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.
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.
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.
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 therapyfor 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.
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.
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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