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Insomnia: Symptoms, causes and treatment of sleeplessness


What happens when you can’t sleep? Chances are you toss and turn in bed, trying very hard to force yourself to relax. And the more you do so, the more you worry about how long you’ve been awake, painfully aware of how this is reducing your sleep time. And so, you’re now dealing with additional worries: about how little sleep you will have had, how tired you will be the next day, how this may affect not only your performance at work, but also your health…


Insomnia may be caused by a variety of causes. It may come from poor sleep habits. It may also have to do with underlying medical problems, or be a manifestation of anxiety or some forms of depression. A widespread notion is that insomnia is caused by worries. While some sleep experts agree with this, not all do.

Dr. Bonnet, director of the sleep laboratory at the Dayton Veterans Affairs Medical Center, believes insomnia reflects the fact that insomniacs have higher heart rates and body temperatures: "Their furnace is turned up higher".

Dr. Perlis, director of the sleep research laboratory at the University of Rochester, also sees insomnia as a predisposition rather than the result of excessive worrying. "Some people say you are awake because you are worrying. I would say you are worrying because you are awake."

Source: The New York Times (1/13/04)

The rest of this article describes simple steps you can take to improve your sleep.


If you have trouble sleeping, the first thing to do is to see whether your habits may be what's hindering sleep. The following simple suggestions constitute good sleep hygiene:

- Avoid stimulants like caffeine late in the day

- Keep a regular bedtime

- Limit the light in the bedroom

- Do not do work or watch TV in bed

- Take a moment to relax instead of rushing into bed while still tense


Let's now talk about managing sleeplessness. Think of this as an experiment that you can conduct over the next 4 to 8 weeks. If you see an improvement in the quality and duration of your sleep, and in your well-being, then continue following this program. If you don’t, then it would make sense to step up and investigate possible underlying medical or emotional problems.

People traditionally measure improvement by one yardstick: the ability to reduce nighttime wakefulness (time you are awake during the night. While this is the end-goal, it is not a good idea to focus on it early on, as it will probably just result in creating a vicious cycle (feeling powerless, worrying, and even less able to fall asleep).

Instead, I suggest you focus on an intermediate goal, which is to improve sleep efficiency (the proportion of time spent asleep relative to the total time in bed).

This approach is counter-intuitive. Instead of forcing yourself to stay in bed while you can’t sleep, you will be limiting the time you spend in bed to just about the hours that you’re actually sleeping. The goal is to first consolidate sleep. Then, keeping as a benchmark these more limited hours of sleep that you actually sleep, let sleep time expand organically and gradually.

What to do:
Get out of bed if you are awake and are unable to return to sleep for more than 15 minutes


See also:

- Stress management

- Proactive counseling



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