is a serious disorder and effective treatment can be crucial to reversing the process in order to get the sleep one needs, and it is best to seek professional help to achieve this.

Chronic insomnia is recognized as part of a number of medical and psychiatric illnesses as well as a side effect of certain medications. Additionally, other sleep problems such as snoring, sleep apnea and restless legs syndrome may cause insomnia. Insomnia in many patients may have been precipitated by an acute stressful event. In those instances, it is not abnormal to have difficulty sleeping. Unfortunately in some, this becomes the kindling keeping the fire of insomnia going. The longer this continues, the bigger the emotional burden and the greater risk of developing unhealthy sleep habits such as staying in bed longer trying to get more sleep. Research shows the more one tries to force sleep, the more frustration and fear of not sleeping overwhelms them. They try to tell their brain to relax, but the brain cannot just simply ignore their fear of not sleeping. This shifts their attention off of sleep and moves internally to their thoughts and feelings which increases their anxiety, uncomfortable body sensations, and further awakening them. They end up managing the body’s internal state not their sleep, and the more they try to suppress or get rid of the discomfort, the more it takes center stage in their awareness: they end up being at the mercy of their emotions. Studies have shown how parts of the brain stay highly active during insomnia and do not turn down even during sleep.

Sleeping pills are mainly useful as short term therapy. Sleeping pills alone may only act as a band aid covering a festering wound. In spite of this, hypnotics continue to be frequently used contributing to both physical and psychological dependence. Furthermore, sleeping pills have been recognized to be harmful to one’s health by increasing the risk of accidents, shortening life spans, and increasing the chances of cancer and dementia.

The solution to insomnia is to address the root cause of the problem and to learn how to de-escalate emotions to achieve restful sleep. According to the American Academy of Sleep Medicine, Cognitive Behavioral Therapy for Insomnia is recommended as first line treatment for insomnia. Unlike sleeping pills, CBT-I helps overcome the underlying causes of sleep problems, and CBT-I is a structured program proven to reduce the hyperactivity of the brain in patients with insomnia. Many insomniacs have dysfunctional beliefs about sleep. CBT-I addresses and corrects those beliefs by helping persons understand and test those thoughts. The cognitive portion of CBT-I helps identify and replace thoughts and behaviors which are not conducive to sleep with behaviors that promote sound sleep. The behavioral part of CBT-I helps develop good sleep habits and avoid behaviors that prevent good sleep. Worrying that one will not or cannot sleep will actually increase wakefulness. Letting go of this worry can help one relax and make it easier to fall asleep. Depending on one’s needs, sleep therapists may recommend a combination of techniques, including improving sleep hygiene, stimulus control, relaxation techniques and passive awakening.

Stimulus control trains one to use their bed and bedroom for sleep and sex only and to avoid using it as a place for other life activities. Relaxation training involves reducing tension and muscular relaxation techniques. Passive awakening involves avoiding intentional thoughts of falling asleep by focusing on thoughts to remain awake, therefore, decreasing worry making it easier to fall asleep.

It is important to understand cycles and learn how beliefs, behaviors and outside factors can affect sleep. To help decide how to best treat insomnia, sleep therapists usually require a detailed sleep diary for one to two weeks.

Insomnia treatment requires a strong and viable support structure to ensure success. Patients should undergo a full assessment to identify any issues which may be contributing to their insomnia.

Learn more about sleep apnea:

Contact 797-1585 or

Article provided by The Neurology and Sleep Clinic.


The Forum News