People sometimes ask whether chronic insomnia is mainly a physiological or a psychological problem. Often it’s both.
High reactivity to stress—whether strictly biological or due to a combination of biological and environmental factors—may predispose you to insomnia. But there’s probably a psychological aspect to the problem if insomnia is a persistent feature of your life.
Certain beliefs about sleep can interfere with getting a good night’s rest. A reality check can help you sort out truth from myth, which in turn may help you sleep.
I need 8 hours of sleep a night to function well.
If the National Sleep Foundation (NSF) recommends 7 to 9 hours of sleep for young and middle-aged adults and 7 to 8 hours for older adults, then it follows that 8 hours of shut-eye is the gold standard, right?
Sleep experts still haven’t figured out how to measure an individual’s sleep need. Prescriptions like the NSF’s are based on huge data sets containing information about sleep duration and longevity. The data, when graphed, fall into a U-shaped curve, with people whose sleep duration falls in the middle of the curve outliving those at both ends (i.e., the really short and really long sleepers).
Authors of recent analyses have concluded that it’s the 7-hour, and not the 8-hour, sleepers who live the longest. And in an early study involving data from over a million patients, people who slept 6.5–7.4 hours outlived the rest.
Keep in mind, too, that data on sleep duration in these big, retrospective analyses are usually based on subjective estimates, not on objective measures of sleep time. Finally, the recommendations on sleep duration set forth by the NSF panel are offered with this caveat: “some individuals might sleep longer or shorter than the recommended times with no adverse effects.”
You may think you need 8 hours of sleep based on personal experience. Especially if you’re not sleeping well, an 8-hour night can feel heavenly. But to assume you need 8 hours of sleep every night is a mistake.
There’s an average amount of sleep each of us needs for peak functioning. Normal sleepers, whose sleep periods are fairly regular, can estimate their sleep need pretty easily based on the time they drop off and wake up.
But insomniacs’ sleep is often erratic—2 or 3 bad nights followed by a good night—with the pattern repeating again and again. Sleep need on a given night is based on several factors: how long you’ve been awake, what you did during the day, and prior sleep. You may need 8 hours of sleep following several stressful days and short nights. But your average sleep need may be more like 6 or 6.5 hours a night.
I’m worried insomnia is going to do serious damage to my health.
Chronic insomnia is a risk factor for several nasty ailments: cardiovascular disease, depression, and fibromyalgia, to name a few. But saying something is a “risk factor” for something else does not imply causality. It simply indicates a correlation between one thing and another.
For example, if chronic insomnia is a risk factor for whiplash (it is), insomnia makes you more vulnerable to whiplash but does not indicate that you will develop whiplash. Even if you have chronic insomnia, the statistical probability of your developing whiplash is still relatively low.
Why scare the sleepless with talk of health problems we may or may not develop? Well, for years insomnia was dismissed as a trivial complaint without consequence. The fact that it has now been shown to have a relationship with other serious ailments makes it clear that insomnia is worthy of attention and treatment, and that insomnia research is worthy of funding. This is actually a boon for us.
All it takes is one bad night and my sleep is toast for the rest of the week.
If you’ve got chronic insomnia, it may be that sleeping poorly triggers anxiety about sleep, which in turn may make sleep more difficult the following night. Anxiety and worry are rarely compatible with sleep.
But as mentioned before, there’s an average amount of sleep each of us needs to function. You may not actually be aware of the amount you need, but your body IS aware of that amount. In fact, there’s a mechanism—the sleep homeostat—with a set point that keeps track of how much you sleep every night.
A bad night is going to register with the sleep homeostat as an inadequate amount of sleep. The result will be a greater build-up of sleep pressure the following night. Two bad nights will result in even greater pressure to sleep on the third night . . . and so on.
So while negative thoughts about sleep can prolong sleeplessness, an array of forces inside your body are actually working to promote sleep. They always win out in the end.
What ideas about sleep cause you the most anxiety?