“I feel very anxious at night,” she said. “I tell myself that there is no reason to be anxious, but it feels almost physical. And it doesn’t matter what I do (meditation, relaxation), I still can’t sleep.”
Insomnia, many of us are told, is mainly a psychological problem. So the physical sensations that accompany it can be unnerving: the fluttering heartbeat, the muscle tension, the racing feeling radiating from torso to extremities, the overheating, the sweaty skin. Yet these sensations should tip us off that insomnia is not just in the head.
A.L. Kennedy, writing about her insomnia in Sunday’s Guardian, remembers adolescence as the time when she first experienced the willfulness of her body: “The term ‘fast asleep’ promised I might be locked safely and quickly away from harm. But my body wouldn’t let me leave. Insomnia,” she says, “was my first intimation of my body’s unreliability.”
If sleep were available on demand, we insomniacs wouldn’t have a problem. Yet at least where sleep is concerned, the body seems to have a mind of its own. No matter how much we crave sleep, the body doesn’t necessarily fall in line.
Changing Habits and Mindset
Sleep therapists claim that insomniacs have more control over our sleep than we think. Sleep is a basic human need and it occurs naturally in everyone. The problem for insomniacs, they say, is that we adopt habits and attitudes that interfere with sleep (erratic sleep schedules, for instance, or a belief that we can’t survive on less than six hours a night). Change these habits and attitudes and our sleep will improve.
Count me as a believer . . . up to a point. I’m all in favor of sleep restriction and other behavioral treatments for insomnia. I think it’s good to examine beliefs and attitudes that may be hindering sleep. There’s plenty of research showing that these strategies work, and they’ve certainly helped me.
At the same time, it’s important to understand that our bodies and brains behave differently from the bodies and brains of people who sleep well. New research is turning up evidence that
- even when asleep, the insomniac brain tends to remain active in some areas. One is the precuneus, which plays a role in memory, visual processing, and self-reflection. Metabolic activity here “may contribute to the subjective experience of self-awareness” at night, researchers say.
- some insomniacs may be deficient in GABA, the neurochemical responsible for shutting the brain down at night.
- in insomniacs, physical exercise produces greater malleability in a part of the brain that controls movement. This suggests, says investigator Rachel Salas, that insomnia is not a nighttime disorder. “It’s a 24-hour brain condition, like a light switch that is always on.”
- a part of the brain called the left caudate nucleus is underutilized by insomniacs when we’re thinking. This condition can be reproduced in good sleepers by disrupting their slow-wave, or deep, sleep.
These studies are preliminary, yet they square with the hyperarousal theory of insomnia and suggest an imbalance in the arousing and calming forces inside insomniacs’ bodies and brains. If insomnia “feels almost physical,” that’s because it really is.
What are some of the physical sensations you experience at night when you can’t sleep?