Stuff You Should Know
Insomnia: Why you can't sleep
Tue Jul 18 2023Description
This episode covers various aspects of insomnia, including its definition, causes, prevalence, diagnosis, types, factors affecting sleep quality, ways to improve sleep quality, sleep aids and treatments, effects of sleep deprivation, and treatment options. It explores the impact of insomnia on daily life and highlights the importance of seeking proper treatment. The episode also delves into the potential risks of sleep deprivation and provides insights into cognitive behavioral therapy routines for treating chronic insomnia.
Insights
Insomnia affects a significant portion of the population
Around 70 million Americans have some sort of sleep disorder, including insomnia. Approximately 10% of people in the United States have trouble sleeping on any given night. About two-thirds of people will experience insomnia at some point in their lives.
Insomnia is often comorbid with mental health disorders
Insomnia is often comorbid with mental health disorders like depression and anxiety. It can also be genetic or related to age and gender, with women being more likely to experience it.
Chronic insomnia requires proper diagnosis and treatment
Chronic insomnia is diagnosed when someone has trouble sleeping at least three days a week for longer than three months. It can significantly affect daily life and wake time. Cognitive behavioral therapy routines like sleep boot camp and stimulus control therapy are effective in treating chronic insomnia without medication.
Sleep hygiene plays a crucial role in improving sleep quality
Practicing good sleep hygiene, such as avoiding exercise close to bedtime, limiting screen time, and creating a sleep-conducive bedroom environment, can help promote better sleep. Relaxation techniques, meditation, and controlled breathing can also aid in falling asleep.
Sleep deprivation can have severe consequences
Sleep deprivation can cause hallucinations, delusions, memory problems, perception issues, and motor control issues. It may also lead to lasting damage such as Alzheimer's and insomnia. It is important to prioritize quality sleep and seek proper treatment for insomnia.
Chapters
- Understanding Insomnia
- Causes and Prevalence of Insomnia
- Diagnosis and Types of Insomnia
- Factors Affecting Sleep Quality
- Improving Sleep Quality
- Sleep Aids and Treatments
- Sleep Medications and Sleep Deprivation
- Effects of Sleep Deprivation and Treatment Options
Understanding Insomnia
00:00 - 07:04
- Insomnia is a sleep disorder characterized by difficulty falling asleep, staying asleep, or both.
- It can occur even if you have ample time to sleep and a conducive bedroom environment.
- There are different types of insomnia, including transient, acute, and chronic.
- To receive a diagnosis of insomnia, you must experience daytime fatigue and impaired functioning due to lack of sleep.
- The amount of sleep needed varies with age, ranging from eight to ten hours for preteens to seven to nine hours for adults aged 18-64.
- As people age, their ability to sleep deteriorates.
Causes and Prevalence of Insomnia
06:43 - 14:05
- Insomnia is defined as taking longer than 20 minutes to fall asleep.
- Some people need 30 to 45 minutes to fall asleep, which may qualify as difficulty falling asleep.
- Worrying about not being able to sleep can have a counterproductive effect on people with insomnia.
- Lack of sleep can cause medical health issues and accidents due to sleepiness.
- Around 70 million Americans have some sort of sleep disorder, including insomnia.
- Approximately 10% of people in the United States have trouble sleeping on any given night.
- About two-thirds of people will experience insomnia at some point in their lives.
- 62% of people worldwide say they don't get enough sleep.
- Humans haven't encountered difficulty sleeping before as a species.
- There are various physiological factors that can keep someone awake at bedtime, such as body temperature, heart rate, and hormone levels.
- Insomnia can be genetic or related to age and gender (women are more likely to experience it).
- Insomnia is often comorbid with mental health disorders like depression and anxiety.
- Transient insomnia lasts for a day or two, while acute insomnia lasts longer but resolves after the triggering event ends.
- Chronic insomnia occurs when someone has trouble sleeping at least three days a week for longer than three months.
Diagnosis and Types of Insomnia
13:52 - 21:56
- The diagnosis of chronic insomnia requires it to affect your daily life and wake time.
- The DSM (official sleep manual) has changed its classification over the years.
- Primary insomnia used to be divided into three subcategories: psychophysiological, idiopathic, and paradigm.
