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A Wake-Up Call for Insomniacs

How'd you sleep last night?

If your answer is "Hardly at all," you're like an estimated 30 percent of the U.S. population.

Insomnia -- the inability to fall, or stay, asleep at night -- is a serious problem, one that's been tied to cardiovascular disease and depression. It causes daytime exhaustion that can lead to on-the-job errors and absenteeism. And, on a purely personal level, insomnia's a frustrating pain in the butt.

Insomnia can be remedied, or at least improved, through medication or behavior modification. Newer sleep medications (such as Ambien and Lunesta) can safely be taken for longer than older products (many of which are addictive) and may help ease insomniacs into better sleep patterns. People can also change their "sleep hygiene" (for instance, reserving the bed for sleep and sex; no books, TV or snacks) with an eye toward breaking free of insomnia. But many insomniacs -- and their physicians -- tend to think the condition will eventually go away on its own.

A new study suggests that assumption's not sound.

As reported in the March 9 Archives of Internal Medicine, researchers conducted phone interviews with a few hundred people with varying degrees of insomnia at three points over three years. Those whose insomnia was most severe at the start tended still to suffer from the condition three years later. Even those whose insomnia ceased for a time during the course of the study ended up being plagued by it again in the end. All in all, according to the study, "Nearly half of the sample (46%) reported persistent insomnia at all time points during the 3-year study, and 74% reported insomnia persisting for at least 1 year."

Oddly, a number of the study participants (the paper doesn't specify exactly how many) were taking sleep medication during the research period. The study is silent, though, on how those meds affected the severity and duration of their users' insomnia.

I know several women who have suffered insomnia (which tends to affect women and the elderly more commonly than others) for years. Though some have sought treatment, others seem to accept sleeplessness as their inevitable lot in life -- and as an excuse to catch up on their reading.

For my part, I'm worthless without a good 8 hours of sleep, and I imagine that if I faced more than the once-in-a-while sleepless night, I'd be clamoring for professional help (and a bigger Starbucks card).

Do you have insomnia? All the time, or just when you're anxious or upset? Do you take sleep medication? What other steps have you taken to try to improve your night's sleep?

By Jennifer LaRue Huget  |  March 11, 2009; 7:00 AM ET
Categories:  Chronic Conditions , Family Health , General Health , Women's Health  
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Comments

I've had insomnia since I was a child. Once I head to bed, it takes on average of 1-3 hours before I fall asleep, if I fall asleep at all. Having ADD keeps my mind spinning at all hours of the day and night and it typically takes utter exhaustion to slow it to the point I can drift off to sleep. One concept that has helped me to clear my mind is referred to as Bilateral Stimulation. You simply move your eyes from right to left about 25 times which promotes balance and calm. It seems to work a bit, though not as well as Nyquil or Ambien.

Posted by: elife1975 | March 11, 2009 1:02 PM | Report abuse

I'm a woman in my mid-30s. Three years ago, I started taking Tylenol PM for occasional insomnia; that med proved ineffectual for a particularly brutal spate of insomnia that followed one year later, during which I upped it to about 3 pills, averaging 2-3 hours/night. At the time I was significantly underweight. The upshot is, my insomnia was more than a frustration. I was seeing trailers and peripheral black blotches. I was an emotional wreck. I almost lost my job. I still take Tylenol PM, and can't imagine a time when I won't. This is too bad, because historically I was an easy, sound sleeper. Now my brain needs its kickstand to be tripped chemically. I hope I'll be able to get my natural sleep back some day, but I sort of doubt it.

Posted by: SFpoppy | March 11, 2009 1:09 PM | Report abuse

Dr. Robert Carl Parisien says: there's some excellent medication available for those with chronic insomnia. Tylenol PM is good for mild cases.

Posted by: DrRobertCarlParisien | March 11, 2009 2:03 PM | Report abuse

Also an intermittent long-time insomniac. One reason is restless-leg syndrome, which I've had since childhood. This is NOT a disease manufactured by the pharmaceutical industry. One of the best OTC sleep aids is Benadryl (which is probably what's in Tylenol PM, minus unnecessary acetominophen), but my own experience confirms that it makes RLS worse. Alcohol helps in getting to sleep, but makes me wake up at 3 a.m. *Sigh*

Posted by: krazykat23 | March 11, 2009 3:41 PM | Report abuse

I've hand insomnia for my entire life. I remember laying in bed as a kid for HOURS waiting to fall asleep. About eight years ago (at the age of 30), I started taking a half a tablet of Unisom each night. It works like a charm. The only problem is that it makes me very tired in the morning, so I have to make sure that I get 9-10 hours a sleep each night, just because I'm too tired in the monring from taking the Unisom the night before. So if anything, I'm getting more sleep now than most people. But I wouldn't give up my unisom for the world. For the first time in my life, I'm getting enough sleep. What I like best about it is that I can control the amount I take by spliting the pill in half (or quarters, if I'm already really tired). TylonolPM contains a pain medication, and I don't want to take medication for a sympton I don't have (pain).

Posted by: MarylandJ | March 11, 2009 5:44 PM | Report abuse

I haven't heard of this elsewhere or seen any comments about this but I've self-diagnosed my insomnia as often being digestion related. Since I have GERD and other mild digestive issues, I've found a correlation with insomnia. Anyone else? I do not take any medication for insomnia as it often occurs in the middle of the night. P.S. Your suggestion in your GERD posting to chew gum has been helpful (but obviously not so much in the middle of the night...)

