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Insomnia

Air Date: 08/19/10 Dr. Rebecca Jankovich, PhD can be reached at 322-1839.8-19-10 InsomniaBrand, Gerber, Puhse, and Holsboer-Trachsler. "Depression, Hypomaia, and Dysfunctional Sleep-Related Cognitions as Mediators Between Stress and Insomnia". International Journal of Stress Management, 2010 Vol. 17, No. 2, p.114-134. Complaints about sleep are on the rise with estimates being from 10-50% of people have trouble falling asleep, staying asleep, or waking up too early and being unable to get back to sleep. Sleep is a very complicated function, necessary for our feelings of overall well-being, our ability to solve problems and think clearly and cope with stress, our capacity for short term memory recall. Disrupted sleep is most often caused by stress and worry, ruminating about problems that keeps one awake, or worrying about being unable to get enough sleep and concern over how terrible one will feel the next day having not gotten enough rest. Sleep problems are also associated with depression, but research suggests the majority of sleep problems is caused by stress and the worrying about sleep that comes with not sleeping. Stress occurs when there are high demands imposed either from the outside, or from the person's internal standards on how they should be, combined with the person's perception that they don't have adequate resources to successfully meet these demands. The longer there's this mismatch between the pressure to solve problems and the sense one won't be able to figure it out, the greater the stress. The longer stress lasts, the person gets worn out; they don't adapt and get used to it; they burn out their capacity to tolerate the pressure. One solution to sleep problems is to acquire better coping skills for dealing with stress: exercise daily; don't over-eat, drink or play with drugs to feel better; change your irrational beliefs that prevent you from fixing the demands causing you stress; don't let yourself ruminate or catastrophize that only the worst outcomes will happen; don't slip into railing that life isn't fair. The more flexible and optimistic you are, the better your coping skills. All of us should follow good sleep hygiene habits. Go to bed at about the same time every night and in time to get 8 hours of sleep; regardless of whether you've finished all your tasks, go to bed adequate sleep is so critical to your well being that getting the sleep is worth dealing with the unfinished tasks, tomorrow. Don't exercise within 2 hours of sleep. Alcohol helps you feel relaxed and sleepy, but it wakes you up later in the night; if you have sleep problems don't drink until they're ironed out. Get up at about the same time every morning and regardless of how tired you feel when you didn't get enough sleep, do not nap because that throws your whole sleeping rhythm off. If you wake up too early and can't get back to sleep, get up; do not lay in bed and teach your brain it doesn't have to shut down when you're in bed. When you get out of bed in the middle of the night, do something that is not arousing: low lights, boring television or book; distract yourself so you don't keep worrying. When you get drowsy, go back to bed or just fall asleep where you are. Do not lay in bed and worry because that teaches your brain it's OK to lay in bed, awake and worry, only increasing the likelihood this is what you'll do tomorrow night as well. People under stress tend to worry. They ruminate, going over and over their problems. They rehearse entire conversations, compose emails, run through the what if' list of worries that further intensifies their distress. The more you worry during the night, the less sleep or rest you're going to get which in turn will ratchet up your anxiety level and you'll gradually sleep worse and worse. If it hasn't happened yet, you don't get to think about it. If it's not under your control, you don't get to think about whether it will happen. And then there's the worry about sleep. Chronic insomniacs worry too much about getting enough sleep. They pay too much attention to things that might keep them from sleeping; if the wind is blowing, they worry the sound will keep them awake; if there's a family problem during the day, they worry that their worries about the problem will keep them awake. And then they worry about how terrible they'll feel tomorrow when they haven't gotten enough sleep. Worries and sleep don't mix well. If you're having trouble with sleep, talk with a psychologist who knows about sleep disorders and stress management. By changing the ways you think and tuning your lifestyle, you can cope better with stress which will help you sleep. Besides working on better sleep hygiene, we have some techniques to train your brain to stay asleep longer. It's not an easy process to change the habits that interfere with sleep but if you do the work, and start getting enough sleep, most things in life will get easier.