WHAT’S THE BIG DEAL?
Insomnia is estimated to negatively impact up to one one-third of the United States population and has become a rising public health concern. While some people talk about their sleep difficulties to friends, family, co-workers, and maybe even their doctor, it is mostly an invisible epidemic. Despite the growing prevalence of sleep disturbance, the real depth of this struggle remains somewhat silent. Insomnia is not typically acknowledged and addressed in the same way as other health concerns, yet the effects of chronic insomnia can be incredibly debilitating.
WHY AREN’T WE TALKING ABOUT IT?
Because when you say those words “I can’t sleep”, it just does not fully convey how severely your functioning is impaired and the depth of your exhaustion. Telling someone that you did not sleep again last night does not tend to have the same impact as telling someone you have a chronic disease or severe mental illness. Insomnia is not generally thought of as a disorder that can be diagnosed in the same way that one would be diagnosed with diabetes, hypertension, Alzheimer’s, depression, etc. Despite the significant impact this issue has on a person’s life, there is often shame attached to the idea of seeking help for sleep disorders. Some common beliefs that an insomnia sufferer has are “sleep is something everyone can do so I must be doing something wrong”, “this should come naturally to me and not require help”, “I should be able to tough this out; it’s not that big of a deal", or similar self-critical messages. Sometimes the fear of getting help is just due to a lack of awareness that there is a solution available or fear that treatment will not work because the insomnia is so severe. It is vital to understand how poor sleep quality is truly impacting both mental and physical health so that you receive appropriate treatment.
HOW IS THIS IMPACTING ME?
Sleep deprivation is connected to notable health issues, such as heart disease, stroke, cancer, diabetes, GERD, or even early death. Read more about this important issue in a recent update from the American Heart Association. Poor sleep also is a significant factor in our mental health, negatively impacting memory, attention and mood, and is even now as a contributing factor in the development of Alzheimer’s Disease. Anxiety and depression are frequently associated with chronic insomnia, and studies show there is a relationship between sleep disorders and suicidal behaviors in people struggling with depression.
SO WHEN SHOULD I SEEK TREATMENT?
There may be times when you struggle with situational insomnia for a brief period of time because of a particular situation or recent stressful events. Try to stay on a regular sleep schedule with the same bedtime and wake time, and do your best to keep anxiety out of the bed during this period. If you are still able to function during the day and the sleep issues resolve in a few weeks, you may not need to seek professional help. If you are struggling with insomnia for more than a few weeks and notice your ability to function during the day has really been impacted, it is probably time to get some help. Another indicator that your sleep issues are problematic is when you start to change behavior in an effort to accommodate sleep. If you become aware that you are spending more time in bed – going to bed earlier to try to catch up on sleep, lying in bed for a long time after you wake up in an effort to recover some much-needed rest, and/or falling asleep in places other than the bed, it is a good idea to seek professional help. We tend to negatively adapt our behaviors in an effort to sleep more, which actually can lead to chronic insomnia that becomes more difficult to resolve. You want to catch yourself before you head into a serious problem.
HOW DO I GET STARTED?
Your primary care physician’s office is a good place to start. Be clear and thorough with the extent of your sleep issues and don’t be afraid to really express how much this is impacting your life. Your doctor may decide to do some initial testing at the office, or may refer you out to a sleep specialist for further evaluation. Identification of sleep issues is key in getting the proper treatment. A full medical workup is recommended as the first part of the assessment process to rule out any physiological issues that could be contributing to the sleep disturbance. Once medical issues have been ruled out, medication is often recommended to resolve insomnia. Medication is one option that can be very helpful on a short-term basis to reset your body and get your sleep cycle back on track. Most doctors agree that pharmacological interventions can be helpful to resolve short-term insomnia, but should not be used indefinitely. There is another solution for insomnia that involves cognitive behavioral strategies. This type of therapy is actually recommended as a first-line treatment choice for chronic insomnia by the American College of Physicians. Many hesitate to seek the help of a therapist because of the stigma attached to any type of mental health treatment. Don't let this fear prevent you from getting guidance and support for effective sleep strategies. Therapy is a vital component of behavioral sleep medicine and seeking appropriate and effective treatment for insomnia and sleep disorders is necessary to end the suffering.
WHERE DO I FIND HELP?
After initial consultation with your primary care physician, he/she may refer you to a specialist. Here are some additional resources for insomnia treatment. To find an accredited sleep center near you, visit SleepEducation. For more information about behavioral sleep medicine, visit the Society of Behavioral Sleep Medicine website. To find a Cognitive Behavioral Therapy for Insomnia practitioner, visit the International CBT-I Provider Directory. The National Sleep Foundation has a great website with sleep resources and information.
If you are in the San Diego area and would like more information on Cognitive Behavioral Therapy for Insomnia (CBT-I), please contact Anissa Bell, LMFT at (858) 400-4646.
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