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Managing Chronic Insomnia
(Quality Life Forum Self-Care Series)
Health Coaching Session, June, 2021

Chronic insomnia is a common problem for many with its prevalence increasing with age. Chronic insomnia lasts for three months or more. Not all insomnia are the same. The problem may be hard to falling asleep (sleep onset),  struggle with asleep nightlong (sleep maintenance), or both.

Common Causes of Chronic Insomnia

The common causes of chronic insomnia for older adults including, but not limit to the following:
  • Stress and anxiety often keep you up, at conscious or unconscious level.
  • Sleep schedule factors, including daytime napping, schedule irregularity, poor sleeping environment
  • Lifestyle factors, including physical inactivity, meal time and portions, caffeine and alcohol use
  • Medication side effects – including medications for hypertension, cold, diuretics and many other drug classes. An increased use of multiple prescription drugs in aging population affect sleep is more common.
  • Medical conditions, physical discomfort and pain - including neurological and mental disorders, respiratory and cardiac conditions, musculoskeletal and dental pains, and more.

Sleep Stages and Physiology 

There are two main types of sleep: 

Non-rapid eye movement (NREM), also known as quiet sleep
Rapid eye movement (REM), also known as active sleep

NREM Stage 1

Stage 1 is the beginning of the sleep cycle and is a relatively light stage of sleep. Stage 1 can be considered a transition period between wakefulness and sleep. The brain produces high amplitude theta waves, which are very slow brain waves. This period of sleep lasts only a brief time (around five to 10 minutes). This stage is not a true asleep.

NREM Stage 2

Stage 2 lasts for approximately 20 minutes. During stage 2 sleep, you become less aware of your surroundings. The brain begins to produce bursts of rapid, rhythmic brain wave activity known as sleep spindles. Body temperature starts to decrease and heart rate begins to slow. According to the American Sleep Foundation, people spend approximately 50% of their total sleep in this stage.

NREM Stage 3

During stage 3 sleep, muscles relax. Blood pressure and breathing rate drop. Deepest sleep occurs.
Deep, slow brain waves known as delta waves begin to emerge. During this stage, people become less responsive and noises and activity in the environment may fail to generate a response. It also acts as a transitional period between light sleep and a very deep sleep.

​REM Sleep

During REM sleep, the brain becomes more active. The body becomes relaxed and immobilized. Dreams occur. Eyes move rapidly.

Most dreaming occurs during the fourth stage of sleep, known as rapid eye movement (REM) sleep. REM sleep is characterized by eye movement, increased respiration rate, and increased brain activity. The American Sleep Foundation suggests that people spend approximately 20% of their total sleep in this stage.
REM sleep is also referred to as paradoxical sleep because while the brain and other body systems become more active, muscles become more relaxed. Dreaming occurs due to increased brain activity, but voluntary muscles become immobilized.

The Sequence of Sleep Stages

It is important to realize that sleep does not progress through these stages in sequence. Sleep begins in stage 1 and progresses into stages 2, and 3. After stage 3 sleep, stage 2 sleep is repeated before entering REM sleep.
Once REM sleep is over, the body usually returns to stage 2 sleep. Sleep cycles through these stages approximately four or five times throughout the night.

On average, we enter the REM stage approximately 90 minutes after falling asleep. The first cycle of REM sleep might last only a short amount of time, but each cycle becomes longer. REM sleep can last up to an hour as sleep progresses.

Managing chronic insomnia

Are you facing challenges of sleeping pattern changes or losing sleep quality? Each long night can be very frustrating, with an exhausting day to follow. Not sleeping well , not feeling well, naturally. How much sleep do we need and what happens if we sleep too little or too much? go to Sleep Well to learn more.

Chronic insomnia can be effectively managed with a combination of cognitive behavior modifications,  sleep hygiene, lifestyle changes, and self-care practice. Sleeping aids are also optional.

Cognitive behavioral therapy for insomnia is a structured professional program that helps you identify and replace thoughts and behaviors that cause or worsen sleep problems with habits that promote sound sleep.  The cognitive part of CBT-I teaches you to recognize and change beliefs that affect your ability to sleep. The behavioral part of CBT-I helps you develop good sleep habits and avoid behaviors that keep you from sleeping well.

Following the CBT-I principles, you may benefit from practice self-care at home - 

1. Regulate emotions to be peaceful
  • Calm your mind, meditation or soft music may be helpful to wind down and reduce anxiety
  • Don’t bring your emotions to bed, let go of the day, no matter good or bad.
  • Learn to relax your muscles and regulate breathing mindlessly 

2. Improve sleep hygiene
  • Get up when awake or unable to sleep, don’t force sleep in bed
  • Avoid caffeine, especially later in the day.
  • Avoid alcohol use and smoking cigarettes before bed.
  • Don’t eat large meals in the evening, nor be hungry for bed.
  • Avoid using computers, smartphones, TV, or other technological devices an hour before bedtime.

3. Lifestyle modifications
  • Keep regularity of sleeping schedule (bed time and get up time), including weekends and holidays.
  • Engage in regular physical activity, plan full workout during the day and an evening yoga stretch or Tai Chi is ideal.
  • Track your daily sleep time. Limit a day time nap no more than 30 min and avoid taking nap in the late afternoon or evening.

4. Making sleep environment comfortable
  • Keep your bedroom dark or use a sleep mask.
  • Keep your bedroom in a comfortable temperature.
  • Minimize the noise level.
  • Make sure your bed and bedding are comfortable.

