Insomnia—difficulty falling or staying asleep—can wreak havoc on people's lives. And with the coroner's finding that Michael Jackson died from a lethal dose of the anesthesia medication propofol (Diprivan), which the pop star reportedly received routinely because of his chronic inability to sleep, it's a good time to revisit safe ways to help cure insomnia.
About 30 percent of adults experience some degree of insomnia at some point in their lives, and about 10 percent have problems that are severe enough that their waking hours are affected, according to the American Academy of Sleep Medicine, which published guidelines for the treatment of insomnia last year in the Journal of Clinical Sleep Medicine. "Almost everyone who walks the face of the Earth will have at least a very transient period of sleep disturbance at some point in their lives," due to stress, pressure, worry, or even medical problems that cause pain and distress, says Michael Sateia, a coauthor of the AASM's insomnia guidelines and chief of sleep medicine at Dartmouth-Hitchcock Medical Center in Lebanon, N.H. For most people, sleep problems are short term and go away on their own. But about 10 percent of adults have chronic insomnia, defined by sleep interruptions at least three times per week for a month or more. Some people experience the problem for years or even decades.
At least eight out of 10 people with insomnia have what's called secondary insomnia, meaning their sleep disturbances are caused by health problems, medications, sleep disorders, or certain substances. But others have primary insomnia, meaning their sleep problems don't have these triggers and may instead result from prolonged stress or emotional upset, according to the National Heart, Lung and Blood Institute. A small study presented at the annual meeting of the Associated Professional Sleep Societies in June suggests another possible cause of primary insomnia: It showed that some sufferers have a neurochemical abnormality that makes it hard for the mind to shut down and allow the body to sleep at night. Researchers looked at the 16 insomniacs' levels of gamma-aminobutyric acid, also known as GABA (which slows activity in many areas of the brain), and then at the GABA levels of 16 normal sleepers. Study participants who'd had primary insomnia for at least six months had lower GABA levels. The study's lead investigator, John Winkelman of Brigham and Women's Hospital in Boston, said the research suggests that insomnia may affect the brain.
Insomniacs don't have to suffer and simply live with their condition, however. "There are a lot of things that individuals can do to improve their ability to sleep or allow themselves to sleep better," says Neil Kline, a Philadelphia-based sleep physician and spokesperson for the American Sleep Association. Here are 9 things you can do if you're battling insomnia:
Consider cognitive behavioral therapy, which attempts to change the thoughts and actions that interrupt your body's ability to get a good night's rest. Because research shows that psychological and behavioral issues factor into insomnia, CBT can be used to help improve sleep, and the benefits last over time, research shows; even a year after therapy, most people report continuing to sleep well, according to the Mayo Clinic. A study published in June in the journal Sleep found that online cognitive behavioral therapy is also an effective treatment for chronic insomnia.
During CBT, you're taught to pinpoint false notions that may affect your sleep—for example, you may think you need eight hours of sleep when your body can actually get by on seven. You're also taught to deal with negative thoughts or concerns that may keep you awake at night and to change certain behaviors, such as caffeine consumption (more on that below). CBT typically includes between four and eight half-hour sessions led by a sleep therapist, and may also include meditation, muscle relaxation, biofeedback, or hypnosis.
Avoid taking daytime naps, which decrease your nighttime sleep needs, Kline says. Of course, being an insomniac can make you sleepy during the day, experts acknowledge. So if you must nap, Sateia says, limit the duration, and make it as early in the day as possible.