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  • What keeps you up at night?

  • Pondering deep questions?

  • Excitement about a big trip?

  • Or is it stress about unfinished work,

  • an upcoming test,

  • or a dreaded family gathering?

  • For many people, this stress is temporary, as its cause is quickly resolved.

  • But what if the very thing keeping you awake was stress about losing sleep?

  • This seemingly unsolvable loop is at the heart of insomnia,

  • the world's most common sleep disorder.

  • Almost anything can cause the occasional restless night -

  • a snoring partner,

  • physical pain,

  • or emotional distress.

  • And extreme sleep deprivation like jetlag can throw off your biological clock,

  • wreaking havoc on your sleep schedule.

  • But in most cases, sleep deprivation is short-term.

  • Eventually, exhaustion catches up with all of us.

  • However, some long-term conditions like respiratory disorders,

  • gastrointestinal problems, and many others can overpower fatigue.

  • And as sleepless nights pile up,

  • the bedroom can start to carry associations of restless nights wracked with anxiety.

  • Come bedtime, insomniacs are stressed.

  • So stressed their brains hijack the stress response system,

  • flooding the body with fight-flight-or-freeze chemicals.

  • Cortisol and adrenocorticotropic hormones course through the bloodstream,

  • increasing heart rate and blood pressure,

  • and jolting the body into hyperarousal.

  • In this condition, the brain is hunting for potential threats,

  • making it impossible to ignore any slight discomfort or nighttime noise.

  • And when insomniacs finally do fall asleep,

  • the quality of their rest is compromised.

  • Our brain's primary source of energy is cerebral glucose,

  • and in healthy sleep, our metabolism slows to conserve this glucose for waking hours.

  • But PET studies show the adrenaline that prevents sleep for insomniacs

  • also speeds up their metabolisms.

  • While they sleep, their bodies are working overtime,

  • burning through the brain's supply of energy-giving glucose.

  • This symptom of poor sleep leaves insomniacs

  • waking in a state of exhaustion, confusion, and stress,

  • which starts the process all over again.

  • When these cycles of stress and restlessness last several months,

  • they're diagnosed as chronic insomnia.

  • And while insomnia rarely leads to death,

  • its chemical mechanisms are similar to anxiety attacks

  • found in those experiencing depression and anxiety.

  • So suffering from any one of these conditions

  • increases your risk of experiencing the other two.

  • Fortunately, there are ways to break the cycle of sleeplessness.

  • Managing the stress that leads to hyperarousal

  • is one of our best-understood treatments for insomnia,

  • and good sleep practices can help rebuild your relationship with bedtime.

  • Make sure your bedroom is dark and comfortably cool

  • to minimizethreatsduring hyperarousal.

  • Only use your bed for sleeping,

  • and if you're restless,

  • leave the room and tire yourself out with relaxing activities

  • like reading,

  • meditating,

  • or journaling.

  • Regulate your metabolism by setting consistent resting and waking times

  • to help orient your body's biological clock.

  • This clock, or circadian rhythm,

  • is also sensitive to light,

  • so avoid bright lights at night

  • to help tell your body that it's time for sleep.

  • In addition to these practices,

  • some doctors prescribe medication to aid sleep,

  • but there aren't reliable medications that help in all cases.

  • And over-the-counter sleeping pills can be highly addictive,

  • leading to withdrawal that worsens symptoms.

  • But before seeking any treatment,

  • make sure your sleeplessness is actually due to insomnia.

  • Approximately 8% of patients diagnosed with chronic insomnia

  • are actually suffering from a less common genetic problem

  • called delayed sleep phase disorder, or DSPD.

  • People with DSPD have a circadian rhythm significantly longer than 24 hours,

  • putting their sleeping habits out of sync with traditional sleeping hours.

  • So while they have difficulty falling asleep at a typical bedtime,

  • it's not due to increased stress.

  • And given the opportunity,

  • they can sleep comfortably on their own delayed schedule.

  • Our sleeping and waking cycle is a delicate balance,

  • and one that's vital to maintain for our physical and mental wellbeing.

  • For all these reasons,

  • it's worth putting in some time and effort

  • to sustain a stable bedtime routine,

  • but try not to lose any sleep over it.

What keeps you up at night?

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B2 H-INT US sleep insomnia stress bedtime sleeping waking

What causes insomnia? - Dan Kwartler

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    Anita Lin   posted on 2018/08/16
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