A Patient’s Guide to Insomnia

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By Elaine K. Howley

If you’ve ever lain awake at night wishing for sleep, then you’ve likely experienced some form of insomnia. For those who struggle with this common sleep disorder regularly, the feeling of missing out on sleep can be excruciating. And the paradox of it is that the more you try to sleep the further away the sweet embrace of slumber seems to slide.

As awful as sleeplessness might feel, if there is strength in numbers, then you can take some small comfort in the fact that you’re far from alone. “The data shows that between 20 and 30 percent of people will be affected with insomnia during the course of their lives,” says Dr. Alex Dimitriu, a sleep medicine specialist who’s double board-certified in psychiatry and sleep medicine and founder of Menlo Park Psychiatry & Sleep Medicine in California.

Although we know that sleep is critical to maintaining health and wellness for all of us, in some people, the drive to sleep is weaker than in others. “Not everyone has the same propensity to go to sleep,” says Dr. Jerald H. Simmons, a neurologist who’s triple board-certified in neurology, epilepsy and sleep medicine and founder of Comprehensive Sleep Medicine Associates, a clinical practice with offices in Houston and Austin. This so-called sleep drive can vary, as does each individual person’s sleep rhythm. This is why some people are night owls while others are morning people. And in some people, a weaker sleep drive is easily disrupted by any number of factors, which can lead to the development of insomnia.

Insomnia is the most common sleep disorder, but not all cases of insomnia are the same. Generally speaking, there are two major categories of insomnia – difficulty falling asleep initially and difficulty staying asleep throughout the night. And the two may be quite different in how they’re addressed. “Don’t confuse going to sleep with staying asleep,” Simmons says. “You can’t lump them all into one category and say, ‘This is the medicine I use for insomnia patients.'” Rather, many people struggling with insomnia are going to need a treatment approach tailored to their specific problem.

Insomnia – More General Information

Sleep Disorders and Chronic Pain
Cognitive Behavior Therapy for Insomnia
Sleep Deprived? You’re Not Alone
Best Doctor for Sleep Problems?
How Sleep Disorders Affect Us – and How to Lay Them to Rest
How to Fall Asleep – and Stay Asleep – the Natural Way

“In most people who have insomnia, it’s caused by something,” says Dr. Jesse Mindel, assistant professor of medicine and neurology at The Ohio State University Wexner Medical Center. And there are many factors that can cause both short-term and chronic insomnia including:

  • Changes to your work or travel schedule. Jet lag and frequent changes to your work schedule, as can happen with shift work, can induce insomnia in some people.
  • Concerns over work, school or health issues. There’s a reason why the saying “to lose sleep over it” exists. Concerns about any number of aspects of your life can lead to disrupted or poor sleep.
  • Concerns about not sleeping enough. Simmons says some people “develop performance anxiety” about sleep and their insomnia is exacerbated by that anxiety. “They’re so worried they can’t fall asleep that they can’t fall asleep,” and it becomes a self-perpetuating problem.
  • Poor sleeping habits. Engaging in stimulating activities in bed or being inconsistent in your sleep-wake pattern can lead to insomnia.
  • Food and drink. How much, what and when you eat can also disrupt the quality of your sleep. Substances such as caffeine, nicotine and alcohol can have an outsized impact on your sleep quality, especially if you’re using them in the evening or just before bed.
  • Age. Some people tend to have more trouble sleeping as they age, and many post-menopausal women report experiencing insomnia or a shift in sleeping patterns that’s related to changes in their hormone levels.
  • Medical conditions. Some medical conditions, such as sleep apnea – a breathing issue that wakes you up multiple times a night – can disrupt your sleep and lead to insomnia. Restless leg syndrome is another condition that can turn you into an insomniac.
  • Mental health disorders. Anxiety and depression can both greatly impact the quality of your sleep and your ability to fall or stay asleep.
  • Medications. Some medications, particularly certain anti-depressants, steroid medications used for asthma, allergy medications, weight loss drugs and some blood pressure medications can cause insomnia as a side effect.

For many people, insomnia is a consequence of modern life. “A lot of insomnia is related to just being forced into a schedule that’s not natural,” Dimitriu says. Busy, stressful lives filled with electric lights and electronic devices that are constantly demanding attention and shedding blue light that disrupts the body’s natural signals to sleep are all implicated in our collective inability to just get some sleep. “LED lights produce a blue light that suppresses melatonin,” a hormone that governs when we feel sleepy, and this can impact your ability to both fall asleep and stay asleep. “There’s evidence that (after exposure to LED light) melatonin is suppressed through the whole night, so late-night phone play messes up the quality of the sleep for the whole night.”

The ubiquity of these screens and their ability to become a detriment to our sleep cycle is a growing problem for many people, especially those who are prone to insomnia. “We’re living in a very tech-heavy world with clocks and other built-in hard stops” to our natural rhythms. “We’re not adjusting to that,” and the evidence of that disconnect between the demands of the waking day and the inadequacy of sleep to meet those demands becomes vastly obvious when you look at the length of the line at your local coffee shop each morning, Dimitriu says.

Most people who have insomnia are well aware of the difficulties they’re having sleeping. Common symptoms include:

  • Difficulty falling asleep.
  • Waking up during the night and having difficulty returning to sleep.
  • Waking too early in the morning.
  • Not feeling refreshed after sleeping.
  • Grogginess or tiredness during the day.
  • Depression, anxiety and irritability.
  • Cognitive issues such as difficulty focusing or concentrating on tasks.
  • Making lots of mistakes in your work or noticing an increase in accidents or clumsiness.
  • Anxiety about not getting enough sleep.

If you’re experiencing symptoms of sleeplessness, it might be time to visit your doctor for an evaluation. There can be a lot of factors contributing to your specific experience of insomnia, and your doctor will likely perform a physical exam and take a medical and sleep history to understand what’s going on.

You may also be administered a sleep test, which sometimes can be done at home but in other cases may need to be conducted in a sleep lab. These tests typically involve sleeping with sensors attached to your body to monitor your vital signs and look for other indications of physical disruption, such as changes in breathing or heart rate that could be causing you to wake up throughout the night. These tests monitor what you do in your sleep and are often helpful in diagnosing obstructive sleep apnea, restless leg syndrome and other conditions that can disrupt sleep.

Ruling out underlying medical conditions should be a primary goal of any visit you make to a sleep specialist. “First and foremost, I want to rule out any other causes that could be feeding into the insomnia,” Dimitriu says. These other conditions may include:

  • Depression.
  • Anxiety.
  • Restless leg syndrome.
  • Sleep apnea.
  • Thyroid problems.
  • Use of substances such as alcohol or drugs.
  • Other medical conditions.

