"Darkness falls across the land. The midnight hour is close at hand. Creatures crawl in search of blood, to terrorize y'all's neighborhood." - Micheal Jackson's Thriller.
What better way is there to describe my insomnia? It is true, I am a crawling creature. Though
I don't wonder around neighborhoods looking for blood at 2 am, I do feel like a zombie on occasion. Thanks to dictionary.com, I now have the perfect zombie name for myself on those days when I have only seen the back of my eyelids for 2 hours. Yes! You can call me Stampcrab. (Google it).
With Halloween close at hand, let's discuss this crazy habitual sleeplessness that causes millions of folks to amble around in a sleep deprived, coffee addicted, somewhat to highly functional state of daily existence. It is nice to know I am not alone in zombie land. Insomnia is a very common medical complaint in the US. According to Ford et al. (2014), 5.5 million people complained about insomnia as a reason for their clinic visit in 2010, but we know millions more suffer from insomnia. The CDC reports approximately 50-70 million folks in the US have insufficient sleep. Phew! That's a lot of winkless/restless nights.
What is insomnia? Well, according to an overview provided on Up-to-Date, insomnia is defined when these three criteria have been met:
1. Complaint of difficulty:
- getting to sleep
- staying asleep
- waking up too early
2. Difficulty sleeping exists even though there is sufficient opportunities and time
3. Impaired sleep causes deficits in daytime function.
When you are tossing and turning at night, think about this: Which type of insomnia do you have?
1. Short-term (less than 3 months): usually related to current stressors such as pain, grief, anxiety. Once the stressor is identified and controlled, typically a healthy sleep pattern will return.
2. Chronic insomnia (greater than 3 months): This is not related to lack of time for adequate sleep. This may develop if stressors, whether environmental, physical, or emotional, are not controlled. Chronic insomnia is further defined by lack of sleep at least 3 times a week for weeks over several months to years.
3. Other insomnia: This is the "everyone else" bucket. Reserved for those who have a hard time falling asleep and/or staying asleep but do not quite fit the criteria for short-term or chronic insomnia.
So, for those who have experienced insomnia, really, we don't need it defined, we live it. What we are interested in though, is how we can actually sleep like a North America Opossum (average sleep time 18 hrs daily) and feel alive throughout the day.
There are many recommendations to help bring us back to sleep and wake us up to life. Start by visiting your provider to discuss possible causes of your insomnia. Some health conditions, like obstructive sleep apnea, can be life threatening if not corrected! Once a serious health condition is ruled out, there are several things suggested that actually work when we turn them into habits. We would try these prior to using medicinal sleep aids.
1. Sleep Hygiene: The National Sleep Foundation provides a great list of actions that help improve sleep. Some things we can change include avoiding those mid-afternoon caffeinated drinks, alcoholic beverages before bed, naps during the day, and smoking before bed. We can also turn off our digital devices and avoid peering at them through the night. https://sleepfoundation.org/sleep-topics/sleep-hygiene/page/0/1
2. Stimulus control: Try to avoid going to bed until sleepy, While laying in bed, do not read, watch tv, or eat. If awake for more than 20 minutes while in bed, then leave the bedroom and sit in a comfortable chair in the living room. Try to relax through listening to light music or reading during this time (remember: don't do this in bed). Avoid turning on the television or eating.
3. Relaxation: Try relaxing the muscles all over the body starting with the face and moving downward. Use deep breathing exercises to help relax the muscles and the mind. Keep your eyes closed.
4. Sleep restriction therapy: This sounds even more tiring but it has shown some benefit where other therapies may not have worked. Again, for more details on this, click on the link provided: http://sleepdisorders.sleepfoundation.org/chapter-2-insomnia/cbt-overview/cbt-sleep-restriction/ . This is a little bit more in depth than this blog.The National Sleep Foundation is full of wonderful information all of us insomniacs can use to try for a better night's sleep.
If all else fails, after we have diligently tried to change our sleeping habits, it is time to discuss some other options with our providers. There are several
safe and effective over-the-counter sleep aids such as melatonin, unisom, and valerian. Some sleep aids contain diphenhydramine (the ingredient in Benadryl). Many of these will help with falling asleep but they may not prevent sleep interruption or early wakening. They also have associated side effects that can linger throughout the next day. Your provider may consider prescribing a sleep aid such as Ambien or Lunesta. These may become habit forming and the longer they are taken, the more resistance can build in the body making these medications ineffective. They also could have some pretty significant side effects such as hallucinations, delerium, daytime somnolence, and increased falls. Any sleep aid should be use with extra caution in the elderly population.
I know none of us will truly sleep like the North American Opossum, but how much sleep do we really need? The following recommendations have also been provided by the National Sleep Foundation:
65 years and older need 7-8 hours of sleep.
26-64 years old need 7-9 hours of sleep.
18-25 years old need 7-9 hours of sleep.
14-17 years old need 8-10 hours of sleep. (ahhh, how I miss those days).
6-13 years old need 9-11 hours of sleep.
3-5 years old need 10-13 hours of sleep.
1-2 years old need 11-14 hours of sleep.
4-11 months old need 12-15 hours of sleep.
0-3 months old need 14-17 hours of sleep.
If only our brains would be quiet! The proper amount of sleep definitely decreases incidents of depression, anxiety, fatigue, and chronic illness. Sleeping well enhances overall cognitive function, energy, and well-being.
Okay, wake-up, this blog is almost over! Now that we have been given the tools and knowledge needed to sleep better, let's do this. Easy peasy, right? We have been cured! De-zombified! I would like to read about some of your stories in dealing with insomnia. They can be funny ones, scary ones, or ways you have improved your insomnia. Please feel free to comment below and let us all know your zombie story.
Ford, E.S., Wheaton, A.G., Cunningham, T.J., Giles, W.H., Chapman, D.P., Croft, J.B. (2014, August 1). Sleep. 2014;37(8):1283. Epub 2014 Aug 1.