Simply put, if you believe you need eight hours of sleep a night, you¿ll arrange your bedtimes and rising times to be in bed for eight hours. If your actual sleep requirement is only six hours, however, this schedule would result in two hours of tossing and turning each night. Even with sleep medication that might make you sleep an extra hour, that would still leave one hour of tortured wakefulness.
Why would someone spend more time in bed than they actually need? Attitudes towards sleep seem to be very important. Charles M. Morin and colleagues at Virginia Commonwealth University found that insomniacs held stronger beliefs than good sleepers about the detrimental consequences of insomnia to physical and mental health, they made stronger attributions of mood disturbances and lack of energy to poor sleep, and they perceived their sleep as less controllable and predictable. Individuals with sleep-onset insomnia (that is, difficulty falling asleep as opposed to difficulty staying asleep) were more likely than those without insomnia to focus on worries, problems, and noises in the environment prior to sleep, and to think about not sleeping or about something that had happened during the day. For instance, if you believe that you cannot function adequately without having had a good night¿s sleep, then even one night of poor sleep may trigger behaviors such as staying in bed later or taking a long nap. These behaviors are likely to make the insomnia chronic.
So how much sleep do you actually need? And how can you tell if you are getting the right amount of sleep? Although eight hours per night is a figure repeated so often that it¿s become an article of faith, the reality is that sleep need is highly individual. Large-scale epidemiological studies have shown that sleeping seven hours per night is associated with lowest mortality risk compared to longer or shorter sleep. In addition, it is likely that as we age, sleep need decreases.
Many people believe that if they've had a good night¿s sleep, they will wake up automatically without an alarm, feeling rested and refreshed. Unfortunately, this is not true. Circadian rhythms studies show that a person is likely to be drowsiest early in the morning, even after a good night¿s sleep. But if you have great difficulty remaining awake during the day (excepting the mid-afternoon slump, when it is normal to be sleepy), then it most likely means you are not getting sufficient sleep. Alternatively, you may have a more serious condition such as obstructive sleep apnea or narcolepsy, or you may be experiencing side effects of medication. In any case, no matter what the cause of your daytime drowsiness, do not drive or operate dangerous machinery when sleepy. If your drowsiness is caused by insufficient sleep, brief naps of 10 minutes or so will most likely be refreshing, but longer siestas may impair your night-time sleep.
On the other hand, if you feel tired but can¿t fall asleep during the day, then your tiredness is more likely fatigue instead of sleepiness. Although many people, including researchers, use the terms fatigue, tiredness, and sleepiness interchangeably, they are different conditions. Most people can distinguish sleepiness or drowsiness such as that felt after being up out of bed all night waiting in the emergency room with a sick child, from the fatigue or weariness experienced after running a marathon. Such "acute" fatigue is different yet again from the "chronic" fatigue experienced by cancer patients, sufferers of chronic fatigue syndrome or fibromyalgia. Chronic fatigue is experienced even without exertion and does not improve with rest or sleep. One hypothesis suggests that chronic fatigue, like depression, may be caused by too much REM sleep. Experiencing this nondrowsy kind of tiredness together with insomnia strongly suggests a person is getting more sleep than he or she needs.
For worriers, the good news is that cognitive-behavioral therapy can modify dysfunctional attitudes about sleep. Insomniacs can be helped by practicing good "sleep hygiene," which includes paying attention to the effects on sleep of environmental factors such as noise, light, and temperature; avoiding behaviors that can lead to conditioned insomnia such as reading or watching TV in bed; avoiding alcohol, nicotine, caffeine, or certain medications before bedtime; and paying attention to the timing of exercise, snacks, and bedtime itself. Sleep restriction (which might more accurately be called restriction of time in bed) may also help. Together, these nonpharmacological treatments for chronic insomnia are more effective and longer-lasting than medications.
Finally, the longer you are awake, the more slow-wave (delta) sleep you will have when you do sleep. Slow-wave sleep is associated with feeling you have slept well, and with feeling refreshed. To sleep well, then, get up early, but avoid going to bed early. I can¿t express this any better than the following proverb, which predates Benjamin Franklin by more that 200 years: "At grammar-scole I lerned a verse, that is this, Sanat, sanctificat, et ditat surgere mane. That is to say, Erly rysyng maketh a man hole in body, holer in soule, and rycher in goodes." (Anthony Fitzherbert (1470-1538): The Book of Husbandry, 1523).
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Reply | Report Abuse | Link to thishttp://psychcentral.com/blog/archives/2007/03/12/light-and-dark/
http://www.blackwell-synergy.com/doi/abs/10.1111/j.1600-079X.2007.00473.x
MINI REVIEW
Kristen J. Navara, Randy J. Nelson (2007) The dark side of light at night: physiological, epidemiological, and ecological consequences
Journal of Pineal Research 43 (3) , 215–224 doi:10.1111/j.1600-079X.2007.00473.x
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A bit more on spectra — here’s a secondary source that appears to be a copy from Brainerd’s 2001 article
http://www.lighttherapycanada.biz/images/LB/ResEng/Brainardcurve2.gif
That’s the band you want to _avoid_ to be able to fall asleep (and the band you want to get to wake up and stay alert, of course — daylight blue skylight as filtered through green leaves, more or less. I have a “Go Outdoors” sign to remind me of that at home!).