“As a physician, first I need to eliminate all treatable medical issues. Then I look at substances” and other extenuating circumstances such as living too close to a source of late night noise or light. “Once you’ve eliminated those variables, you discover some people just have pure insomnia. This may be schedule-related or circadian rhythm related. Once we’ve eliminated all the scary stuff that could be treated medically, using a little medication or behavioral intervention can get people sleeping again,” Dimitriu says.

Treating insomnia and making sure that you’re getting enough sleep is an important aspect of overall health and wellness. While there are many things you can do to help ease yourself to sleep, one of the most important things is habituating your body to sleep and the ritual of sleep. “Rhythmicity is key, so having a regular bedtime and wake time and not deviating from that at all,” says Dimitriu. That, alas means “no sleeping in on the weekend, and no napping during the day.” The idea is that by forcing your body to stay awake during the day and adhering to a strict bedtime and wake time regardless of what else is going on, you can retrain your body to accept sleep when it’s most appropriate.

Simmons says many people who deal with insomnia have “poor sleep hygiene,” which means “they’re doing all the wrong things. They’re drinking caffeine in the evening. They’re taking naps in the middle of the day if they have the opportunity to,” and so on. Those sorts of actions “throw their biologic rhythm off. Those individuals need to wake up at a regular time in the morning. They shouldn’t sleep in and they need to get bright light exposure that will lower melatonin levels.” You want to increase the naturally occurring levels of melatonin in your brain at bedtime, and then help them drop in the morning when it’s time to get up and get going.

Other elements of good sleep hygiene include winding down from the day and creating a ritual around bedtime that helps your brain get ready to sleep. Switch off the television and step away from any other screens. Keep your bedroom cool, dark and quiet.

Simmons also recommends taking a hot bath shortly before bedtime to help you relax and get ready for sleep. “As we get drowsy our body temperature drops, and you’re going to sleep better in a cool room. So, if you take a hot bath before bed, that enhances that change in body temperature.” Just be sure to make it the last thing you do before bed. “That window of opportunity where the cooling will help is only 45 minutes to an hour,” he says.

If you’re still having trouble sleeping, it might be time to see a sleep specialist for further testing or more specific treatment. Simmons says that for some people, particularly those who engage in shift work, a consultation with a sleep specialist might help them develop a good strategy for dealing with or avoiding insomnia. “Seek out a consultation with a psychologist or physician who is well versed in sleep disorders to work on a unique plan that’s tailored to your needs,” he says.

Sleep medicine was only recognized as a specialty field of medicine in 2007. Although the science is still young it is expanding, and today there are a growing number of specialists who can help you with sleep problems with a variety of techniques. Simmons says some sleep specialists are now using cognitive behavioral therapy, an approach common in treating mental health problems that can retrain the brain to sleep properly.

Another technique called neurofeedback is a form of “biofeedback using brainwave activity (to) train someone to put themselves into a state conducive to falling asleep,” Simmons says. Using this approach, patients “learn how to relax and we train the brain through this feedback process on how to wind down and go to sleep without medication.” It’s a process that’s similar to meditation. In fact, Simmons says “I jokingly refer to it as meditation on steroids.”

Dimitriu uses similar CBT and meditation techniques to help patients retrain their bodies and brains to accept sleep. The challenge with some of these approaches is that they take time and practice. But tired people aren’t generally well known for being the most patient among us, especially when it comes to sleeping more. “A lot of people say, ‘I slept well last night, why am I still tired?’ The answer is sleep debt takes time to replenish – on the order of about one to two weeks.” That’s why it’s important to keep at it and not give up if you don’t seem to have solved your insomnia problem after just a few nights. Think of it like dieting – it takes a while for your efforts to add up to results, but if you stick with it, you’ll likely see an improvement.

That’s why Dimitriu says it’s important to keep practicing and trying to sleep without the assistance of medication as much as possible, especially when the stakes are low. “It’s easier to practice driving in the parking lot than to practice driving on the highway. By the time you have a big meeting the next day and you can’t fall asleep, meditation can help, but you’d better be good at it by then.” Therefore, he says it’s best to “practice when it’s easy” and you don’t have that pressure of getting to sleep immediately.

There’s a multitude of meditation and sleep-inducing apps and programs available online these days, or a sleep specialist can design a program specific to your needs. And remember to be patient. “If you can learn to meditate, you’re pretty likely to solve your insomnia problem, but that takes time and effort,” Dimitriu says.

Couples are getting ‘sleep divorces’ – and it could save your relationship

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It’s becoming what’s known as a ‘sleep divorce’ and far from being a sign of a relationship in trouble, experts are saying it could be a good thing.

Perhaps one of you is a night owl, while the other is an early bird. If one partner often has disrupted sleep, then this can impact the other. Other reasons people sleep apart include different schedules, snoring , co-sleeping and even the temperature of the room.

“Poor sleep also can have negative effects on relationships,” PT reports.

“Lack of sleep may diminish the positive feelings we have for our partners. Researchers found people with lower quality sleep demonstrated lower levels of gratitude, and were more likely to have feelings of selfishness, than those who slept well.

“People who slept poorly showed less of a sense of appreciation for their partners.

“What’s more, poor sleep on the part of one person in the relationship had a negative effect on feelings of appreciation and gratitude for both partners.”

If this sounds like something you could both benefit from: “Tell your partner that you really love them but you’d be [less resentful of their sleeping habits] if you slept in separate beds.

“Suggest trying it for one or two nights a week and see how it goes.”

15 Things To Avoid Doing When You’re Sleep Deprived, No Matter How Tired You Are

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If you missed a few hours of sleep, you’re definitely going to feel tired the next day. And with that fatigue will likely come all sorts of ideas for staying awake, such as guzzling caffeine, taking a long nap, or going to bed super early. But even though it all seems like a good idea when you’re tired, these are things you should avoid at all costs.

The only real cure for fatigue is getting a good night’s sleep, every single day. And that means creating a healthy sleep schedule, one night at a time. “Resetting your sleep schedule or establishing good sleep hygiene is a process and takes more than a few days,” licensed psychologist Nicole Issa, PsyD, tells Bustle.

And yet, the sooner you can start, the better. “It will begin with having a consistent wake up time and sticking to it,” she says. “Your bedtime will gradually shift to an earlier time to allow you to get enough rest.”

Creating a relaxing evening routine can come in handy, too, such as slowing down, putting away your phone, reading a book, and even getting ready for bed beforeyou’re tired. As Dr. Issa says, “That way you can just go to bed when you are ready and not get woken up by washing your face, brushing your teeth, etc.”

These are things you should do for good sleep, as opposed to the things listed below, which experts say you should try to avoid if you’re tired.