OTC sleep aid options may include:
  • Melatonin -  a hormone that is naturally produced by the body and is involved in the sleep cycle, available as supplements commercially.
  • Valerian root - a perennial flowering herb native to Europe and Asia
  • Chamomile tea - Chamomile flowers are best known for their role in tea but are also found within calming blends in herbal supplements.
  • White noise app or device – a device to produce soft nature sounds, such as water flow, rain, winds, etc.

If you require prescription medications for insomnia, it should not be used longer than 3 months to prevent drug dependency. Also be aware of the side effects.

In summary, chronic insomnia is a common issue for many with its prevalence increasing with age. Not all insomnia is the same. With better understanding of how we sleep and why we can’t sleep, chronic insomnia can be effectively managed with a combination of cognitive behavior modifications,  sleep hygiene,  lifestyle changes, and self-care practice. Sleeping aids are also optional.

If you are suffering chronic insomnia, take action today; don’t put it off. Feel free to contact QualityLifeForum@outlook.com for support. Health coaching can help you achieving your personal health goals.


© All rights reserved

References:
https://www.sleepfoundation.org/insomnia/what-causes-insomnia
https://www.healthline.com/health/chronic-insomnia#causes
https://www.verywellhealth.com/the-four-stages-of-sleep-2795920
https://www.mayoclinic.org/diseases-conditions/insomnia/in-depth/insomnia-treatment/art-20046677

Disclaimer: This information is for educational and informational purposes only. It is not medical advice. Consult your healthcare professional for personal conditions.

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  • Home
  • Forum
    • Mind and Body
    • Feeling well
    • Feeling ill
  • Coaching
    • Coaching Programs >
      • Loneliness Breakthrough
      • Therapeutic Lifestyle Changes
      • Time-Restricted Feeding for Healthy Aging
      • Patient-centered Health Navigation Program
      • Customized program
    • 2022 health coaching monthly >
      • Health: the Cornerstone for Quality of Life
      • Aging Eye Facts
      • Age-Related Hearing Loss
      • Aging and Oral Health
      • Aging Skin and Sun Safety
      • Making Transition From A Patient To An Educated Healthcare Customer
      • Daily Routine for Healthy Aging
    • 2021 Health Coaching Monthly >
      • Hew Year Brings New Hope
      • Pandemic Winter Blues
      • Make a Self-Care Plan for Your Golden Years
      • Are You Fully Vaccinated?
      • Less is More
      • Managing Chronic Insomnia
      • Range of Motion Recovery from Frozen Shoulder
      • The Milestone of Age 65
      • Aging Brain
      • Muscle Memory and Cognition
      • Navigation for Healthcare Needs
      • Gratitude Power for Wellbeing
    • 2020 health coaching Monthly >
      • The Key Role of Protein in Healthy Aging
      • Healthy Fat for Healthy Aging
      • Healthy Aging Energy Source Carbohydrate
      • Transform Pandemic Fear to Self-Care
      • Hope endures
      • Breathing and Blessing
      • Listening to your body
      • Keep Fit for Your Age
      • Time-Restricted Feeding Is A Healthy Lifestyle Choice
      • Process and Results
      • Moderation
      • Invest In yourself
    • 2019 Health Coaching Monthly >
      • Empty Nest
      • Food Safety and H. pylori Infection
      • Body Image and Self-Care After Midlife
      • Exercise is Medicine
      • Cognitive Health
      • Dietary Supplements Are Not Drugs
      • GERD
      • Downsizing in the Golden Years
      • Time for change
      • Action is what counts
      • Osteoporosis in Women
      • Dealing with Difficult Emotions in Holiday Season
    • 2018 Health Coaching monthly >
      • The Golden Keys for the Golden Years
      • loneliness Breakthrough
      • Regulate Blood Pressure
      • Lowering Cholesterol
      • Blood Sugar Self-Management
      • TLC Transformation
      • Golden Mindset
      • Nourish Your Body for Healthy Living
      • Keep Life in Motion
      • Tough Fight for the Belly Fat
      • Dealing with chronic stress
      • The Most Valuable Gift
    • 2017 Health Coaching monthly >
      • Willness Attitude and Winterizing Fitness
      • Live with Thyroid Nodules
      • Exercise for Blood Sugar Regulation
      • Longevity and Quality of Life
      • How to Reduce Aging Eye Fatigue
      • Sleep Well
      • Intermittent Fasting
      • Facing a life-threatening illness
      • Music Learning for older adults
      • Better to Eat Meat or Plant Food
      • Immunity and Aging
      • A Special Holiday Gift
    • 2016 Health Coaching Monthly >
      • Wellness Mindset
      • Get Active
      • Balance Training
      • Emotional Healing
      • Vitamin D Deficiency
      • Weight Management
      • Health Literacy
      • Prevention
      • Significant Health Indicators
      • Gratitude for life
      • Home Coming for Holidays
  • Health Product Guide
    • Choices for Healthy Living
    • Vitamins and minerals
    • Digestive Health
    • Heart Health
    • Eye Health
    • Joint Health
  • About
  • Contact
  • Blogs
    • Blog How much water to drink in a day?
    • Blog What’s Good to Eat?
    • Blog Are You Motivated for a Healthy Life Style?
    • Blog A Green Tea Invitation
    • Blog The Value of Vitamin and Dietary Supplements
    • Blog Holiday Edition 2015
    • Blog Travel album of Switzerland
    • Blog A Mourning Dove Story