Sleep Problems Following a Stressful Childhood

Only a minority of the insomnia sufferers I interviewed for The Savvy Insomniac said their insomnia began in childhood. But regardless of when their sleep problem began, a number reported having had stressful and/or abusive experiences in childhood.

Is there a relationship between adverse childhood experiences and insomnia later in life? Anecdotal and scientific evidence suggests there is.

insomnia can occur following a stressful childhoodOnly a minority of the insomnia sufferers I interviewed for The Savvy Insomniac said their insomnia began in childhood. But regardless of when their sleep problem began, a number reported having had stressful and/or abusive experiences in childhood.

Is there a relationship between adverse childhood experiences and insomnia later in life? Anecdotal and scientific evidence suggests there is.

Difficult Childhoods

Liz’s insomnia started in adulthood, worsening around the time of menopause. But she remembered being “a very, very nervous, anxious child”:

I have my suspicions that my trouble sleeping goes back a long, long way. My mother and father had difficulties and they fought a lot, and that made me anxious. I don’t think I feared for myself so much as I felt a general anxiousness about the disruption. Then I had a brother who was 6 years older than me and was always getting into trouble. He grew up with his father away in Egypt during the war. All of sudden he was 6 years old and he had a father and there were major problems between them. That was another disruption, another source of anxiety for me.

Keith thought it was the pattern of abuse he experienced at the hands of a family member that set him up for trouble sleeping:

I experienced severe childhood abuse—physical, emotional, and sexual abuse. It started when I was young and continued a long, long time. It happened early in the morning. When I wake up early now, and I often do, there’s frustration that I’m not able to sleep because I’m vigilant, I’m unable to relax. I’m pretty sure the childhood abuse is the source of my sleep difficulties.

What the Research Shows

Adverse childhood experiences (ACEs) increase people’s susceptibility to health problems later in life. The relationship between ACEs and mental illness, substance abuse, and heart disease is well documented. A recent literature review conducted by Harvard researchers shows that children who experience trauma are also more vulnerable to sleep disorders as adults.

In a majority of studies documenting this relationship, sleep problems were assessed subjectively, by the patients or participants themselves:

  • In a retrospective study of data collected from 17,337 HMO members, trouble falling and staying asleep was significantly associated with several types of childhood trauma: (1) physical abuse, (2) sexual abuse, (3) emotional abuse, (4) witnessing domestic violence, (5) household substance abuse, (6) household mental illness, (7)parental separation or divorce, and (8) household member imprisonment.
  • In a subsequent study, the authors found these same ACEs to be associated with frequent insufficient sleep.
  • In a longitudinal study, children who experienced family conflict between the ages of 7 and 15 were more likely to report insomnia at age 18.
  • Among women overall, there was a strong association between childhood sexual abuse and sleep disturbances reported in adulthood.

In two studies, sleep problems were assessed objectively using a wristwatch-type device:

  • Among 39 insomnia patients, a history of abuse and neglect explained a moderate amount of variance in sleep onset latency (39%), sleep efficiency (37%), number of body movements (40%) and moving time in bed (36%).
  • Among 48 psychiatric outpatients, childhood stress load was a correlate of total sleep time, sleep latency, sleep efficiency, and number of body movements.

Finally, the more traumatic childhood events people reported, the poorer was their quality of sleep:

  • People who experienced 1 to 2 ACEs were twice as likely to report poor sleep quality as people with no ACEs. People who experienced 3 to 6 ACEs were 3.5 times as likely to experience poor quality sleep as people with no ACEs.
  • As the number of ACEs went up, so did the prevalence of insufficient sleep.

Clearly adverse childhood experiences make it more likely that people will develop chronic insomnia or insomnia symptoms in adulthood. I did not experience familial abuse or neglect. I’m guessing, though, that the bullying I experienced one year at school increased my susceptibility to insomnia . . . but that’s a topic for another blog post.

How about you? Do you think there’s a link between your trouble sleeping and adversity you experienced in your youth?

Helping Baby Sleep . . . Like a Baby

Got an infant whose sleep is getting worse rather than better (and could this be a sign of incipient insomnia)? A toddler who won’t sleep alone? A 4-year-old who shifts into overdrive when he should be winding down?

Help is at hand. A new book, The Happy Sleeper, is a friendly guide for parents of young “problem sleepers.” In reality, say authors Heather Turgeon and Julie Wright, most babies and children have no trouble sleeping at all. Instead, the problem lies in the misguided tactics well-meaning parents use to help their babies sleep.

