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An Epidemic of Sleeplessness

17 Jul

We are a nation of people who long for a good night’s sleep.  Restful Sleep is the new Holy Grail, sought by one in three bleary-eyed Americans. 

In fact, the Center for Disease Control in Atlanta has declared sleep insufficiency to be a nationwide public health epidemic, with a whopping 50-70 million US adults suffering from some sort of sleep or
wakefulness disorder. 

Even the Surgeon General of the Army, LTG Patricia Horoho, has focused considerable effort and resources on improving the quality and quantity of our soldiers’ sleep, seen as critical to their health and welfare.

The Downside of Sleep Insufficiency

Sleeplessness is associated with motor vehicle crashes, industrial accidents, weight gain and occupational errors.  People who don’t get enough sleep are more likely to suffer from hypertension, diabetes, depression, cancer and obesity.  And they die sooner. 

At the very least, sleep insufficiency results in irritability, poor judgment, muddy thinking, strained relationships, less satisfying sex, sub-par functioning and generally decreased enjoyment of life.


An Epidemic of Sleeplessness
Download the Report (PDF)


What Causes Sleep Insufficiency?

A big factor in this escalating epidemic is our round-the-clock access to technology and the increase in flexible work scheduling.  But it is also heavily associated with obstructive sleep apnea and snoring; it’s a common side effect of menopause; and it’s often a result of garden variety stress, anxiety and posttraumatic stress, too.


Two Common Kinds of Sleep Trouble

The two most common manifestations of sleeplessness are the kind where you have trouble falling asleep, and the kind where you wake up in the middle of the night and can’t fall back to sleep.


Tried & True Tips for Better Sleep

Fortunately, there are quite a few simple, proven behavioral suggestions that can really make a difference.  Some you may already know about, but some you may not. Several of them are easy to implement, some not so much.  A few may be completely unrealistic for the life you lead.  I suggest you pick and choose what makes sense for you. Even doing a couple of things differently can produce some truly dramatic positive improvement.


A Time and Place for Sleep

  • If possible, try to go to sleep and wake up routinely at around the same time each day. It is understood that for some this is easier said than done - babies, shift work, roving work schedules and various family constraints can make this impossible. But try it if you can do it.
  • Consider napping – napping is a beautiful thing - but not after 4 pm.
  • Don’t sleep late as a regular practice.  Getting up early generally helps sleeping at night.
  • Keep your bedroom cool and well-ventilated.
  • Sleep on a firm mattress.
  • Keep your sleeping space simple, uncluttered and pleasing to the eye. Surround yourself with a few objects that feed your spirit and nourish your soul.
  • Invest in real-deal, room-darkening window shades. This is money well spent, and may be the most effective thing you can do for your sleep.
  • If you need to get up to go to the bathroom, use a flashlight rather than turn on an overhead or bedside light.
  • Mask disruptive noise with a fan (even if it’s turned toward the wall), white noise or soothing nature sounds.

Some Lifestyle Changes

  • If you work out or exercise at night, it would be better to switch to the morning or afternoon – not just before bedtime.
  • If you’re a worrier, try to make a habit of writing down, before bedtime, all the things you need to take care of for the next day, so that you are, in essence, getting them out of your head and onto a sheet of paper.
  • More general journaling of your thoughts and feelings also serve the same purpose in a more wide-ranging way.
  • Consider doing something relaxing around an hour before bedtime. Meditation, guided imagery, listening to music, reading, yoga breathing and the like can be an ideal nightly ritual. Balancing your checkbook or watching a violent TV show is not recommended.
  • Try to resist falling asleep right after dinner.  Instead, do some light exercise - walk the dog, do the dishes, water the plants, call a chatty friend and talk while walking around the house… things like that. You want to do modestly active things like that, to gently prevent you from sleeping on an overfull stomach, but don’t rev you up.
  • Getting sufficient natural light during the day is equally important for regulating your melatonin. So be sure to get outside during the day if your work keeps you cooped up in artificial, man-made light.