1. Drinking Tons Of Energy Drinks

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Even though they can give you a quick boost of energy, it’s not a good idea to load up on these drinks as a way to stay awake.

“[They] often have a lot of B vitamins, which can be stimulating, and then cause insomnia, which perpetuates the cycle of being tired and reaching for more energy drinks,” Catherine Darley, ND, from the The Institute of Naturopathic Sleep Medicine, tells Bustle.

Instead, stick to one caffeinated drink in the morning, so it has plenty of time to wear off before bed, when you can officially catch up on your rest.

2. Taking A Nap

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If you can, try to resist the urge to take a nap. Or at least try to time it right.

“Avoid taking a nap longer than 30 minutes to ‘catch up,'” Doug Hale, a sleep expert from Brooklyn Bedding, tells Bustle. “Just as important, don’t take a nap late in the day as that will disrupt your normal sleep cycle, leading to insomnia at night.”

3. Going To Bed Super Early

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While it might be tempting to pass out the moment the sun goes down, try to stay awake as long as possible, or until your usual bedtime.

“Going to bed too early […] can result in what is essentially a long nap late in the evening,” Dr. Darley says, “which then causes the inability to sleep through the night.”

Do this, and you’ll likely wake up at 3 a.m., and be just as tired the next day.

4. Staying Inside

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When you’re tired, you might want to hide away from the blinding light of the sun. But stepping out can actually be a good thing.

“Get outside in bright sunlight for 20 minutes soon after getting up, then continue with light bursts of 10 minutes every couple hours,” Dr. Darley says. “Full spectrum light naturally increases alertness.” And that can help get you through the day.

5. Doing A Strenuous Workout

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“It might seem like a good idea to burn off energy in order to get a restful sleep, but working out later in the day can cause cortisol to spike which can prevent some people from being able to fall asleep,” health coach Rachel MacPherson tells Bustle. Instead, do your workout in the morning. Or skip it entirely until you’ve caught up on sleep.

6. Snacking To Stay Awake

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Fatigue can make you feel hungrier than normal, and lead to cravings for simple carbohydrates. And while that’s fine, keep in mind that eating sugary snacks can crash your blood sugar, and make you feel even worse. Instead, “eat a healthy balanced diet so your blood sugar levels remain steady,” Dr. Darley says.

7. Drinking A Night Cap

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A night cap may seem like a good idea, if you want to fall asleep faster. But if you want that deep sleep, you may want to stick with water.

“Alcohol interferes with your deep sleep cycles and REM cycles,” Jason Piper, a sleep and nutrition coach, tells Bustle. “These are the restorative phases we go through at night. Alcohol keeps you mainly in a light sleep phase.”

8. Cramming For A Test

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If you have a big test tomorrow, and plan to stay up all night studying, it may be smarter to just go to bed. “You may feel like you are making progress, but when you finally go to sleep and it is a short duration, you will miss out on a lot of your REM sleep,” Piper says. “REM sleep is when the brain moves short-term memories into long-term memory, so a lot of what you were studying becomes lost.”

9. Sleeping In

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Just like going to bed early, sleeping in always seems like a good idea in the moment. And yet, “it can shift [your] circadian rhythm for the day, making it harder to fall asleep at night,” Piper says.

Basically, sleeping in — even for just one hour past your usual wake time — throws off the timing of the sleep hormone, melatonin. It’s best to stick to your normal sleep and wake times, to help your body get back on track.

10. Eating Right Before Bed

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While it’s OK to have a light snack before bed, keep in mind that eating a big meal can make for a rough night.

“Your body needs to digest the food,” Piper says. “So it will raise your internal core [temperature] as it metabolizes the food and also will divert energy away from sleep to digesting the food.”

With all that going on, it’ll be hard for the body to slip into a deeper, more restorative sleep cycle, Piper says, and you’ll feel even more tired come morning.

11. Checking The Clock

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If you ever find yourself in bed, tired, and yet unable to fall asleep, do yourself a favor and avoid staring at the clock. Or worse, wondering when (or if) you’ll ever fall asleep.

“Doing this isn’t going to change anything,” Dr. Issa says. “In fact, it will only make you feel more anxious which will increase your physiological arousal and make it harder to fall asleep.”

12. Relaxing With Your Phone

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However tempting it may be, don’t lay in bed and scroll through you phone, as the “blue light from it will interfere with your ability to fall asleep,” Dr. Issa says. If you want to fall asleep easily, and wake feeling rested, avoiding electronics before bed will be key.

13. Willing Yourself To Sleep

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Have you ever had that moment where, despite how tired you feel, you just can’t fall asleep? When that happens, it’s actually best to get out of bed, instead of lying there wishing for sleep.

“Doing that will probably come with a lot of other thoughts about your lack of sleep,” Dr. Issa says, including anxiety about how tired you’ll feel the next day.

“Instead, get out of bed and take a break,” she says. “Get up and go in a different room until you start to naturally feel tired. Then go back into your bed.”

14. Making Important Decisions

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If a big decision can wait, do yourself a favor and wait. “Whether financial, relationship, or anything important, you would be much better off making that decision in the morning when your mind and body are fully rested,” Bill Fish, certified sleep science coach and co-founder of Tuck, tells Bustle. When you’re fatigued, you just won’t have the capacity to think clearly.

15. Soaking In A Hot Bath

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In order to fall asleep quickly, it may be a good idea to avoid warm showers and baths right before bed, and instead opt for a quick (and cool) rinse.

According to MacPherson, since your core body temperature drops at night in preparation for sleep, taking a hot bath can disrupt that cycle, increase your heart rate, and make it difficult to sleep.

Even though it often seems like a good idea, doing these things when you’re tired tends to be anything but helpful. The best and only way to feel less fatigued is to get a good night’s sleep, which includes sticking to a bedtime routine, and getting the right amount of rest every day.

People With Insomnia Struggle With Regulating Their Emotions When It Comes To Embarrassing Memories, A New Study Shows

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When most people make a mistake that really bruises their ego, they’re usually able to brush it off eventually — unless they have insomnia, that is. The Netherlands Institute for Neuroscience published new research in the journal Brain that found that people with insomnia can’t get rid of emotional distress, according to a news release. The researchers’ findings show that one of the causes of insomnia might be related to brain circuits in the brain that regulate emotions, the news release said.

Be prepared to cringe. The researchers took MRI scans of participants’ brain activities while they thought about their most embarrassing experiences that happened decades ago, according to the news release. The people who slept well were able to “neutralize” those memories, the news release said, while the people who experienced insomnia couldn’t do the same. The researchers say their findings might suggest insomnia could be caused by the inability to quell emotional distress, which could explain why insomnia is one of the leading risk factors for developing mood disorders, anxiety, and post-traumatic stress disorder, according to the news release.

