How to Treat Insomnia or Getting Rid of Agrypniaphobia

General considerations

Excessive anxiety, being upset and tense and having difficulty relaxing, as well as apprehensiveness about the future, all interfere with restful sleep.

Rx: What are some of the treatments for insomnia? Relaxation and stress-reduction are very effective but part of the solution depends on whether you are having trouble initiating sleep or staying asleep.

Of the former, limit caffeine and alcohol consumption in the evenings. Eat regular and healthy meals and take a multivitamin supplement once-a-day. Set your alarm and put the clock underneath your bed to avoid nervousness caused by clock-watching.

Use soothing music to fall asleep to, if that is helpful (e.g., quiet piano solos). A hot bath before sleep is also very effective (particularly, when followed by a loving massage). So are regular and satisfying sexual unions.

For the latter, use a contoured pillow to avoid stress on neck and turn over your mattress to get even wear (or consider getting a more comfortable mattress). Set room temperature to 75 degrees F or below and keep humidity down; higher temperatures tend to disturb sleep, particularly, REM sleep and stages 3 and 4 (see below).

Keep noise down during sleep: Women are more sensitive to noise and noise sensitivity increases with age. Only use sleeping pills for emergencies as they depend to depress REM and thus interfere with the quality of sleep. They also cause rebound insomnia. In general, psychoactive drugs are not effective in the treatment of insomnia, at least, not on a long-term basis.

A specific plan

Get up at the same time every morning and get regular exercise 3x-a-week in the morning, preferably. One approach, if you have trouble initiating sleep, is to begin by going to bed four hours before you plan to get up. And increase that by one half-hour a night for every five days of sleep in which you slept for at least 90% of the evening, an index of your “sleep efficiency” or the percentage of time you actually slept. Continue this procedure until you are getting a full night’s sleep. Generally, this is 8 – 8 1/2 hours but some people need less and some more.

Biology of sleep and dreaming

There are five stages of sleep that have been revealed through the use of electroencephalograms (EEG), eye movement recordings, and recordings of muscle activity. Neurons (nerve cells) in the brain generate electrochemical signals that routinely spread across the cortex or outer layers the brain and produce an electrical field that can be measured and manifest regular rhythms or “brain waves.” They are measured by EEG (measured in hertz or Hz).

Here are the five stages of sleep (recently, stages 3 and 4 have been consolidated into one stage):

Awake 1: Eyes open – Beta waves (14-30 Hz)

Awake 2: Relaxed with eyes closed; Alpha waves (8-13 Hz)

Non-REM (NREM) Sleep:

Stage 1: Theta waves (4-7 Hz)
Stage 2: Bursts of high-frequency waves (i.e., sleep spindles)
Stage 3: Delta waves (1-3 Hz)
Stage 4: Delta waves

REM Sleep:

Rapid eye movement with theta waves

These stages cycle through 90” periods. The first four stages are called non-REM sleep (NREM). Disorders such as sleeptalking or sleepwalking occur in stages three and four (i.e., not when you are dreaming). Night terrors, which may occur in children 3 – 8 years of age and during the first two hours of sleep, turn up in Stage four. They are believed to be due to faulty maturation of brain stem and psychosocial stress. Nightmares occur during REM sleep when dreaming occurs. Surprisingly, when sleeping we do monitor the outside environment. For example, mothers are particularly responsive to their infant’s nighttime cries. Insomniacs appear to be completely unable to shutout outside stimuli and may be partly the cause of their sleep problems. In any event, sleep problems are very common. In the US, about 50% of adults report problems in initiating or staying asleep. You are not alone.

Some suggesting reading

Hauri, P., & Linde, S. (1990). No more sleepless nights. NY: Wiley.