Insomnia
by
David C. Mathis, Ed.D.
In 1993, the National Commission on Sleep Disorders Research reported to Congress. The commission sought to bring attention to the problems associated with sleep disorders. Sleep disorders affect productivity, susceptibility to other medical conditions, on-the-job accidents, decreased stress-tolerance, and safety. One study found that 27 percent of automobile accidents in which the drivers lost consciousness was due to falling asleep. However, this 27 percent accounted for 83 percent of fatalities. Once a driver has fallen asleep, he or she cannot attempt to avert the collision. The National Transportation Safety Board concluded that the probable cause of fatigue in 57 percent of fatal truck accidents. The direct costs to taxpayers for sleep disorders is estimated at 16 billion dollars per year. Clearly, sleep disorders have a significant impact on society. Most of us, however, are particularly concerned about the personal affects of sleep problems. Insomnia is one sleep disorder which can greatly interfere with one’s functioning.
Insomnia is the perception of inadequate sleep because of difficulty falling asleep, difficulty remaining asleep, awakening too early or feeling unrefreshed upon awakening. Since people vary in the need they have for sleep, insomnia is not necessarily defined by how many hours a person sleeps. Some individuals are more susceptible to intermitted (on and off) episodes of insomnia. Others may develop transient (short term) insomnia in reaction to a stressful event of even a disruption such as a medical illness. Insomnia becomes particularly troubling when it is chronic (constant). Individuals with chronic insomnia have often struggled for years and have thus become conditioned to expect troubled sleep. They may often develop maladaptive patterns of functioning which actually interfere with returning to adequate sleep. These maladaptive patterns can include napping to catch up on sleep, erratic sleep schedules, use of stimulates to promote alertness, and then, ineffective sedatives (such as alcohol or cigarettes) to promote sleep. It is often common for such “insomniacs” to develop very negative associates with attempts to sleep because such attempts are often frustrating and unsuccessful. They may also develop anxiety related features which further frustrate their ability to get a good night’s sleep.
Treatment for chronic insomnia would include a careful study and review of sleep patterns and habits. This might help uncover behaviors which may actually worsen insomnia. We have learned much about sleep hygiene which will help promote good sleep. Relaxation training is often used to decrease the anxiety from the negative associations with insomnia. There are also techniques such as sleep restriction which can readjust an individual’s internal clock which helps promote sleep.
In one study, it was estimated that of the 65 million people with insomnia that only 5 percent visited their physician specially for complaints of insomnia. If you are having chronic difficulty with insomnia, talk with your physician or a sleep disorders clinic.