“Sayings like ‘sleeping on it’ to ‘get things off your mind’ reflect our nocturnal digestion of daytime experiences,” Rick Wassing, first author of the study, said in the news release. “Brain research now shows that only good sleepers profit from sleep when it comes to shedding emotional tension. The process does not work well in people with insomnia. In fact, their restless nights can even make them feel worse.”

The brain imaging shows that one of the causes of insomnia might be brain circuits in the brain responsible for regulating emotions, the news release says, and these circuits contain risk genes for insomnia that might not always activate properly during rapid eye movement (REM) sleep. “Without the benefits of sound sleep, distressing events of decades ago continue to activate the emotional circuits of the brain as if they are happening right now,” the researchers said.

These new brain image findings support similar findings the same research group recently published in the journal Sleep, which found that people who experience insomnia felt more shame after a night of restless sleep. The researchers in that study made participants feel embarrassed and self-conscious by having them sing karaoke without being able to hear themselves (ouch), and then had them listen to their out-of-tune recordings, according to the news release. The people who slept well got over their feelings of embarrassment, the news release said, but the people with insomnia felt more upset the next day.

People with insomnia have trouble falling asleep, staying asleep, or they wake up earlier than they want to, according to the National Sleep Foundation. But if you’re struggling to get a good night’s sleep on the regular, there are things you can do to try to get some quality rest. The National Sleep Foundation recommends giving yourself around 30 minutes of wind-down time before bed to relax, including shutting down those electronic devices so you make it easier for your brain to fall asleep. But if it’s been more than 20 minutes and you still can’t fall asleep, the National Sleep Foundation says to get up and do something relaxing, like listen to music or read a book.

If emotional distress is keeping you up at night, you’re definitely not alone. You can try some sleep hygiene tips to calm your mind, and if that doesn’t work, you can talk to your doctor or a therapist about ways to help you get a better night’s sleep. Just remember that you’re not destined to toss and turn forever, because there’s help available if you need it.

The Powerful Link Between Insomnia and Depression

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When one has difficulty sleeping, the waking world seems opaque. On top of feeling tired and fatigued, those who experience sleep disturbances can be irritable and have difficulty concentrating. When one has more severe cases of insomnia, one also faces a higher risk of developing heart disease, chronic pain, hypertension, and respiratory disorders. It can also cause some to gain weight.

Sleep disruptions can also have a major impact on one’s emotional well-being. A growing body of research has found that sleep disturbances and depression have an extremely high rate of concurrence, and many researchers are convinced that the two are biconditional—meaning that one can give rise to the other, and vice-versa. A paper that was published in Dialogues in Clinical Neuroscience concluded, “The link between the two is so fundamental that some researchers have suggested that a diagnosis of depression in the absence of sleep complaints should be made with caution.” The paper’s lead author, David Nutt—the Edmond J. Safra Chair in Neuropsychopharmacology at Imperial College London—found that 83 percent of depressed patients experienced some form of insomnia, which was more than double the amount (36 percent) of those without depression.

Bei Bei, Dpsych, PhD, from the Monash School of Psychological Sciences in Clayton, Australia, said the inverse was true, as well: “If a person does not currently have depression but goes through extended periods of time with sleep disturbances or insomnia, the sleep disturbances can potentially contribute to a mood disturbance or to even more severe depression.”

The Mechanisms Behind the Two Diseases

The sleep-wake cycle is regulated by what is known as the circadian process. When working properly, the circadian process operates in rhythm with the typical cycle of a day. One gets tired as the light of the day fades and the body prepares for sleep. One awakes as it becomes light again. The internal mechanisms behind the circadian cycle involve a complex orchestration of the neurochemical and the nuerophysiological presided over by the hypothalamus.

Depression, meanwhile, is a medical condition and a mood disorder. While there are several possible antecedents to depression, as genetic and environmental factors can lead to a depressive episode, the neurophysiological causes of depression pertain to a deficiency of chemicals in the brain that regulate mood: serotonin, dopamine, and norepinephrine.

However, these neurotransmitters do far more than just regulate mood. They have also been found to be integral to sleep efficiency. Disruptions in these brain chemicals can lead to disturbances in sleep, particularly REMsleep, and can also lead to more restlessness during typical times when one should be in bed. This can create a vicious cycle wherein the more severe one’s depression becomes, the more severe one’s insomnia becomes. The inverse can also true: The more severe one’s insomnia becomes, the more severe one’s depression becomes.

Evaluation and Treatment

Because these concurrent afflictions reinforce one another, medical professionals need to address both simultaneously for optimal treatment. However, there is not one cookie-cutter response that can eliminate both depression and insomnia. Many variables, including improper medication, can contribute to insomnia and different symptoms indicate different causes, which is why it is important to provide your mental health professional with any information that can give them with more insight about your condition. Describing your symptoms to your doctor allows them to narrow down the list of likely culprits and prescribe medications with greater precision. For example, letting your doctor know that you wake up in the middle of the night, and then have difficulties falling back to sleep is a distinct symptom from having difficulties falling asleep in the first place.

Though depression and insomnia are commonly linked, they can be independent of one another. Then again, they may be part of a larger array of comorbid disorders that require specific treatment plans to resolve. To determine the best course of action, your doctor may recommend a sleep study, medication, or a behavioral therapy.

Sleep Study

A sleep study is a test that measures how much and how well you sleep. During this test, you will be monitored by a team of sleep specialists who will be able to determine if there are any other disorders, such as restless leg syndrome or sleep apnea, that may be causing your insomnia. Even if the study does not reveal a definitive culprit, the sleep study will also allow your doctor to get a better picture about what is behind your insomnia.

Medication

Sleeping pills may help you fall asleep, but they are not long-term solutions to mental health. If you are suffering from a bout of insomnia that is related to a psychiatric disorder, you need to address that disorder to address your insomnia. Oftentimes, this will require a treatment plan that includes a pharmaceutical component. This component will be unique to each patient, as there is not a one-size-fits-all regimen of medication for optimal mental health. Furthermore, there are numerous comorbidities with depression, such as anxiety, that may be contributing to your insomnia and that may not be resolved by certain types of anti-depressants alone.

Another potential treatment involves a combination of medication, light treatment, and melatonin, a hormone that helps regulate the circadian process. The conditions of patients who receive light therapy in conjunction with antidepressant therapy tend to show more improvement than those who are prescribed antidepressants alone. This is true for patients with seasonal and nonseasonal depression.

Cognitive Behavioral Therapy for Insomnia

In other cases, some mental health professionals may recommend you see a sleep specialist to receive cognitive behavioral therapy for insomnia. Cognitive behavioral therapy for insomnia (CBTI) involves numerous non-drug techniques to induce sleep and it can be utilized before resorting to the use of pharmacological sleep aids with surprisingly good results.