- Idiopathic insomnia has been mostly eliminated as a category due to the belief that there is always an underlying cause.
- Psychophysiological insomnia is characterized by worry about sleep leading to self-fulfilling prophecy of sleeplessness.
- Paradoxical insomnia refers to experiencing sleeplessness without negative effects during the day.
- Secondary insomnia arises from another disorder and treating the primary issue should resolve the insomnia.
- Pregnancy, aging, depression, anxiety disorder, bipolar disorder can trigger secondary insomnia.
- Certain medications like SSRIs can also cause secondary insomnia.
- There are common drugs with side effects of sleeplessness like those for cardiovascular disease and asthma.
Factors Affecting Sleep Quality
21:27 - 28:37
- Sleep deteriorates with age, losing about 27 minutes per night each decade from middle age.
- Low income households and chronic pain are high-risk factors for insomnia.
- Restless leg syndrome can disrupt sleep maintenance.
- Diagnosis of insomnia starts with discussing symptoms with a doctor and keeping a sleep diary.
- Sleep hygiene includes avoiding exercise close to bedtime, limiting screen time, and avoiding stimulants like alcohol.
- Bedtime yoga can help promote better sleep.
- Having a regular bedtime and creating a sleep-conducive bedroom environment are important for quality sleep.
Improving Sleep Quality
28:11 - 35:25
- Having a separate bedroom for sleeping can improve sleep quality.
- Architects are being asked to create two primary bedrooms instead of one.
- Watching TV before bed can disrupt sleep, so it's recommended to have a transition period before sleeping.
- Switching from blue light to warmer light on devices can help with sleep.
- Removing the TV from the bedroom can improve sleep.
- Transitioning to bed can sometimes cause anxiety and insomnia.
- Taking breaks during work and having naps can be beneficial for sleep.
Sleep Aids and Treatments
34:56 - 41:59
- Relaxation techniques, meditation, and controlled breathing can help with sleep.
- Remaining passively awake can remove anxiety and help with falling asleep.
- Avoiding the bedroom during the day can improve sleep hygiene.
- Melatonin can be used for jet lag or transient insomnia, but prolonged use can have negative effects on sleep and other bodily functions.
- There is limited scientific evidence for supplements like aromatherapy, tryptophan, Valerian, and CBD for improving sleep.
Sleep Medications and Sleep Deprivation
41:39 - 48:21
- Woody Harrelson's brother has his own line of it.
- Matthew McConaughey and Woody Harrelson may be brothers.
- Woody Harrelson's dad was a suspect in the JFK assassination.
- Prescriptions like Ambien and Lunesta can be habit-forming.
- Remelteon is a non-habit forming sleep aid with fewer side effects than Ambien.
- Antidepressants in low dosages can help with anxiety over not sleeping.
- Sleep medications like Ambien come with warnings of engaging in risky behavior while asleep.
- People have attempted to break records for sleeplessness, but Guinness stopped monitoring due to safety concerns.
- The longest recorded period without sleep was 18 days, 21 hours, and 40 minutes by Robert McDonald in 1986.
- Randy Gardner stayed awake for a record-breaking 11 days and experienced hallucinations, delusions, memory problems, perception issues, and motor control issues.
Effects of Sleep Deprivation and Treatment Options
48:04 - 55:21
- Sleep deprivation can cause hallucinations, delusions, memory problems, perception issues, and motor control issues.
- Sleep deprivation may lead to lasting damage such as Alzheimer's and insomnia.
- Cognitive behavioral therapy (CBT) routines like sleep boot camp and stimulus control therapy (SCT) are effective in treating chronic insomnia.
- Sleep boot camp involves spending 25 hours in a sleep lab, trying to fall asleep in short sessions while being woken up after three minutes of sleep.
- SCT involves getting out of bed after 20 minutes if unable to fall asleep and engaging in relaxing activities before trying again.
- A combination of sleep boot camp and SCT over five weeks can help cure chronic insomnia without medication.
- Most people can cure their insomnia with proper treatment, but many do not seek help or take action.
- Counting sheep is not an effective method for falling asleep; instead, envisioning a relaxing place or engaging in engrossing thoughts can help induce sleep.