Biology 103
2002 First Paper
On Serendip

Do I Have Insomnia?

For about two and half weeks now, I haven't been able to sleep properly. I feel tired at a relatively normal hour, around eleven or midnight, but when I go to bed I can't fall asleep. I lay awake for hours, and then when I do fall asleep I only sleep for an hour or so before waking up again. In search of a cure for my sleeplessness, I decided to research sleep disorders.

Sleep disorders are much more common than I had expected. According to the National Institute of Neurological Disorders and Stroke, about 60 million Americans per year suffer from some sort of sleeping problems. There are more than 70 different sleep disorders that are generally classified into one of three categories: lack of sleep, disturbed sleep, and too much sleep (1). All three types of disorders are serious problems and can pose a grave risk to the sufferer's health, but because of my problem I have decided to focus my paper only lack of sleep, or insomnia.

To understand why not getting enough sleep was affecting me so much, I needed to understand a little more about sleep. Sleep is a period of rest and relaxation during which physiological functions such as body temperature, blood pressure, and rate of breathing and heartbeat decrease (2). Sleep is essential for the normal functioning of the body's immune system and ability to fight disease and sickness, as well as for the normal functioning of the nervous system and a person's ability to function both physically and mentally (1). Sleep also helps our bodies restore and grow, and some tissues develop more rapidly during sleep. There is also a theory that while the deeper stages of sleep are physically restorative, rapid-eye movement (REM) sleep is psychically restorative. REM sleep also might incorporate new information into the brain and reactivate the sleeping brain (2). These are just a few of sleep's less obvious duties, not to mention that it refreshes us and makes us alert for the next day.

I always thought that insomnia was just not getting enough asleep. One interesting definition that I found described insomnia as the 'perception of poor-quality sleep' (3). This seems to indicate that it can almost be caused just by a person thinking that they aren't getting enough sleep. Insomnia can refer to difficulty falling asleep, trouble staying asleep, problems with not sleeping late enough, or feeling unrefreshed and tired after a night's sleep. Insomnia can cause such problems as sleepiness, fatigue, difficulty concentrating, and irritability.

Insomnia can be divided into three main categories, transient, chronic or intermittent. Transient insomnia is if it lasts from one night to four weeks. If transient insomnia returns periodically over months or years is becomes intermittent. It is chronic insomnia when it continues almost nightly for several months (4). Transient and intermittent types often do not require more treatment than an improvement in sleep hygiene.

There are many factors that can contribute to insomnia, and different issues trigger each type of insomnia. Transient and intermittent insomnia can be caused by something as simple as the sleeplessness that occurs just before a big test, and are very common and considered a normal stress reaction that will typically go away (5). Depression, internalized anger, anxiety and behavioral factors are the most common reasons for insomnia. The most frequent behaviors include consuming too much caffeine, alcohol or other substances, excessive napping, or stimulating activities such as smoking, exercising or watching television before bedtime (3). Insomnia can often be linked to mental illnesses or other diseases; for example, chronic insomnia is usually caused by depression (1). When a person is having sleep problems because of something else, it is called secondary insomnia. Environmental factors, such as discomfort or excessive light, and changes in a normal sleeping pattern, such as jet lag or moving to a new time zone, also cause transient insomnia (1). When none of these factors are contributing to a person's sleeplessness, they are considered to have primary insomnia, or insomnia that isn't caused by other obvious causes.

People who have insomnia tend to worry about the fact that they are not getting enough sleep, and sometimes their daytime behaviors contribute to increased lack of sleep. Worrying and stress will only increase insomnia, and habits developed to make up for a lack of sleep can delay the return of a normal sleep schedule. These behaviors include napping during the day, giving up on regular exercise, or drinking caffeinated beverages to promote staying awake or concentration (5). In order to regain normal sleeping patterns, insomniac have to practice good sleep hygiene.

After learning about the causes for insomnia, I decided that I didn't have any of the main underlying causes such as alcoholism or depression, so I decided to research good sleep hygiene. Sleep hygiene consists of basic behaviors that promote sleep and try to change behaviors that might increase chances of insomnia. These habits include going to sleep and waking up at the same time, not taking naps during the day, avoiding caffeine, nicotine, and alcohol late in the day, getting regular exercise but not close to bedtime, not eating a heavy meal late in the day, not using your bed for anything other than sleep or sex, making your sleeping place comfortable, and making a routine to help relax and wind down before sleep, such as reading a book, listening to music, or taking a bath (1). Interestingly, while sleeping pills can be effective for transient or intermittent insomnia, they are not recommended and they may make chronic insomnia worse (1). The best way to cure insomnia is to use good sleep hygiene, and be aware of any underlying causes that might be causing it.

After learning about insomnia, I decided that I don't really have it. The only side effect that I have in common with ones associated with insomnia was difficulty concentrating. I'm not irritated or sleepy during the day, and as far as I can tell I don't have any of the typical causes of insomnia. My sleep hygiene had been pretty good before I learned about it, but I did try to improve that as much as I could. The last two nights I have gotten six consecutive hours of sleep, and now I am feeling more tired during the day than when I was only getting three hours. But I do feel like my sleeplessness is declining, whatever the causes were.

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