Babies sleep better when they feel securely attached and structure is built into their livesGot an infant whose sleep is getting worse rather than better (and could this be a sign of incipient insomnia)? A toddler who won’t sleep alone? A 4-year-old who shifts into overdrive when he should be winding down?

Help is at hand. A new book, The Happy Sleeper, is a friendly guide for parents of young “problem sleepers.” In reality, say authors Heather Turgeon and Julie Wright, most babies and children have no trouble sleeping at all. Instead, the problem lies in the misguided tactics well-meaning parents use to help their babies sleep.

“Over time, parents’ ‘helping ways’ overshadow their baby’s natural sleep abilities,” they write. “Children get confused as to whether they or their parents are doing the soothing, and parents aren’t sure when and how much to back off so their little ones can take over the job.”

Developmental Stages

Turgeon and Wright are marriage and family therapists who coach parents in helping young children and babies sleep easily and well. Backed by scientific research (the subtitle of the book is The Science-Backed Guide to Helping Your Baby Get a Good Night’s Sleep—Newborn to School Age), the method they use is based on these premises:

  1. Babies and young children need warmth, sensitivity, and a sense of security
  2. Little ones thrive and sleep best when structure and routine are built into their lives, and when parents set clear expectations.

The best way to balance these principles changes over time. So after the introductory chapters, The Happy Sleeper is organized according to developmental stages: (1) babies 0 to 4 months old, (2) babies and toddlers 5 months to 2 years old, and (3) children 2 to 6 years old.

Sleep and Self-Soothing Come Naturally

Parents must follow their infant’s cues about eating and sleeping during the first months of life. Even so, parents can pave the way to good nights ahead. One thing to do is look for opportunities to put your baby to bed while she’s drowsy but still awake. Learned associations are quickly acquired, and a child who always falls asleep in your arms may feel she must be in your arms to fall sleep long after she’s outgrown the need. Another suggestion is to gradually loosen the association between feeding and sleep. The authors spell out how to do it.

As babies get to be 4 and 5 months, parents should look for behaviors that signal children’s readiness to soothe themselves to sleep. Babbling, squirming to get comfortable, moving the head from side to side, sucking on a finger, and even squawking are some of the many ways babies lull themselves to sleep. For children still too young to manage on their own, Turgeon and Wright encourage parents to create a “Soothing Ladder.” The aim is to use the least invasive measure to lull babies to sleep before progressing up the ladder to measures requiring greater parental involvement.

Establish Routines

At about 5 months, babies’ circadian systems are maturing and internal processes are following regular rhythms. Parents should reinforce these rhythms wherever possible. Setting an early and consistent bedtime is crucial to the process, as is establishing a wind-down routine in the evening. Regular naps are important, too. And just as regularity is the key to happy sleep for Baby, it’s the best way to avoid sleep deprivation or developing insomnia yourself.

“Good sleep isn’t just about hitting the numbers,” Turgeon and Wright say, “it’s about setting up habits and routines in your house that feel good for everyone.” For parents of children still unable to soothe themselves to sleep, the authors have developed a protocol called “The Sleep Wave.” It helps instill in little ones a sense of parents’ presence while at the same time training them to self-soothe.

Older children with trouble sleeping can become independent sleepers as well. Techniques for helping children ages 2 to 6 to are similar and equally well presented.

Valuable Information

The Happy Sleeper makes for easy reading and is full of practical tips. Troubleshooting sections make it clear that the authors have experience helping parents manage almost any situation that could come up with babies and young children at night.

The final chapters are lighter in substance. For parents of twins or triplets or a person interested in the science of baby sleep, the information in this book may not suffice. But most parents will find everything they need to nurture a happy sleeper and avoid sleep deprivation themselves.

If your child has trouble sleeping, how have you tried to help? Did it work?

Young, Sleepless, and Looking for Help

David walked in late to a presentation I was giving on managing insomnia. I’d surveyed my audience and launched into a talk for retirees. But here was David, a high school teacher in his early twenties, and I realized I was going to have to change the remarks I was about to make.

We think of insomnia as mainly an affliction of older adults. But the facts don’t bear this out.