Posted by: Afriend3 | March 11, 2009 9:01 PM | Report abuse

Interesting connection, Afriend3; I share your curiosity as to whether others link their insomnia to their GERD or other GI issues.

By the way, here's a link to the original posting re treatments for GERD: http://voices.washingtonpost.com/checkup/2008/11/the_cider_vinegar_heartburn_cu.html

Thanks for writing.

Posted by: Jennifer LaRue Huget | March 11, 2009 9:19 PM | Report abuse

i have PTSD, and my sleep is punctuated by nightmares at least 5 nights a week, if not multiple times a night every week. you name it, ive tried it: sleep hygiene, deconditioning (get out of bed if you cant fall asleep in 30min and do something else until your tired), psychological therapy and biofeedback, staying up for 36-48hrs at a time, and OTC, prescription, and recreational/illegal drugs. the first three strategies are a part of my life now, an ingrained habit. the drugs, on the other hand... if i go to sleep intoxicated, at least i dont remember the nightmares. the nights i fall asleep sober, i have horrifying nightmares and PTSD symptoms the next day (sustained hyperarousal, inability to concentrate, irritability, inappropriate fear/panic responses, etc). it affects my ability to go to school, to work, to just be normal. for several years, drugs like alcohol, pot, diphenhydramine, and a slew of prescription drugs of all classes were all that would get me to sleep.

so far, the only thing that has helped and is genuinely sustainable is my cat. i recently adopted him, and every night since he has slept with me. i fall asleep to his purring and wake up once or twice a night to his meows. when he wakes me up, im always sweaty, breathing hard, tangled in the sheets, and feeling panicked or threatened. he knows when im having nightmares and wakes me up. falling back to sleep after the nightmares is infinitely easier now, and even the initial lapse into sleep is easier. i havent had to use my ambien since i adopted him. i hope i never have to go back to it.

Posted by: studentkt | March 11, 2009 9:36 PM | Report abuse

Like Afriend3, my insomnia is often acid reflux related. This is especially annoying when I've been good and not eaten any of my trigger foods. Occasionally, I get the brain-on-overtime version.

Over-the-counter medications contain antihistamines, which make me hyper (except for Benedryl which makes me hyper and sleepy at the same time). The prescription medications all say that one shouldn't take it unless you can get 8 hours of sleep. By the time I figure out that I've got insomnia, it is 1 or 2 in the morning and I no longer have 8 hours. My best cure for insomnia is stretching exercises followed by dull television.

Posted by: magicdomino | March 13, 2009 10:31 AM | Report abuse

YES, it's persistent, YES, it can be lifelong, as many of us well know. I've had insomnia as long as I can remember, which is why I wrote INSOMNIAC. It addresses most of the questions raised on this blog, what people have found that works, which drugs, what they do, on the basis of my own experience and the many insomniacs I interviewed, writing the book.
The comments on this blog are great. I love the purring cat idea....
sleepstarved.org

Posted by: gaylegreene | March 13, 2009 4:03 PM | Report abuse

I've had insomnia my entire adult life and for the last 7 years have taken 5mg of Ambien every night to fall asleep. It works almost all the time. I am certainly dependent on it but have not had to increase the dose. I experimented with Lunesta when it came out but that did not work for me at all. Nor does the new controlled release Ambien. So I'm sticking with original Ambien (now available in a generic but the 10 mg pills are a challenge to split. Best wishes for a good night's sleep to all.

Posted by: Putney1 | March 13, 2009 5:03 PM | Report abuse

I started having severe back problems in my twenties and couldn't stay in bed more than 3 hrs. without experiencing excruciating pain. This of course limited my sleep to 3 hr. stretches. I apparently compensated by taking catnaps at every opportunity (some less than fortunate). My sleep is still disturbed by chronic pain, which no one has a cure for. Wonder how many others like me are out there.

Posted by: ejefferies | March 17, 2009 2:04 PM | Report abuse

Cats surely are wonderful creatures. I often find that I cannot fall asleep if my cat is not purring in my bed. I awake every morning about 3 or 4am & just relax until sleep comes again, within the hour. If I got up to read, I'd be fully awake for an hour or so & absolutely shot in the morning. If I have to go to work early, I feel exhausted by 11am & fall into a deep sleep for an hour. It's great if your work/school schedule allows that. I never used any med to sleep better. Prefer my sweet cat. Try it, you'll like it.

Posted by: lynneknu | March 17, 2009 3:39 PM | Report abuse

I'm similar to elife1975, though I don't have ADD. I've had insomnia for as long as I remember. As a child in kindergarten, I was unable to nap. I simply couldn't fall asleep.

There have been many nights in my life when I never did fall asleep. Most of the time it has taken me 1-3 hrs to fall asleep.

The one thing that has improved (but not eliminated) my insomnia has been to increase my level of serotonin naturally in a dietary and behavioral program devised by Dr. Kathleen DesMaisons (radiantrecovery.com). I have also eliminated the inflammation brought on by sugar, white flour, and caffeine ingestion through this program; I don't consume any of these anymore.

BTW, much of our serotonin is produced in the gut, so it makes sense that gut problems could result in insomnia.

I don't take sleep medication because my body is set up for addiction. I know I would become dependent on it. No thanks. Limiting my computer and television use in the evening (none after 9pm) helps. And I love the cat idea. Wishing all a good night's sleep.

Posted by: domystic8 | March 17, 2009 11:20 PM | Report abuse

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