Several studies have shown CBTI to be quite effective in treating insomnia and some forms of depression. A paper published in the Journal of Clinical Sleep Medicine in 2006 concluded that “The benefits of CBTI extend beyond insomnia and include improvements in non-sleep outcomes, such as overall well-being and depressive symptom severity, including suicidalideation, among patients with baseline elevations.” A paper published in the International Review of Psychiatry in 2014 found that CBTI may help with other comorbidities beyond depression. These include anxiety, PTSD, and substance abuse issues.

The National Sleep Foundation notes that this type of therapy can still be quite intensive. CBTI requires regular visits to a clinician for assessment, keeping a sleep diary, and, perhaps most importantly, the changing of behaviors that may be felt as though they are firmly part of one’s routine. CBTI may also include some sleep hygiene education, where patients learn how different settings and actions can inhibit or promote sleep. It may also rely on relaxation training, where patients learn methods of calming their bodies and minds.

Concluding Thoughts

If you are struggling with either depression, insomnia, or both, treatments are available. The above studies demonstrate that there are holistic approaches, as well as pharmaceutical remedies, that can help induce sleep without the aid of sleeping pills. It is also a reminder that the most effective treatment plans are tailored to both the individual patient and the patient’s concurrent illnesses.

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Can’t Fall Asleep? How To Create The Perfect Sleep Environment

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Canadians are not getting enough sleep — and we really need it.

“We are a chronically sleep-deprived society,” Alanna McGinn, the owner of Good Night Sleep Site, told Global News. “It really is a growing concern.”

Data shows that about one in four Canadians are dissatisfied with the quality of their sleep, and an even greater proportion of us have problems getting to bed.

According to a recent government report, 43 per cent of men and 55 per cent of women between the ages of 18 and 64 say they have trouble going to sleep or staying asleep sometimes, most, or all of the time. Experts say that stress, technology use and not going to bed early enough, are all playing a role.

READ MORE: Sleep deprived? What missing too much sleep might be doing to your body

This lack of sleep has serious consequences on our well-being, as sleep deprivation is associated with heart disease, diabetes and depression.

So what helps us hit the hay? Here, sleep experts share their tips on how to create a positive sleep environment that will foster quality rest.

Turn off technology

Many of us like to “unwind” by watching TV before bed, or have a tendency to stream shows on our laptops while tucked in.

But according to Dr. Reut Gruber, a sleep researcher and associate professor in the department of psychiatry at McGill University, using gadgets before bedtime is hurting us.

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Gruber said that devices like laptops and phones put us in a state of “hyper-arousal,” which makes it hard for our bodies to prepare for sleep. Checking our emails before bed is a bad idea, too, as this may increase our anxiety — which is also a sleep killer.

Then there’s the light that devices omit.

“The light from our devices is really harmful,” said Beth Wyatt, a GTA-based insomnia coach. “Staring at those devices all day and all night is really not helpful in transitioning into a peaceful slumber.”

READ MORE: How to wake up early without hating your alarm clock

Research shows that light affects our internal clocks (or circadian rhythm), as exposure to light may suppress the production of melatonin — a hormone that helps us sleep.

To combat this, experts say it’s important to avoid bringing devices into the bedroom. If you use your phone as your alarm, keep it on silent and face down so no alerts can wake you.

Fabrics matter

Our body temperatures can affect how well we sleep, Gruber said, and running too hot in the night may wake us.

McGinn said that cotton bedding or other breathable fabrics are best for sleeping, as microfibers — like fleece or plush — keep heat in.

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What you wear to bed can also play a role in how well you sleep.

McGinn said pyjama styles are a personal choice, and knowing how hot or cold you get in the night can help you pick out the right pair.

“If you’re a person who tends to sleep hot, you really want to focus on natural fibres that are going to help with perspiration,” McGinn said.

“A lot of people think if they’re hot, it’s better to sleep in nothing, but what tends to happen is they end up sweating into their sheets and being in wetness — which isn’t comfortable.”

READ MORE: Super Awesome Science Show — Disturbed sleep

Dark, cool and quiet

The spring and summer months bring more hours of light — which is great for waking up but not so great for falling asleep.

Experts say your bedroom should be cool and dark, as both help promote rest.

“When you turn out the lights and cover the windows at night, it should be pitch black,” Wyatt said. “Even the smallest light can affect our sleep.”

She suggests black-out curtains and adjustable lighting. “Choose light bulbs that have a soft, warm glow to them instead of bright, fluorescent blue,” she added.

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If you’re someone who is bothered by noise, you may want to try a white noise machine, McGinn said. Or, in the warmer months, running a fan to help regulate temperature and noise.

“I find mornings are a lot louder in the spring and summer — birds are louder and chattier — so fans will help drown out those external sounds,” she explained.

Keep your bedroom clean

A cluttered room is not a sleep-positive room, experts say.

Gruber said your room should be “clear of anything that’s stimulating.” Research shows that clutter and mess can cause stress, and stress can hinder sleep.

READ MORE: Waking up early — are there benefits to being a morning person?

“An uncluttered, clean space is key,” Wyatt said. “When you’re looking out from your bed at all the things you need to get rid of, it’s not helpful.”

McGinn said it’s also important to keep our bedroom spaces for sleeping and sex only. The goal, she said, is to create a “sleep sanctuary” that promotes rest — not work.

“Our bedrooms can become our home office, our entertainment centre, our kids’ playroom … and we really want to work on strengthening that positive association between sleep and our bed,” McGinn said.

WATCH BELOW: Excessive sleep, lack of sleep can lead to cognitive impairment: study

Keep a sleep schedule

Going to bed at the same time and waking up at the same time fosters quality sleep, McGinn said.

Getting the right quantity of sleep — which is typically between seven to eight hours — is also key. “We really should be basing our bedtime off of our wake time, because when we wake in the morning is really dictated by our lifestyles,” McGinn said.

READ MORE: Why a regular bedtime is good for your health

This is especially important in the summer, McGinn said, as we often stay up later and get less sleep when the sun is out longer. “We all tend to go into the fall really sleep deprived.”

“Following consistently sleep patterns during the summer months can really help us start the new fall year better rested.”

Laura.Hensley@globalnews.ca

11 Habits That Can Actually Be Signs Of Mental Illness

Author Article

Ashley Batz/Bustle

While the signs and symptoms of different mental illnesses can be tricky to spot, it helps to consider how they might show up in the form of certain daily habits. By knowing what to look for, it can be easier to see these habits for what they really are, and even get some help. Because if they’re holding you back, or negatively impacting your life, then they very well may be something worth treating.

