Insomnia

What it is

Insomnia is the inability to fall asleep, go back to sleep after waking up, or both. It also can be associated with waking up too early and unrefreshing sleep. Chronic insomnia is when this occurs several days per week for months … or longer. Insomnia can be caused by many factors (discussed below).

Misconceptions

  • Going to bed earlier to create more time to fall asleep will help you get more hours of sleep - FALSE! Often, this is a behavior that makes insomnia worse, leading to more hours in bed awake!

  • I’ve tried everything! I’ve kept my room cool and dark, I go to bed at the same time every night, I don’t use electronics near bedtime, I’ve eliminated blue light, I’ve cut out alcohol and caffeine. This is NOT everything! These are called “sleep hygiene.” Sleep hygiene is meant to prevent developing insomnia, not to treat it. To put it another way, it's like getting a flu shot while you have the flu already … it’s too late for that!

The Nuts & Bolts

  • Chronic insomnia is a very common ailment, affecting 10-15% of the adult US population.

  • While somewhat more common in women, insomnia is not gender specific.

  • Many different things can cause/contribute to insomnia: stress, psychological trauma, medical ailments (both sleep disorders and others), medications, environmental factors, and others.

  • Often, insomnia is a “Pavlovian Response,” or “Conditioned Response.” Do you remember Pavlov’s Dog? The experimenter links the conditioned stimulus (the bell) to the unconditioned stimulus (the food) so that the dog’s brain associates the bell with food.

Top left: dog sees and smells food - dog drools. Top right: dog hears bell - no reaction. Bottom left: dog sees and smells food while bell is ringing - dog drools. Bottom right: dog hears bell - dog drools.

Top left: dog sees and smells food - dog drools. Top right: dog hears bell - no reaction. Bottom left: dog sees and smells food while bell is ringing - dog drools. Bottom right: dog hears bell - dog drools.

  • Insomnia is similar. The bed is the conditioned stimulus (the bell). The inability to sleep due to some external force (e.g., stress) is the unconditioned stimulus. Over time, the subconscious brain associates the bed with the inability to sleep. This is why sometimes you might feel like you’re ready to sleep, you get up to go to bed, and by the time you’ve gotten to your bed, you’re now wide awake and your mind is racing.

  • The fight-or-flight mechanism has kicked in. Your endocrine system has started dumping stress hormones into your bloodstream, so now you’re ready to fight or flee … except you’re trying to sleep. This mechanism increases the heart rate, heightens alertness, and activates the mind - exactly the things you don’t want when you’re TriNa Sleep! (Sorry I couldn’t help it - it’s the nickname of the company!)


The Symptoms

  • Sleeplessness - Duh! It’s the main feature. Nonetheless, the list has to start here.

  • Fragmented sleep - Fragmented sleep is a hallmark of many sleep disorders, but it is a common occurrence in chronic insomnia.

  • Fatigue - There is a difference between “sleepiness” and “fatigue.” Both a sleepy person and a fatigued person will welcome a couch to lie down on. The sleepy person will go to sleep, while the fatigued one will stay awake and lie there “resting.”

  • Racing thoughts - As stated above, the fight-or-flight mechanism can activate the mind, leading to rapid thoughts.

  • Catastrophizing - “I can’t sleep. If I can’t sleep, I won’t be functional at work tomorrow. I might fall asleep driving and get into a car accident. I’ll mess something up at work. I might get fired. We’ll have no income. We could lose the house …” Ever have this happen at 3 a.m.? This is called, “catastrophizing.” You’re not alone. It’s a common thing in insomnia.