You know what really bugs me as an insomniac? Whenever people write about insomnia, there's always a section about how persistent insomnia is caused by other things, with an obligatory mention of depression. I've never seen someone end an article by saying:
Reply | Report Abuse | Link to thisScience is just beginning to understand the brain circuitry involved in sleep. No one knows how many people have faulty sleep circuitry and are in a state of constant sleep deprivation, the symptoms of which can be interpreted as depression, ADD,.... etc. If YOU have faulty sleep circuitry there is no cure for you right now and your life may be extremely painful while you wait.
Your depression is causing the insomnia.
I hear this repeated by doctors/people over and over again. And it is belittling to millions of us who can't sleep normally, suffer severe mental effects because of it, and are then fed a series of utterly ineffective and expensive anti-depressants. Depression is a category that people are put in. It is not an identification of biological disregulation, and cannot be the CAUSE of anything. The psychiatric categories (especially depression) have become a dumping ground for all patients who have problems that science doesn't yet understand.
For someone to be diagnosed with primary insomnia under its current definition (sleeplessness that cannot be attributed to a medical, psychiatric, or environmental cause), they'd have to be experiencing severe sleep problems and have NO mood problems whatsoever. Not only that, if we assume someone DOES have shoddy sleep regulation as a first cause, they will NOT be diagnosed with primary insomnia, because of course they will be exhibiting all sorts of psychiatric symptoms.
So what we have here is a definition created solely as a way for the industry to conceal medical ignorance regarding people who's brains won't sleep properly. If the orexin blockers are effective when they hit the market I guarantee you that suddenly everyone will be diagnosed with primary insomnia, and the definition will magically change.
Psychiatrist tell us that Primary Insomnia is very rare . And by their strange definition it is. But malfunctioning sleep circuitry in the brain as a root cause of a patient's problems may be extremely common.
This is the kind of garbage that is written--again and again --by people who haven't a clue about what insomnia is or what it's like to live with. Getting all the sleep we need--honestly, get real. Come and live in my body for a month, or even a few nights, see how it feels. Read my book INSOMNIAC .
Reply | Report Abuse | Link to thisI'm amazed this kind of article still gets published, when sleep science is so much more advanced and more interesting and nuanced in its discoveries than this pap indicates. Everybody's sleep system is different, some fragile and some robust, there are biological variabilities, physiological differences, that this one size fits all kind of psychobabble totally blurs, and no, we are NOT getting all the sleep we need! A brain scan tells you that. Why not read something about the science before you dish out the nonsense.
And Cherrywater (comment above)--right on!
And Sci Am--you can do better than this!
well im experiencing insomnia right now and let me tell you its living hell and its ruining my future for success
Reply | Report Abuse | Link to thisI believe that people just thinking to much can lead to insomnia.
Reply | Report Abuse | Link to thisAlso not owning a good <a href="http://www.sleepys.com">mattress</a> might lead to some insomnia.
Reply | Report Abuse | Link to thisI suffer from insomnia. I purchased a new mattress topped with memory foam. Helped my body relax but did not cure my insomnia. I was prescribed seroquel for sleep, made me too drowsy and caused me to sleep too long. I looked up the chemistry on seroquel and discovered an antihistamine in my cabinet would work just as well. I have been using chorpheneramine Maleate for a month with great success. What you eat before retiring has an influence on your sleep I have learned. Eating alot of protein before bed can increase brain chemicals like histamine that makes one alert. Also taking in some low glycemic carbs at bedtime works great for boosting adenosine that has a neuroinhibitory affect on the brain. I also have added 3-5 mgs melatonin under the tongue plus listening to Soma, track 2 for 30 minutes and I am back to getting my deep delta wave sleep again.
Reply | Report Abuse | Link to thisI suffer from insomnia. I purchased a new mattress topped with memory foam. Helped my body relax but did not cure my insomnia. I was prescribed seroquel for sleep, made me too drowsy and caused me to sleep too long. I looked up the chemistry on seroquel and discovered an antihistamine in my cabinet would work just as well. I have been using chorpheneramine Maleate for a month with great success. What you eat before retiring has an influence on your sleep I have learned. Eating alot of protein before bed can increase brain chemicals like histamine that makes one alert. Also taking in some low glycemic carbs at bedtime works great for boosting adenosine that has a neuroinhibitory affect on the brain. I also have added 3-5 mgs melatonin under the tongue plus listening to Soma, track 2 for 30 minutes and I am back to getting my deep delta wave sleep again.
Reply | Report Abuse | Link to thisI am an avid reader of SciAm and am usually impressed by your well written and balanced articles. You dropped the ball on this one. I have epilepsy and suffer from several sleep disorders as well. I get very little REM sleep because of my brains faulty circuitry so I went through about 21 years of sleeping problems and about 12 years of utter desperation before my diagnosis went from insomnia to anything else. It is only because of the epilepsy I got any help at all. How many people out there that do not see neurologist, see a doctor that knows much about sleep disorders? Not very many. I have been a sleep eater for 12 years and the first 3 doctors laughed at me, and one of them referred me to a psychiatrist.
Reply | Report Abuse | Link to thisInsomnia may sound like a benign and easily treatable condition. But insomnia can sometimes be a symptom of a larger problem. Just something to keep in mind.
Normally I disagree with Gayle Greene and what she suggest, but think she's partly right this time.
Reply | Report Abuse | Link to thisAs a former insomniac (who was 'cured' not by sleep restriction or any of the other suggestions in the article) he does come across as slightly patronizing.
From my own experience I don't think insomnia is usually am matter of worrying to much, although I doubt catastrophising about the effect insomnia has on your life helps either.