“A habit becomes a sign of mental illness once it hijacks your physical and/or mental well-being and interferes with your [life],” Dr. Georgia Witkin, Progyny’s head of patient services development, tells Bustle. “For instance, constant worry [can lead you] to make life-altering changes, such as not leaving the house,” which can impact your career, relationships, and hobbies.

These habits can take many forms, and will be different for everyone. But what you’ll want to keep an eye out for are habits that seem out of character, or ones that are making life more difficult. When that’s the case, “it’s worth a visit to a healthcare provider who can help to identify and address the underlying issue(s),” Susan Weinstein, co-executive director of Families for Depression Awareness, tells Bustle.

With that in mind, read on below for some habits that can be a sign of a mental health concern, according to experts.

1. Wanting To Spend More Time Alone

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“No longer wanting to see loved ones or participating in hobbies is indicative of mental illness,” Dr. Witkin says, with depression being one of the most likely culprits, since it can make it difficult to go about your usual routine.

That said, it’s always OK to take time for yourself, and hang out alone. But if you used to go out, see friends, or enjoy certain hobbies, it may be a good idea to reach out to a therapist, if you can no longer find the energy to do so.

2. Missing Work Or Appointments

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If you’re generally on top of your schedule, but have developed the habit of showing up late to work, calling out, or blowing off appointments, take note.

“Individuals [that] frequently disengage could be dealing with high anxiety, which often leads to avoidance, or possibly depression, which can lead to an inability to reach out,” Reynelda Jones, LMSW, CAADC, ADS, tells Bustle.

Even things like bipolar disorder, and other mental health issues, can make it difficult to get to work on time — or even get there at all.

3. Spending A Lot Of Money

Hannah Burton/Bustle

There’s nothing wrong with going shopping, or treating yourself to something nice. But for many people, excessive spending can be a sign of a health concern.

For example, “spending large amounts of money often manifests in an individual whose experiencing a manic episode,” Jones says, which is an aspect of bipolar disorder.

“Often the individual spends money beyond [their] financial means,” she says, only to feel really guilty or hopeless about how much they spent, once they come down from this phase. If this has become an issue for you, it may be time to ask for help.

4. Feeling Irritated & Picking Fights

Andrew Zaeh for Bustle

While it’s fine to have the occasional disagreement, acting in an excessively angry or cranky way, or picking little fights with others, isn’t a habit that should be overlooked.

“Anger and irritability, such as flying off the handle or constant grousing, can be signs of depression or bipolar disorder, particularly when they seem unprovoked and unusual for that person,” Weinstein says.

If these habits sound familiar, reaching out to a therapist may be a good next step, so you can figure out what’s going on.

5. Starting New Projects And/Or Businesses

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This is another habit that’s common among people who have bipolar disorder. But unlike folks who are starting businesses because they’ve thought it through and are thinking clearly, someone with this disorder might go forth with no concern to the risks they’re taking on, Jones says.

When someone is manic, they might also talk rapidly or jump from topic to topic, Dr. Indra Cidambi, psychiatrist and addiction expert, tells Bustle. Or they’ll take on too many things at once. Oftentimes, manic episodes are followed by periods of depression, which is when these grandiose plans can fall apart.

While it’s always great to learn new things, start new projects, and get excited about business ideas, this habit could mean something isn’t quite right.

6. Developing New Mannerisms

Hannah Burton/Bustle

“A shifting posture or gesture or even how we walk throughout our day can signal shifts in mood, which can often be a sign of mental health concerns or maybe even mental illness,” therapist Erica Hornthal, LCPC, BC-DMT, tells Bustle.

It could, for example, point to a mood disorder, since movement can be a “reflection of our emotional state and mental health,” she says. Think along the lines of new mannerisms, and other habits that seem out of character.

7. Misplacing Things

Andrew Zaeh for Bustle

Not being able to find belongings in a messy room, along with an inability to make decisions and forgetting things, can be a sign of depression, Weinstein says.

If this is a problem you’re struggling with, let a doctor know. They can help you figure out if it is, in fact, stemming from depression, and set you on the right course of treatment.

8. Staying Up All Night

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“Sleeping either too little or too much can be a symptom of a mental disorder,” Dr. Witkin says. “Often times, anxiety disorders cause insomnia or restless sleep, while depression causes oversleeping and eventual fatigue.”

In general, it’s healthy to sleep about seven to nine hours a night. If this is something you struggle to do, you may want to look into reasons why, including possible mental health issues.

9. Worrying About The Day Ahead

Ashley Batz/Bustle

While it’s common to feel a bit stressed or worried as you think about the day ahead, it might be a sign of anxiety if you worry to the point of distraction, avoid certain situations, or play out worst-case scenarios.

As Dr. Cidambi says, “Excessive worrying that is disproportionate to normal, everyday events is one important sign that one may be suffering from an anxiety disorder.”

10. Repeating Small Daily Rituals

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“Normal rituals we might all partake in that are a way to mark a change of pace for the day — such as kissing a [partner] goodbye, or checking to make sure that we have our keys or phone — are normal, and can be helpful rituals,” licensed clinical psychologist Dr. Scott Hoye, PsyD, tells Bustle.

But for folks with obsessive compulsive disorder (OCD), these habits can take over. Instead of locking your front door once, for example, you might lock it ten times, or even drive back home to lock it again.

That’s because this disorder can cause you to doubt yourself, perform rituals over and over again, or experience magical thinking. So when a habit has turned into an obsession, Dr. Hoye says it may be a sign of a mental health concern.

11. Needing A Drink After Work

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There’s nothing wrong with getting a drink after work, having wine with dinner, or hanging out at the bar. But if this habit has turned into something you need to do in order to relax, consider how it might be a way to mask symptoms of anxiety or depression, Dr. Hoye says.

It’s not uncommon for folks experiencing excessive worry, for example, to develop ways to relax, such as reaching for a drink. So if you’re concerned, don’t hesitate to let a doctor know.

It can be tough to spot these habits, and see them for what they are. But if you or someone else notices them, it doesn’t hurt to seek out the help.

By speaking with a therapist, you may realize that one of your habits was, in fact, a sign of a mental health concern. And in doing so, you’ll be starting the process of getting help and support, so you can get back to feeling better.

Editor’s Note: If you or someone you know is seeking help for mental health concerns, visit the National Alliance on Mental Health (NAMI) website, or call 1-800-950-NAMI(6264). For confidential treatment referrals, visit the Substance Abuse and Mental Health Services Administration (SAMHSA) website, or call the National Helpline at 1-800-662-HELP(4357). In an emergency, contact the National Suicide Prevention Lifeline at 1-800-273-TALK(8255) or call 911.`

Getting A Good Night’s Sleep Doesn’t Have To Be A Distant dream

Author Article

Phoebe Smith calls herself an extreme sleep adventurer. She’s been enlisted by a sleeptime app to be a storyteller for the sleep app calm.com. CALGARY

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A good night’s sleep is something we all cherish, but in our 24/7 plugged-in world, slumber can be as elusive as winning the lottery.

