America is increasingly sleepless.
It’s no surprise. Insane politics and politicians cause many sleepless nights. But insomnia can be caused by sleep apnea and shift work; hypothyroidism and hyperthyroidism; depression and anxiety; alcohol and marijuana; chronic lung disease and congestive heart failure. Just as there hundreds of causes of insomnia, most people who suffer sleeplessness do so from multiple causes. The COPD patient is put on drugs that aid breathing, but stimulate both the heart and arousal. The heart failure patient is given medications like beta-blockers that decrease heart work, but commonly wake folks up. The shift worker has a fall that adds shoulder and back pain to biological clock reasons to keep her awake. Worse, virtually anyone who can’t sleep can develop psychophysiologic insomnia – a fear and concern with sleeplessness that can induce insomnia all by itself.
So what is one to do?
Recently cognitive-behavior therapy of insomnia (CBT-i) has been endorsed by national clinical groups and experienced a boom in net based therapies. Some meta-analyses declare the net based treatments as good as the face-to-face versions; others find results that are opposite. But there’s something almost anyone can do when faced with sleeplessness.
So here are a few ways to get to sleep, even when you’ve got half a dozen causes for insomnia:
1. Get up at the same time every day. Yeah, lots of people tell me that’s impossible. Shift workers can’t if they want to keep their jobs. Kids’ school schedules conflict with getting to work. Getting up to an alarm “violates my freedom,”others tell me.
Tell your biological clocks that. Time rules life. Pretty much all life on this planet.
Over hundreds of millions of years we have been built to internally respond to the shift of sun and moon, stars and seasons. There’s a 24 hour clock in every cell. When people get up at the same time every day, they anchor their biological clocks in a place that makes them work right.
Do you want your car engine to work without a timer? There’s plenty of evidence that blowing out your inner clocks leads to multiple diseases, weight gain, increased risk of infection, and early death. Don’t you want to listen to your body when it tells you it’s time to sleep?
Well, it can’t do that if it doesn’t know the time. To make everything work better, try also to go to bed at a standard hour. That really helps keep biological clocks healthy.
There will be plenty of obstacles. Shift-workers can try to keep to schedules for the days they’re on and off work. Parents can remonstrate with athletic coaches who want their kids practicing in the early morning hours when injuries are more likely. College students can tell school administrators they don’t want cookies and ice cream “meet and greet” sessions that begin at midnight.
You’ve got to start somewhere. We need sleep like food. Clocks control when you sleep. They’re innate.
Let them help you. Please don’t fight them.
2. Get light. Light is one of the most abundant drugs on the planet. Light can work better than prozac to treat depression. Light increases alertness, literally enlightening us. Exercising in light may make for bigger muscles. Light quickly turns on different parts of the immune system.
Light is the biggest zeitgeber, or “time giver” in our biological clocks system. People who get morning light sleep better. They have better moods. They wake up faster – and many of us can take one or two hours to fully wake up.
And if you live in northern Alaska, you can buy a nice lightbox for 50 bucks to replace a fitful sun. Light is a drug. Make it one of your drugs of choice.
3. Make a list of all the drugs you take and check each of their capacities to induce sleeplessness. Preferably you’ll do that with your doctor, though some useful information, along with much misinformation, can appear on the Net.
When I write drugs I mean all drugs. Not just prescription drugs, but the stuff you ingest that acts as information molecules that might change your sleep. That includes everything over the counter, including all those supplements that promise youth, beauty, better skin and thinner thighs. Don’t forget the alcohol served at dinner, the chocolate in the dessert éclair, the “cool” smoothie laced with caffeine-like alkaloids, the cigarettes and marijuana you like to smoke. Your body is an information system. Sleep is a third of your life. Most of the things you ingest can affect your sleep.
The great French gastronomist Brillat-Savarin said “tell you me what you eat and I’ll tell you what you are.” Replace “eat” with “ingest” and he wasn’t that far wrong.
4. Move. Your body is built to walk, to saunter, to roam and climb. If your legs don’t move, use your arms. If you can’t afford any athletic machine, put a book (preferably not one of mine, though they work fine) in front of your TV set. Step on it as you watch great hits of the 1960s or Oscar losers. If tied to a desk at work, briskly walk over to the bathroom. If stuck inside, use the stairs for short bouts of interval training.
The fitter you are, the better you’ll sleep. Many possible forms of exercise are part of everyday life. Use them whenever you can.
5. Write. Train your brain to think in terms of solutions, not just problems.
Cognitive-behavioral treatment works for lots of stuff besides insomnia. It can aid treatment of anxiety. It’s probably the best therapy for depression in the world. A third of Americans will end up depressed.
But cognitive-behavioral therapy can also become part of a worldview that can help you get through lots of stuff each and every day.
The world looks scary right now. All the more reason to think of ways to solve the problems we face.
So writing down problems – and their plans for resolution – can do a lot more than aid sleep. We can train our brain to see what can be done to fix things, including intractable problems like insomnia. And by writing a few minutes every day, relentlessly looking for possible solutions, evaluating what worked and what didn’t, creating Plan B and Plan C and Plan D, we can see ways to help ourselves and the people around us we have not thought of before.
So helping yourself get to sleep can do more than help your body feel rested and alert. It can make you see and deal with the world in a different, better way.
Which provides hope. Sleeplessness can shatter hope.
It’s time to return hope to the night.