Food & Drink

  • If you drink alcohol at dinner or after, it might help you fall asleep in the short term, but it’s also likely to be what’s waking you up 2 or 3 hours later.  Booze is a terrible intervention for insomnia.
  • While you’re at it, it’s a good idea to forego caffeine (that’s not just coffee, folks – tea and soda count, too), nicotine, sugar-loaded desserts, chocolate and big meals at dinner or after mid-afternoon.
  • On the other hand, a glass of warm milk or some other source of calcium can soothe jagged nerves. So can chamomile or lavender tea.
  • If you’re hungry, a half a turkey sandwich or a banana can promote sleep, too.

Calm the Mind

If you wake up in the middle of the night and your mind revs up with worries, plans, problems, irritations and the like, you will either need to pleasantly distract your mind – with reading, music, guided imagery, meditation; or else you need to get out of bed and address these things in a more proactive way. The worst thing you can do is to just lie there thinking “I have to get some sleep!!! I’m going to be exhausted tomorrow!!”, because, of course, once you’re having that conversation with yourself, you won’t be sleeping any time soon.


Keep it No-Tech

  • Speaking of reading, avoid backlit reading, as on an iPad.  That kind of light wakes up your brain, with or without you knowing it.
  • And speaking of computer light, you’d be surprised what a perfectly dark room can do for you.  Use a thick hand towel to cover your digital clock, your phone and anything else that emits those weird lights, and your body will produce the melatonin it needs to get you your zzzz’s. 
  • In an ideal world, you’re not supposed to have a TV or computer in your bedroom, but if you do, shut ‘em down and/or cover those too.

Learn about Sleep

Stay informed of the latest information and research findings. There is a wealth of data on effective treatments for sleep insufficiency. For example, Investigators from the University of Michigan School of Nursing in Ann Arbor examined the effects of using guided imagery targeting sleep on post-cardiac surgery sleep disturbances (problems with sleep quality, time taken to fall asleep and total sleep time) and systemic inflammatory response. The patients who used the guided imagery had consistently better sleep quality, more total sleep time and took less time to fall asleep. And they also enjoyed a greater decline in inflammation over time, as measured by their cortisol levels and C-reactive proteins.

Sleep Resources

As for resources, you can condition yourself to fall asleep to guided imagery or any kind of guided meditation – so much so that in a short while you’ll only hear the first paragraph or two and then you’re out.  This is because imagery has just enough content to distract your mind – it’s called “cognitive recruitment” – while, at the same time, the voice tone, pacing and music take the primitive brain from agitation to a peaceful calm.  Even people who describe themselves as addicted to sleeping pills have reported that guided imagery weaned them away from meds and produced as good or better sleep without the side effects.

Other modalities, such as yoga, guided breathwork and acupressure, or simply listening to meditative music are also highly effective. For our curated list of resources, click here.

See your Doctor   

If you’re in the middle of a heinous insomnia cycle that’s lasting way too long - weeks or even months - and you’ve tried all of the above to no effect, you would do well to see a skillful family doc or internist for a prescription – not as a permanent solution, but to break the cycle of sleeplessness and get you back on track. Work with your provider to find a good medication that works well for you, without producing a “hangover” the next day. It’s best to experiment over a weekend or on a week night when you don’t have to be terribly sharp the next morning.

So try some of these and track your sleep to see how it changes.  There are several sophisticated and reasonably priced sleep efficiency monitors you can get for accessing state-of-the-art feedback. You wear them on  your wrist, and they tell you how well you slept - how many hours you actually got and how many times you woke up during the night.  The Fitbit does this, as does the Zeo and the Sleep Tracker.  Somehow getting the feedback of a sleep efficiency rating each morning becomes very motivating. 

Hopefully a few of these changes will produce some wonderful and lasting results that will yield unanticipated benefits in all parts of your life.  Sweet dreams and best wishes.

Featured Guided Imagery for Better Sleep

   
Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award.