Millions of Canadians who settle into bed have a tough time staying in dreamland bliss.

If we were thinking outside the box spring, perhaps the remedy to staying asleep is doing what Phoebe Smith does. She’s a travel writer and self-described “extreme sleep adventurer.”

“I sleep much better when I’m in the wilds, more than in my own bed,” says Smith, who has slept inside a glacier, suspended in a hammock in a tree, and on mountaintops.

Phoebe Smith says she sleeps better in nature than at home in bed. She’s been enlisted by a sleeptime app to be as a sleepteller. ADAM PLOWDEN /CALGARY

Her stories of sleeping in exotic places, such as on the Trans-Siberian Railway train, so captivated Michael Acton Smith, co-founder of the sleep app calm.com, that he asked her to be the app’s Sleep Storyteller in Residence. The 17-and-counting stories she has written are read by the soothing voices of such celebrities as author Stephen Fry and  have been listened to millions of times. Other stories found on the app are read by famous names such as actor Matthew McConaughey and British singer-songwriter Leona Lewis.

Smith, like all of us, has moments of insomnia when she’s not on the road.

“When you’re back in your bed, you’re worried about paying bills … that phone call, those emails … for work. But in the wilds, everything is put in perspective.”

Sleeping in nature untethered to tech is not something most Canadians can do on a regular basis. Clinically significant insomnia, a disorder requiring medical help, affects about six to 10 per cent of Canadians, says Dr. Charles Samuels, medical director of the Centre for Sleep & Human Performance in Calgary.

But a larger proportion of the Canadian population — around 30 per cent — struggle to either fall sleep or stay asleep. One of the causes, says Samuels, is our addiction to technology, a significant issue for teenagers.

He predicts the problem will persist.

“It’s going to keep me in business until I’m dead,” says Samuels. “This is a serious thing that people don’t really acknowledge as serious.”

Late night computer and cellphone use is leading to widespread sleep disruption and insomnia. And it’s not just among teens. TERO VESALAINEN / GETTY IMAGES/ISTOCKPHOTO

Samuels and his team see teenagers daily with severe anxiety causing insomnia. “That is exacerbated by their attachment to technology. The fascinating thing is that when you confront them, they sort of say ‘What’s the big deal?’ ”

Many have “terrible behaviours,” like sleeping with phones under their pillow, alerts buzzing all night long. Phones expose them to light, but it is the constant interaction that is more “devastating,” in his view.

Samuels has done years of sleep research for several organizations, including law enforcement and elite athletes.  Educating people about the negative impact of technology can be a big learning curve, he says.

Insomniacs often go to bed earlier and earlier because of fatigue. But that only makes them more anxious because they just lay there, fueling the insomnia. To change the behaviour, Samuels says, people actually need to go to bed later and later.

“Once they do it, within seven days they improve. It’s counterintuitive. It’s about improving sleep efficiency.”

Although technology is a cause of sleeplessness, it also has a role in treatment. Many people use trackers which claim to determine the amount of REM sleep achieved. Although Samuels’ clinic uses evidence-based trackers customized to each patient, he’s a skeptic of commercial models.

“These trackers are based on technology that uses movement to articulate sleep stage, but it has not been validated.”

They can be counterproductive. If a tracker indicates you only got four hours of sleep, it can cause more sleep anxiety. Other trackers feed information into an application and offer advice about how to improve sleep.

“If it’s helping a person, (then) fantastic,” Samuels says. “If not, (then) they really need to be seen by a sleep physician to be evaluated or their primary care doctor.”

He says Sleep IO and Shut-Eye are two commercial brands that have been studied and proven to be equally, if not more, effective than one-on-one treatments.

Bear in mind, he says, the foundation of treating insomnia is through behavioural therapy. It addresses the hyper-arousal afflicting people with insomnia — the inability to unwind, which some people are genetically predisposed to.

But what about sleep apps with dreamy stories, meditations and music, like calm.com or Headspace? Samuels says if it works for you, “Hallelujah, off you go.

“But that doesn’t mean it’s a pill for your insomnia. It just means you can relax and maybe that will improve your sleep. If you’re relaxing and still adopting poor sleep behaviours, it’s not going to work.”

Woman lying in bed suffering from insomnia. Getty Images/iStockphoto KATARZYNABIALASIEWICZ /GETTY IMAGES/ISTOCKPHOTO

The process of mindfulness — the practise of being in the present moment through meditation — is also gaining proponents among doctors, used to help insomnia and other illnesses.

Dr. Nikhil Joshi, a physician, author and speaker, has developed an app called Medical Meditation, a guided series for a variety of conditions, including insomnia. It will be available in April.

Mindfulness is the idea that the brain is very active and always producing rational thoughts. “We have to slow down the part of the mind that is creating active thought. We need to evoke a change in our brainwaves to get a more restful sleep,” says Joshi, a Calgary-based doctor.

“Meditation is about preparing your mind for a deeper rest, activating a different part of the brain that is usually active in our day to day life.”

The irony that we’re using technology to treat insomnia isn’t lost on Joshi. “We … have to recognize that the improper use of technology can lead to emotional issues. But proper use of technology can help solve those issues. It’s a double-edged sword.”

Samuels says bedtime rituals are also important.

“The idea people have in their heads is, ‘I should just be able to fall asleep.’ No. That’s not the way the brain works.”

Obviously, it also means getting off tech.

“I tell people to put it away at 5 o’clock,” he says. “Of course, people are appalled.”

11 Fascinating Things It Means If You Need More Than 8 Hours Of Sleep

Author Article

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There are many things it could mean if you need more than eight hours of sleep per night. In some instances, snoozing the day away could be a sign of a health issue, such as an underlying infection or a mental health concern — which could keep you in bed past the typical sleeping times. But those aren’t the only things that could lead to an increased need for sleep.

“Doctors recommend that all adults get between seven and nine hours of sleep on a nightly basis,” Bill Fish, certified sleep science coach and co-founder of Tuck, tells Bustle “That variance depends on each individual, but if you aren’t getting at least seven hours of sleep, you are considered sleep deprived. That said, there are also times that we might need more sleep than our normal routine.”

If you have a cold, for instance, you’re going to need more sleep than usual as you recover. And the same may be true if you’re going through a difficult time in life, experiencing depression, if you’ve been exercising more than usual, and so on. It’s important to listen to your body, and get the rest you need. But it’s also a good idea to let a doctor know if you can’t get out of bed, or if you don’t feel well-rested.

