Periodically we all experience a sleepless night. Perhaps we have a cold or indigestion. Or the neighbor's dog is barking. But for some people sleeplessness becomes chronic. Americans spend millions of dollars each year on over-the-counter sleep aids and an estimated 10 million Americans take prescription sleeping pills.
In addition to their becoming less effective over time, studies also show the many sleep medications interfere with our normal stages of sleep. When we fall asleep, our body temperature goes down and we enter what is called "alpha rhythm" brain wave patterns. During this phase many people experience sudden jerking movements. This signals a sudden burst of brain activity, followed by muscle relaxation and slowing of the pulse. If unawakened, the sleeper now enters phase 2, a period where our brain waves grow larger, our eye's roll from side to side, and do not see if opened. If a person wakes during either phase 1 or 2 they may believe no sleep has occurred.
After about 30 minutes of sleep, stage 3 is reached, with even breathing and slow, large brain waves. This is followed by stage 4, "delta" sleep, the deepest part of our sleeping. After about 20 minutes of this pattern, we go into REM sleep, so named for it's rapid eye movements. We dream during 85% of REM sleep. Our heartbeats and blood pressure fluctuate. We continue to cycle through REM and back to phase 2 for the remainder of the night, generally cycling about every 90 minutes. Toward morning the periods of REM are relatively longer.
It seems that the order of our sleep cycles are biologically essential. Studies show that people deprived of REM sleep become hostile and anxious. Those deprived of delta sleep become depressed and apathetic. Knowing this, it is wise to question the extended use of sleeping aids that may interfere with these important sleep patterns.
So what can you do instead of reaching for a medication? First, have a thorough physical examination to rule out a medical problem. Then look to your eating, drinking and exercise patterns. Lifestyle problems such as irregular times of going to bed and arising, night work, daytime naps, lack of any exercise, overuse of caffeine or alcohol, or other drugs (including nicotine) can all cause sleep disturbance.
Sometimes what is believed to be insomnia isn't. Some people feel that if they don't get a full eight hours sleep, they have a problem. In fact, 8 hours may be too much for some and not enough for others. Average amounts of normal sleep can vary from 5 to 10 hours per night, and a few persons habitually get only 2-3 hours and awake refreshed. We require less sleep as we grow older, especially after age 55. Also, women can be more easily aroused from sleep than men, and start requiring less sleep at an earlier age.
Another type of "insomnia" occurs when persons believe they have not been asleep but actually were. This can occur because periods of light sleeping and wakefulness are often fused and the insomniac believes he or she hasn't slept at all. Also, some folks have more difficulty than others in judging time at night and can overestimate wakeful night hours.
During a stressful life circumstance, insomnia is common. This type of sleeplessness usually disappears by itself once the crisis has passed. Insomnia can also be a indication of more serious emotional problems. Both anxiety disorders and depression can have sleep disturbance as prominent symptoms. For example, many depressed persons experience early morning awakening. Those suffering from anxiety often have great difficultly initially falling asleep and may awaken too often during the night.
Thus, psychologists almost always inquire about a person's sleep patterns. Problems in this area can be dealt with several ways. Basic relaxation techniques can be easily taught in the office. These involve attention to breathing patterns and relaxation of muscle groups by a simple tensing and relaxing exercise. Folks can quickly learn these and then use them at home. If the sleep disturbance is a symptom of underlying anxiety, depression or other emotional problems, psychotherapy or medication may be the best answer.
Fore more on sleep please read Is Your Sleep Renewing You? Sleep Loss Has Serious Consequences, Guidelines for Getting Good Sleep, and Advice on Sleeping Pills and Naps
Dr. Moore is a licensed psychologist and Founder and Director of Fall Creek Associates. She is President of the Sacramento Psychological Association, adjunct faculty member in the School of Psychology at the Fielding Graduate Institute, teaches classes through The Learning Exchange, and frequently appear as a guest on public service programs having to do with psychology and emotional wellness. She has also written a newspaper column called Senior Wellness, which focuses on general psychology topics as well as those of special interest to senior readers. In addition to working with private clients, she welcomes the opportunity to disseminate information on psychology and mental health issues to the general public through her PsychPages website.
