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Marilyn
Monroe, Winston Churchill,
and Napoleon Bonaparte
You
may likely share the experience of insomnia with these three
notables –
each in his or her own field of endeavor a high achiever. As millions
of Americans know, insomnia can be a significant impediment to maintaining
a balanced and healthy lifestyle. And, as you may personally know,
a poor night’s sleep can severely compromise your productivity
and satisfaction in the workplace the next day.
THREE
SCENARIOS OF INSOMNIA
Do
any of the following
scenarios describe your
sleep?
Scenario
1: Bedtime
Perhaps
as Marilyn Monroe experienced, you’re in bed, in your
bedroom, and your alarm clock confirms that it’s bedtime. You’ve
made all of your usual preparations for bed, you’ve locked your
house
for the night, you can taste the aftertaste of toothpaste in
your mouth, you’ve
tried to wind down, and you’ve turned off the lights.
But,
though you’ve been exhausted all day and the stage is
now set for relaxing to sleep, you feel, with dread and frustration,
a sense of being too mentally alert and too physically keyed
up to relax. You
think, "Here we go again,,
another tough night of getting to sleep, and another endless
day tomorrow.
Scenario
2: Middle of the Night
You’re
in bed, and your alarm clock unpleasantly informs you that
it’s 2:30 a.m. You’ve
slept a little, but
now you're awake
again, for no known reason.
You
feel with dread and frustration a sense of being too mentally
alert and too physically keyed up to return to sleep, and you
think, "Here we go AGAIN…, another bout of missing sleep
when I need it the most, and another unbearable tomorrow of
feeling wasted. What’s
wrong with me?"
Scenario
3: One Hour Before Arise Time
Or,
perhaps as Napoleon Bonaparte experienced, you’re in
bed, and your alarm clock informs you that you’ve awakened
an hour early, despite your intense need for sleep. The
first light of dawn confirms this unpleasant reality.
And
you remain fully awake for the next hour, seething with frustration
and despair. You
just can’t stop feeling mentally alert and physically
keyed up, and you think, "This is so hopeless and depressing. When
the alarm goes off, I’ll feel like a lead weight. The
day’s already ruined. Why
can’t I sleep… What’s wrong?"
THREE
FORMS of INSOMNIA
Onset
Insomnia. If
you identified most with Scenario 1, you’re likely suffering from what sleep medicine specialists
call onset insomnia, where your falling asleep requires 30
minutes or more.
Maintenance
Insomnia. Or,
if you identified most with Scenario 2, you’re probably experiencing maintenance insomnia,
where you’re awake for a total of 30 minutes or more
after initially falling asleep.
Early
Morning Awakening. Or,
if Scenario 3 best captured your experience, your complaint is
probably that of early morning awakening, where you awaken significantly
earlier that your preferred arise time, unable to return to sleep.
Insomniacs
often complain of two or even all three forms of sleeplessness
as routine, nightly occurrences. They frequently refer to their
sleep as
"twilight sleep," where they feel half-awake, half-asleep, and
they commonly suffer from fatigue during the day.
GOOD
SLEEP = WORK
EFFICIENCY
1993
National Commission on Sleep Report
- The National
Commission on Sleep Disorders reported in 1993 that a wide
range of sleep disorders affect as many as one-third of all
American adults, with 60% of these afflicted by chronic sleep
problems.
- The same
report revealed that each year, sleep disorders and daytime
fatigue add an estimated $15.9 billion to the national health
care bill.
- And,
it found that, "...because insomnia is such a pervasive
problem, it appears to be accepted as a normal part of
life. However, ...insomnia can have devastating effects
on the careers and personal lives of those afflicted."
- Specifically, "Sleepy
individuals are less ambitious and less productive. Sleep
loss impairs performance on cognitive tasks involving memory,
learning, logical reasoning, arithmetic calculations, pattern
recognition, complex verbal processing, and decision making."
- And,
it concluded that, "The costs of a sleepy society include...lost
income, disability, lost educational opportunities, accidents,
and family dysfunction... The effect on the quality of life
for millions of individuals and families is incalculable."
1995
National Sleep Foundation Report
- A
Gallup Organization study prepared for the National Sleep
Foundation in 1995 revealed that 72% of people with sleep
deprivation are not aware of current treatments available
for sleep disorders.