Read on below for some possible reasons why you need more than the recommended eight hours of sleep per night, according to experts.

1. It’s In Your Genes

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If you need more than eight hours of sleep each night, you might want to thank your DNA. “Some folks are just genetically inclined to need more sleep,” Matthew Ross, co-founder and COO of The Slumber Yard, tells Bustle. “Not every person shares the same sleep patterns and circadian rhythms.”

2. Depression & Other Mood Disorders

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If you have a mental health concern, like depression, there’s a good chance it’ll impact your sleep one way or another.

Depression can cause a desire to sleep too much, or it may cause insomnia,” Rose MacDowell, chief research officer at Sleepopolis, tells Bustle. “People with bipolar disorder might sleep too much during the depressive phase and too little during the manic phase.”

If you happen to notice any changes either way, it can help to let a doctor know.

3. Hypersomnia

Mladen Zivkovic/Shutterstock

“Hypersomnia is a classification of sleep disorders that includes narcolepsy, probably the best-known form of hypersomnia,” MacDowell says. And this can result in an increased need for sleep.

“Narcolepsy is caused by an autoimmune reaction that damages hypocretin, the brain chemical responsible for feeling awake and alert,” MacDowell says. “People with hypersomnia can sleep up to sixteen hours a day and still feel the need to nap.”

4. Restless Legs Syndrome

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Sleep disorders that make it difficult to rest properly, such as restless legs syndromeand sleep apnea, can also cause you to need more sleep.

“Because both sleep disorders interrupt or prevent sleep,” MacDowell says, “sufferers may feel excessively sleepy during the day and spend an unusual amount of time asleep.”

The best thing to do, if you think a sleep disorder is to blame, is to make an appointment with your doctor. There are ways to overcome such issues, and get the sleep you need.

5. Medication Side Effects

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Some medications list sleepiness as a side effect, including “antihistamines, found in certain cold, motion sickness, and allergy medications,” MacDowell says. “Antihistamines cause sleepiness by blocking the effects of the brain’s natural histamines, which regulate wakefulness and sleep.” But other medications can do this, too. If you feel sleepier than usual, let your doctor know so they can help adjust your dosage, or switch you to a new medication that won’t be as intense.

6. Chronic Illnesses

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Unexplained fatigue is one of the many symptoms of a chronic illness. “Common conditions include fibromyalgia, hypothyroidism, anemia, and rheumatoid arthritis,” Ross says. “People who suffer from conditions that result in fatigue and pain often require more sleep in order for their bodies to properly rest and recover.”

7. Colds & Infections

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“If we are fighting some sort of cold or sickness, our bodies can become drained [from] exerting more energy than normal to fight the virus, and we may require more sleep than normal as we recuperate,” Fish says. When an illness is to blame, you’ll want to make time to get all the extra rest you need, until you feel better.

8. Exercise

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Have you been getting more exercise than usual? If you’ve just started running, training for a marathon, or lifting weights, and your body isn’t accustomed to this new physical exertion, Fish says you may need more sleep than usual until your body adjusts.

9. Trauma

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“One of the most common causes of acute (temporary) insomnia is stress and/or a traumatic event,” sleep expert and author CM Hamilton, tells Bustle. If you’ve recently been through a traumatic event — a breakup, a death in the family, etc. — you may be sleepless at first, and then super exhausted as your body recovers.

10. You’re Young

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Young people tend to need more sleep than many older folks would deem appropriate. And yet, younger people require more sleep for a reason.

“Teenagers’ brains are developing at rapid rate and therefore require additional sleep, when brain development takes place,” Riki Taubenblat, a pediatric sleep consultant, tells Bustle. So if you’re young, snag that sleep while you still can.

11. Sleep Deprivation

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“The most common reason to need more sleep than usual is because your body is trying to repay a sleep debt, which comes after a few days or weeks of consistent sleep deprivation,” Taubenblat says. If you haven’t been getting those seven to nine hours, you will feel tired — and need more sleep.

To catch up, try sticking to a more consistent schedule, where you go to bed and wake up at the same times each day. Eventually, your body will fall into a pattern, and you’ll hopefully feel more rested.

It is OK, though, if you need a little more or a little less sleep than the average person each night. But if you’re sleeping ten hours or more, or don’t feel rested, let a doctor know so they can help uncover the reason why.

Editor’s Note: If you or someone you know is seeking help for mental health concerns, visit the National Alliance on Mental Health (NAMI) website, or call 1-800-950-NAMI(6264). For confidential treatment referrals, visit the Substance Abuse and Mental Health Services Administration (SAMHSA) website, or call the National Helpline at 1-800-662-HELP(4357). In an emergency, contact the National Suicide Prevention Lifeline at 1-800-273-TALK(8255) or call 911.

Emotional Neglect In Childhood Predicts Higher Levels Of Insomnia In Young Adults

Author Article

New research has found a link between childhood emotional neglect and insomnia. The findings appear in the journal Frontiers in Psychiatry.

Previous research has found a strong link between childhood maltreatment and depression. “Importantly, sleep disturbance may be one critical mechanism through which individuals exposed to maltreatment are vulnerable for recurrent depressive episodes. Indeed, sleep complaints are among the most common residual symptoms of depression,” the authors of the study explained.

The researchers surveyed 102 young adults with a history of clinical or subclinical depression regarding childhood trauma, recent life stressors, and anxiety symptoms. The participants also completed a daily measure of depressive symptoms and kept a sleep diary for 2 weeks.

They found that young adults who experienced more childhood emotional neglect reported more difficulty falling and staying asleep, even after controlling for factors such as daily depressive symptoms, recent stress, anxiety, other forms of childhood maltreatment, and several demographic factors.

In other words, participants who did not feel loved or looked out for by their family as children tended to report higher levels of insomnia symptoms.

“Thus, our results highlight a distinct relationship between emotional neglect during childhood and difficulties initiating and/or maintaining sleep as young adults, which is important given that emotional neglect is one of the most prevalent forms of maltreatment,” the researchers said.

Emotional neglect may contribute to insomnia symptoms by depriving individuals of sense of safety, leading to heightened psychophysiological arousal, they explained.

Emotional neglect, however, did not predict sleep duration. But this could be due to the fact that the researchers relied on the participants to keep track of when they went to bed and woke up in the morning, rather than more objective measures of sleep like a wrist-worn actigraph that monitors physical activity.

“Our measure captured time in bed, which may not be the most accurate representation of time spent asleep,” the wrote.

The study, “Childhood Trauma and Sleep Among Young Adults With a History of Depression: A Daily Diary Study“, was authored by Jessica L. Hamilton, Ryan C. Brindle, Lauren B. Alloy, and Richard T. Liu.

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