Some insomniacs sleep for hours yet swear they were awake all night
At any given moment, somewhere from 10% to 30% of adults are living with insomnia, and up to half of people have it at some point in a year. Yet about 5% of sufferers have a stranger version: sleep tests show they slept for hours, but they are convinced they lay awake all night, a condition called paradoxical insomnia.
Insomnia means struggling to fall asleep or to stay asleep as long as you want, and it usually brings daytime drowsiness, low energy, irritability and a flat mood, along with poorer concentration and a higher chance of accidents. Short bouts last days or weeks; the long-term kind persists beyond a month. Around 6% of people have insomnia lasting over a month that is not explained by some other problem. People over 65 and women are hit more often, and complaints of sleeplessness go back at least to ancient Greece.
It takes several shapes. Trouble dropping off at the start of the night often travels with anxiety, and a body clock shifted late, known as delayed sleep phase disorder, is sometimes mistaken for it. Among people who find it hard to fall asleep, two-thirds also wake in the night, and more than half of those then struggle to drift off again. Waking more than 30 minutes too early, before reaching 6.5 hours of sleep, is typical of depression, which also disturbs the hormonal stress system and floods the body with cortisol. Sleep can feel unrefreshing when a person never reaches stage 3, the deep delta phase thought to be restorative.
Triggers range widely: stress, chronic pain, heart failure, an overactive thyroid, heartburn, restless legs, menopause, and substances such as caffeine, nicotine and alcohol, with night shifts and sleep apnea raising the risk. Sometimes the original cause fades but sleeplessness continues, kept alive by dread of another bad night; this is called primary insomnia. Overusing sleeping pills can cause rebound insomnia, athletes often take longer to fall asleep after exercise, and a rare inherited prion disease produces a permanent, ultimately fatal form.
Cognitive behavioural therapy is regarded as the first-line treatment. Sleep hygiene, meaning regular bedtimes, a dark and quiet room, daytime sunlight and exercise, is widely recommended, though its benefit is not firmly proven. Sleeping pills can help but some are tied to falls, mental fogginess and dependence, and they are generally not advised for longer than four or five weeks. Anthropologists add that artificial light, city life and changing work patterns shape how people sleep, and that ideas of normal sleep differ from one society to another.
Source: Insomnia