- The
same report found that 46% of sufferers attribute their
sleep problems to stress, and that 26% believe that one
cannot be successful in one’s career without sleep
deprivation.
- <And,
it reported that more than 92% of those who have sleep
deprivation do not seek treatment, very likely because
the concept of a good night’s sleep seems inconsistent
with America’s deeply rooted work ethic, which emphasizes
a good day’s work above all, even if it means routinely
burning the midnight oil.
NORMAL
SLEEP
There
are two forms of productive sleep:
- First
involving dreaming (for restoration of mental functioning)
- Second
involving no dreaming (for restoration of the body):
REM
Sleep for Mental Restoration
"REM
sleep," during which dreaming occurs, stands for "rapid eye
movement sleep," referring to the fact that a person’s
eyes move rapidly while he or she dreams. This form of sleep
occurs about four times during a normal sleep phase, at about
90-minute intervals, first for about five minutes, second
for about 10 minutes, third for about 15 minutes, and fourth
for 30 to 60 minutes. REM sleep predominates in the last
third of a normal sleep phase.
A
main purpose of REM sleep appears to be restoration of mental
functioning in preparation for the next day. It permits the
sleeper to address and resolve problems, often symbolically
with dream imagery. During REM sleep, blood flow is primarily
directed to the brain (to support increased mental activity);
and heart rate, blood pressure, and breathing rate all increase,
or fluctuate up and down. Nightmares can occur only during
REM sleep.
Non-REM
Sleep for Physical Restoration
A
main purpose of "non-REM sleep," or non-dream sleep, appears
to be restoration of the body in preparation for the next
day. Here, blood flow is primarily directed to the muscles
(resulting in infrequent, fragmented mental activity); and
heart rate, blood pressure, and breathing rate all decrease,
in the interest of deep physical rest. Non-REM sleep predominates
in the first third of a normal sleep phase.
Normal
Sleep Cycles
Normal
sleep occurs in four to six "sleep cycles" per night, depending
on how long a person sleeps, with each cycle involving these
specific sleep stages:
First
Cycle The first sleep cycle, about 90
minutes in duration, lasts from the onset
of sleep until the end of the first REM period. It involves
transitions from, first,<
- non-REM
Stage 1, down to
- non-REM
Stage 2, then down to
- non-REM
Stages 3-4, then up to
- non-REM
Stage 2, then up to
- non-REM
Stage 1, then to
- the
first REM period
Second
Cycle The second sleep cycle – also lasting
about 90 minutes and replicating the above "architecture" of
the first cycle –
ends with the second REM period,
followed by a brief awakening for which the normal sleeper usually
has amnesia.
Subsequent
Cycles In
the third and subsequent sleep cycles, each lasting about
90 minutes, normal sleepers tend not to enter non-REM Stages
3-4. These cycles usually involve transitions from, first,
- non-REM
Stage 1, down to
- non-REM
Stage 2, then up to
- non-REM
Stage 1, then to
- a
REM period
Final
Awakening Following the last REM period, which is
the longest period of dreaming,
the normal sleeper awakens, perhaps recalling fragments
of the last dream of the sleep phase.
Effects
on Daytime Functioning
Normal
sleep is truly restorative to mental and physical functioning.
Upon awakening at their usual arise time, normal sleepers
usually report feeling refreshed and in a positive mood.
During the day, they feel energetic, with their memory and
concentration abilities intact; and they commonly report
feeling physically relaxed and mentally calm, as well as
confident about their ability to sleep the next night.
References
Ancoli-Israel,
S. (1996). All I Want is a Good Night’s Sleep. St. Louis:
Mosby.
Dement,
W. C., & Vaughan, C. (1999). The Promise of Sleep. New
York: Delacorte.
Hauri,
P., & Linde, S. (1996). No More Sleepless Nights: A Proven
Program to Conquer Insomnia. New York: Wiley.
Jacobs,
G.D. (1998). Say Goodnight to Insomnia. New York: Holt.
Morin,
C.M. (1996). Relief from Insomnia: Getting the Sleep of Your
Dreams. New York: Doubleday.
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