Lately, I’ve been having some awful problems with insomnia. One of my jobs involves staying overnight with a young man who has a Pervasive Developmental Disorder. I’m allowed to grab a few hours of sleep on a loveseat in the living room, but it’s not terribly comfortable. I shouldn’t complain, as the discomfort wakes me up early enough to finish the housecleaning. Then again, I’m sometimes nonfunctional for the rest of the day.
Depression and anxiety are at the roots of my insomnia (along with that uncomfortable loveseat). I’ve found that sleep deprivation feeds my depression, just as depression makes it harder to sleep well.
Even before I began working the overnight shift, I often had trouble falling asleep. Too many thoughts–sometimes excited and positive, more commonly worried about the next day’s events or the repercussions of the day just past.
Recent studies suggest that up to 40% of people in the United States experience insomnia at some point. Through absenteeism and lost productivity, insomnia is said to cost the U.S. $63.2 billion per year. If you experience insomnia like I do, know that we’re in good company.
Symptoms and Causes of Insomnia
Insomnia is the term covering a few different kinds of sleep problems: most commonly, difficulty falling asleep, difficulty staying asleep, or early waking without a return to sleep. Medical issues can cause it, and it is a common symptom of mental illnesses such as Major Depression, General Anxiety Disorder, and Asperger’s Disorder.
Medications can also cause insomnia. Selective Serotonin Reuptake Inhibitors (SSRIs) such as Zoloft (sertraline), most ADHD meds, thyroid medication, and the herbal medicine St. John’s Wort have the potential side effect of insomnia.
Of course, insomnia is a defining feature of bipolar mania and sometimes of psychosis, but those are special circumstances we’ll not be addressing in this article.
For most people, stress is the culprit. Common stress from work, family, social life, or any other facet of human existence, if there’s enough of it, can make the body uncomfortable, the mind disturbed, and the brain chemicals unbalanced. Even a “normal” brain takes on an abnormal character. Irritability increases, reason declines, and emotions are labile. Imagine what chronic insomnia does to those of us who are already chronically mental. (Unfortunately, many of us don’t have to imagine.)
Fighting Insomnia
Stress is common to both the Differently Brained and to “normal” folk. Reducing stress is an important part of countering insomnia. Exercise (no later than a few hours before bed), meditation, breathing exercises, and other stress reduction techniques can be incorporated with relative ease into our daily schedule.
Routine is also very important to sleep regulation. Going to bed at the same time every day, when possible, is a big part of this, as is waking up at the same time every day. Routine dinner (a few hours before bed) and snack (light) times, routine medication times, and a cut-off for caffeine several hours before bed will help. Reading, taking a warm bath, or listening to calming music just before bed can both relax us and psychologically trigger the beginning of our sleep process, if we do it the same way daily.
The environment in which we sleep plays an enormous role in our quality of sleep. Make sure the room is dark and quiet and that the bed is warm and comfortable. “White noise” machines can help drown out both environmental noise and the noise in our head.
Some say writing lists can help when thoughts are running nonstop in our brains: To-Do Lists for next-day worries, Gratitude Lists for past regrets and negative thinking. Of course, there are all kinds of folk remedies and helpful tricks for insomnia, many of which can be found here.
Brain Chemicals and Insomnia
The hormone responsible for sleep is called melatonin. There are melatonin supplements available that encourage regular sleep. We can also increase our melatonin by increasing our serotonin–the major neurotransmitter deficient in depression. Nutritionally, we can increase serotonin and melatonin with enough tryptophan (an amino acid), vitamin B6, magnesium, and vitamin D. A balanced diet is essential for this.
Melatonin may take a few days of daily use before enough builds up in our systems to show results. In combination with a routine and an environment that support sleep, melatonin is a highly effective sleep aid with few or no side effects, since it is found naturally in the body. Anecdotal evidence supports melatonin supplements as a good solution for people who work third shift and must sleep during the day.
Insomnia can rob us of clarity and calm and exacerbate the symptoms of our mental illnesses. Improving sleep will improve our mental and emotional state during waking hours. Self-care is the key to ensuring that we have a good night’s sleep and a good day to follow.