Everyone has sleepless nights. Often it is caused by stress, a broken routine, illness, children, or all manner of other things. Sometimes people can go for a couple of weeks without sleeping well. That is not insomnia. That's just a bad couple of weeks. Insomnia is an uncontrolled chronic inability
to sleep properly.
Children need to learn how to go to sleep by themselves. They wake up during the night and as far as they are concerned, it's time to get up and be active, but they are still tired. Parents lose a lot of sleep over this problem until they find a way to teach their children to settle themselves back to sleep after waking up. There are various methods for doing this, the most common - and contraversal - is the controlled crying method. There are other ways, but that is not the issue here. The fact is, children need to learn how to do it... and so do some adults.
Some people simply never learn how to settle themselves properly back to sleep, others forget how after a long period of disrupted sleep. A sleepless parent who has spent too many nights unable to settle may forget how to relax back to sleep. How many times have you woken up 3 minutes before your alarm would normally go off to realise you don't have to go to work and you can sleep in... and be unable to actually do so? This is more of a routine problem than insomnia, but it can lead to insomnia if left unchecked. The person wants to go to sleep but just doesn't know how. Many people turn to using sleeping tablets in times like this to force themselves to get to sleep. Once they are asleep they are usually okay, they get a good nights sleep and can start getting back into a routine. If they could learn how to settle themselves to sleep without any medication, they would be able to get back into a good sleep routine and have no problems. The tricky part is learning how to settle.
Some people, especially teenagers, have a tendancy to throw out their sleep patterns because they are too interested in what they are doing to want to go to sleep. They spend many late nights doing something interesting and then have to drag their butts out of bed to go to school or work at the same time each morning regardless of when they went to bed, and they suffer a lack of sleep night after night... and this can eventually become a habit whereby they end up being able to rely on having a reduced amount of sleep and still function somewhat normally for long periods. This isn't insomnia so much as another change in routine. It's not a safe one, as lethargy will still have it's effects on reaction times and cognitive ability, but people do it all the same. When people start doing all the wrong things, like consuming drugs, drinks, and foods that create a physical and mental stimulation that keeps them awake, they are only contributing to the problem. These factors can also lead to insomnia if left unchecked.
People that are suffering from extreme stress, have ADHD, anxiety, or any number of other such conditions can have a lot of trouble getting to sleep. Once they are asleep, they are usually fine, it's getting to sleep that is the hard part. For these people, learning to settle is extremely hard because it's not just a matter of learning how to do it, it's also a matter of getting past the problem that is keeping them awake in the first place. This is where appropriate medication or therapy to control the cause of the problem is important. Once that is remedied, their ability to go to sleep will improve... if they can learn to settle.
With a proper routine, keeping an eye on what we eat and drink, the medications we are using and how and when they are to be used, and learning how to settle ourselves to sleep, insomnia is something that can be avoided in the first place, and if it's too late, it can still be completely abolished by taking control of the situation and doing something about it.
Sufferers of PTSD have all the above problems, and a few extras thrown in for good measure. Their sleep routines have usually been thrown out the window for a very long time before they were ever diagnosed. Getting back that routine is harder than for most people. PTSD sufferers can also have anxiety, stress, hyperactivity, paranoia, and hyperalertness... all of which are underlying problems that stop them from getting to sleep. Overcoming one of these problems is hard enough for anyone to do... just try to imagine having them all at once. If they can all be overcome, then they still have the problem of learning to settle on top of that.
PTSD sufferers also have nightmares, which wake them up in a state of sheer terror (see PTSD Part 2). Getting back to sleep after that is one thing. Imagine going through that night after night, re-living your greatest fears every time you close your eyes. You would eventually get to a point where you simply wouldn't want to go to sleep anymore... and that is exactly what happens. The sufferer can't go to sleep, doesn't want to go to sleep, and if they do fall asleep, they wake up in terror very soon after. This is insomnia at it's worst.
I have gone for years on end surviving on an average of 4 hours sleep in every 24 hour period...for months on end with an average of 2 hours sleep in every 24... weeks on end with only 1 hours sleep in every 24... and at one point I went for 3 weeks with no sleep at all and it literally drove me insane. I ended up in hospital, and after being there and not getting any sleep there either, a doctor came in on the 5th night and gave me an injection that put me to sleep... I stayed asleep for a whole 2 hours before waking up again. At that point I was given a very strong and highly addictive prescription medication that would knock me out fast and keep me drowzy enough to go back to sleep if I did wake up... and I was still lucky if I could get 5 hours sleep on it. But that was better than nothing. On the bright side, I've had times where I not only have managed a full 8 hours sleep every night for months on end, but at some points I've crashed for as long as 24 hours after a long period of insomnia. Getting 10 to 12 hours solid sleep after a nasty lack of it is a wonderous miracle, but it happens often enough to keep me sane.
Telling someone that has PTSD to go to bed and get some sleep can be like telling them to go and build an aeroplane out of matchsticks, get it to fly 1000 feet in the air, and jump out of it without a parachute. The prospect of going to sleep is not only difficult, for some it can be downright scary. Even if they can get past the fear of facing another night of terrifying nightmares and want to go to sleep, they may not be able to get past any anxiety, hyperalertness, hyperactivity, stress, or paranoia they may have at the time. If they can get past all of that, they then need to be able to settle. That's all assuming they haven't been filling their body with stimulants, such as too many cups of coffee and chocolate cake. You'd be better off suggesting they do something quiet so they don't keep everyone else awake and give them some space to wear themselves out and settle themselves down so they can sleep when they are ready... and if they get to sleep and don't wake up, don't wake them up if you can avoid it.
Sleep deprivation can be very nasty, and even dangerous, for anyone. A lack of decent sleep can lead to slowed reactions and a decreased ability to notice things... which makes driving a vehicle or operating machinery dangerous as you may as well be drunk. It also causes irritability, shortened temper, mood swings, and depression... which can create social probems. It reduces cognitive ability, concentration, and memory abilities, making learning and even just thinking difficult at best. It's also physically exhausting and can effect a person's health, making them far more prone to every contageous disease they come in contact with, as well as more susceptable to conditions such as stroke, heart attack, cancer and all the big nasty 'natural' killers that we are all vulnerable to.
When we sleep, our brainwaves change and go through a series of 're-programming'. Part of this pattern includes a dream state and REM (Rapid Eye Movement), among other things. Without this process being completed, the brain stops functioning properly. Studies have been done on the effects of sleep deprivation, and sleep deprivation has even been used as an effective torture method. The brain can not handle being awake for too long. Negative effects are many and varied according to exactly how little sleep has been had and what has gone on in the time awake. Eventually permanent brain damage and death are the extreme results. Some of the more nasty effects I have suffered over the years when it has gotten really bad for me include: hallucinations, delirium, memory loss, seizures.
Don't take a good nights sleep for granted. In fact, don't take any sleep for granted. If you are suffering from insomnia, get to the bottom of the reason why and do something about it. If your problem is like mine, there may not be much you can do. But if you are one of those people that play computer games and sip coffee all night and then complain all day about not getting enough sleep, I suggest you take a real good look at yourself and what you are doing, and realise how lucky you are; and know that people like me wish we could be like you.
