Difficulty falling asleep? Beating insomnia a two-front fight

  • There are ways to resolve insomnia, including changing your sleeping patterns and getting help from professionals. Metro Creative Graphics

  • Some people lie awake all night — or a good part of it — if they have insomnia. Metro Creative Graphics

Recorder Staff
Published: 7/25/2016 12:52:34 PM

Have you been getting your social media fix on your smartphone or checking off a chapter in the book you’ve been tearing through on your e-reader before hitting the sack at night?

Well, if you’ve had a hard time getting to sleep or staying that way lately, that could be part of the problem: the light emitted by your device’s LED screen suppresses melatonin, the hormone in your body that helps make you sleepy once the sun has set, according to Dr. Karin Johnson, the medical director of Baystate Medical Center’s sleep program.

It’s one of the many things that can factor into developing insomnia — a condition where a person has difficulty falling asleep or staying asleep that results in adverse symptoms during the day time, Johnson said.

Insomnia comes in two forms, Johnson said. Acute insomnia is a shorter-term condition that can be brought on through stress, the loss of a loved one, sickness or other events. Chronic insomnia is when the sleep troubles continue on past the initial event.

Johnson also draws a distinction between insomniacs who are unable to stay asleep and those who can’t fall asleep in the first place: if someone wakes up a lot during the night, that can be a sign of another condition such as sleep apnea, movements during sleep or urination problems.

The most common type of insomnia is the inability to stop one’s thoughts from racing and an unhealthy focus on the sleep problem itself before bed, Johnson said — that’s called psychophysiological conditional insomnia.

“A lot of people think about their difficulty sleeping, or not getting enough sleep or that they won’t feel well if they don’t get to sleep,” she said. “We over-analyze, and that tends to feed into the problem.”

Insomnia can lead to problems at work, an increased risk of being injured, having a stroke or heart attack, getting into car crashes and problems in your personal life.

So, how do you stop it?

The first thing Johnson talks about with her insomnia patients is “sleep hygiene.”

Insomniacs can improve their condition by setting regular sleep schedules close to the amount of time they should be sleeping, and restricting themselves to only sleeping or trying to sleep during that period.

Then, they need to establish a good bedtime routine to wind down from the day.

She recommends abstaining from electronics, lowering the lights and practicing relaxation techniques, as well as reducing caffeine, nicotine and alcohol consumption.

People who’ve had traumatic experiences earlier in life tend to become insomniacs, she said, and cognitive behavioral therapy can help take away negative associations with sleeping.

“You need to balance all the things that help you get to sleep with all the things that keep you awake,” she said. “Being up for longer, having a restrictive sleep schedule, don’t take naps, all of those can help (fix your sleep rhythm.)”

Also, avoid watching the clock. That can trigger anxiety around sleeping when a person wakes up during the night and make it hard to get back to sleep.

Sleep doctors tend to use less medication to treat patients than other doctors, Johnson said, but some of those can come in handy — but, they need to be the right ones. Used improperly, they can actually make long-term insomnia worse and develop dependencies.

“If someone has acute insomnia, having something to get through that period might help,” she said. “But for most chronic insomnia, CBT and behavioral therapy are much more likely to be successful.”

Antihistimines as sleep aids should be avoided, she said. They can increase the risk of dementia and make chronic insomnia worse.

is it insomnia?

Not everyone who has a hard time falling asleep has insomnia, Johnson said.

“If you’re fine, healthy and functioning the next day, that’s not insomnia. But, if you’re constantly tired or fatigued or have medical issues, that might be,” she said.

Many of her patients who’ve recently retired commonly think they have insomnia because they’re attempting to sleep more and change their sleep cycles from decades of a 6-hour cycle to a 10- or 12-hour cycle, she said.

“They’ve always been a 6-hour sleeper, and now they’re trying to sleep for 10 hours and they say they can’t sleep,” she said. “Everyone has their own sleep time and you have to have the right expectations.”

You can reach Tom Relihan at: 413-772-0261, ext. 264, or trelihan@recorder.com On Twitter, follow @RecorderTom


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