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Imsomnia: How To Beat It

Thursday, April 9th, 2009 Imsomnia: How To Beat It

It is understood that mental preparation as opposed to drug use is pertinent to a good nights sleep according to the Telegraph (08 04 09) by Anthony Gardner.

He begins his article by asking the question, ‘Which would you rather have: sex or a good night’s sleep? According to a recent survey, 80 per cent of us would choose sleep. The question is how to get it in an age of unrelenting pressure where, no longer able to crash in a cave after a day spent chasing mastodons, half the adult population suffers from restless nights.

Moreover, it is important to consider that advanced stages of insomnia are linked to suicide as reported by Rebecca Smith in the Telegraph (31 03 09).

She makes the point that doctors should be aware that patients who have reported sleeping problems are also at risk of suicide. This applies even if the person does not have a psychiatric condition.

Essentially researchers have found that early morning waking has been linked to a 2.7 fold increased risk of attempted suicide while difficulty staying asleep showed a three fold increased risk for suicide attempts.

Dr Marcin Wojnar, a research fellow at the Department of Psychiatry at the University of Michigan in the United States and Associate Professor of Psychiatry at the Department of Psychiatry at the Medical University of Warsaw in Poland, said: “People with two or more sleep symptoms were 2.6 times more likely to report a suicide attempt than those without any insomnia complaints.

It is important to assess who is at high risk. Wojnar adds, ‘This has implications for public health as the presence of sleep problems should alert doctors to assess such patients for a heightened risk of suicide even if they don’t have a psychiatric condition. Our findings also raise the possibility that addressing sleep problems could reduce the risk of suicidal behaviours.”

It is not clear from the study whether difficulty sleeping induces suicidal behaviour or whether people who are already thinking about suicide have insomnia.

However, Gregg D Jacobs of Massachusetts University Medical School believes that he has the answer. His book Say Goodnight to Insomnia, published in the UK this month, sets out a six-week programme which, he boasts, is the first viable alternative to sleeping pills. The statistics from trials in the US are impressive: 90 per cent of users reduced their dependence on drugs and 75 per cent became normal sleepers.

The aim of the programme is to teach the art of relaxation and a shift in attitudes towards the value of healthy sleeping patterns. In his book ‘Say Goodnight to Insomnia,’ he sets out a six week programme, whereby he boasts that there will be no need for any sleeping pills.

Alas the findings are somewhat impressive 90 per cent of users reduced their dependence on drugs and 75 per cent became normal sleepers.

Nothing aggravates insomnia, Dr Jacobs argues, as much as worrying about it: this makes your bed a battleground rather than a snooze-inducing haven. ”Having the right mattress may make a small difference,” he says, ”but behavioural factors are the critical ones.” By training your mind to reject negative thoughts and habits, you cannot only escape sleeplessness but discover a new life of ”energy and joy”.

Jacobs began to formulate his theory on a visit to Sikkim in India, where he saw monks preparing to meditate by wrapping themselves in sheets soaked with icy water. To his amazement, instead of catching cold, they were able to dry the sheets by raising their body temperature. “It became clear to me,” he says, “that the mind has the ability to control the body, and therefore to control sleep.”

Fundamentally the first week of the programme, Jacob is replacing negative thoughts with positive ones. For example, insomniacs worry about not getting eight hours’ sleep; but, he says, ”The majority of people don’t need that much. In fact, those who sleep for seven hours generally live longer.” Once we assimilate this idea, the quest for enough sleep becomes less of a challenge.

It is then important to establish a constructive timetable. Jacob’s believes in the fact that if we can stay awake for longer periods then we are more likely to be exposed to the valuable sunlight, we can exercise longer. We are more likely to feel tired towards the end of the evening and therefore should sleep better.

The irony is that if we try to make up for lost sleep by getting up later, we have less exposure to sunlight and so upset the cycle; equally, if we go to bed early – before we are really tired – we will find it hard to doze off. We should get up at the same time every day, and go to bed later after a bad night, not earlier.

If this sounds challenging, other parts of the programme allow for human frailty. Afternoon naps are encouraged, though they should be taken before 4pm and last no longer than 45 minutes. Two cups of coffee a day are permissible, if drunk before lunchtime; a glass of wine with dinner is allowed.

Having gone to bed, says Jacobs, you should fall asleep within half an hour. If you don’t, get up again until you feel properly tired. His advice for those who wake in the middle of the night is the same: time spent tossing and turning is counter-productive.

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