Insomnia afflicts the young as well as the old, and stress is a causal factorDavid walked in late to a presentation I was giving on managing insomnia. I’d surveyed my audience and launched into a talk for retirees. But here was David, a high school teacher in his twenties, and I realized I was going to have to change the remarks I was about to make.

We think of insomnia as mainly an affliction of older adults. But the facts don’t bear this out. Data collected from the U.S. Behavioral Risk Factor Surveillance System showed the following:

  • Reports of sleep disturbance were highest among adults in the youngest age group, 18-24.
  • Tiredness and lack of energy were also highest among adults ages 18-24.

What’s more, 42% of the nearly 2,400 young adults surveyed in a study by the Harvard School of Public Health reported insomnia symptoms. That’s higher than the national average of 30%. What’s behind the sleep problems of millennials, the generation that started coming of age at the turn of the century?

Drivers of Insomnia in the Young

Trouble sleeping in millennials may be due to a circadian phase delay. The internal circadian period, which in humans averages a little more than 24 hours, expands in adolescence (for reasons unknown) and this longer circadian period can continue as people move into their twenties. The result is that they want to stay up late and get up later in the morning. Sleep preferences that conflict with school and work schedules are a setup for insomnia.

The phase delay could be exacerbated by use of blue light-emitting devices at night, which I blogged about last week.

But David had a different explanation for his insomnia. “I have trouble falling asleep sometimes,” he said. “But the main problem is that I wake up 2 hours before my alarm goes off. Either I go into a very light sleep or I don’t get back to sleep at all. It’s probably due to stress.”

Stress and Sleep Disturbance

Stress may well figure as one of the main culprits when insomnia shows up in the young. The American Psychological Association’s 2013 Stress in America survey showed that reports of lying awake at night due to stress were highest among the youngest adults and fell off as people aged. Here are the figures:

  • 52% of millennials reported stress-related insomnia, as did
  • 48% of gen Xers
  • 37% of baby boomers, and
  • 25% of seniors.

As for the main source of stress, millennials and gen Xers were most likely to say they were stressed by work, money and job stability. With unemployment among millennials running in the double digits for 6 years now and the average student loan debt at $30,000, it’s hardly surprising that employment and financial concerns would sabotage the sleep of the young.

Sacrificing Sleep to Get Ahead

Not only are young adults losing sleep to worry about money and jobs. TODAY.com has just publicized results of a Snooze or Lose survey that shows that millennials, much more than any other age group, believe that to get ahead in their careers, they must survive on less sleep. Here are the numbers:

  • 33% of adults ages 18-34 endorsed this belief, as did
  • 19% of adults ages 35-54, and
  • 6% of adults ages 55 and above.

Currently there’s a drive to raise awareness about sleep issues in teens. But I don’t see an effort being made to address the sleep problems of young adults trying to gain a toehold in the job market. Why not? Twenty-somethings who struggle with insomnia may cope with it in unhealthy ways, and once insomnia becomes chronic, it puts even the young at risk for depression, obesity and heart attacks.

Why not launch a public health campaign aimed at helping the young and sleepless at a time of life when the help would do most good?

If you’re in your twenties and have trouble sleeping, what do you think is the single biggest cause of your insomnia?

 

Blue Light's Effect on Sleep? It's Not All Bad

Blue light gets a bad rap these days in articles about sleepy teens. Exposure to blue light in the evening interferes with the secretion of melatonin (a sleep-friendly hormone), pushing circadian rhythms out of whack. This can lead to insomnia or sleep deprivation. Doctors are counseling teens and the rest of us to turn off devices that emit blue light—computers, tablets, and smartphones—in the run-up to bedtime.

This is sound advice as far as it goes. But the story on light is bigger than this simple warning suggests. Knowing how to manage your exposure to blue light can help you steer clear of sleep problems and increase your daytime stamina.

Blue light interferes with sleep and melatonin secretion at night but is beneficial during the dayBlue light gets a bad rap these days in articles about sleepy teens. Exposure to blue light in the evening interferes with the secretion of melatonin (a sleep-friendly hormone), pushing circadian rhythms out of whack. This can lead to insomnia or sleep deprivation. Doctors are counseling teens and the rest of us to turn off devices that emit blue light—computers, tablets, and smartphones—in the run-up to bedtime.

This is sound advice as far as it goes. But the story on light is bigger than this simple warning suggests. Knowing how to manage your exposure to blue light can help you steer clear of sleep problems and increase your daytime stamina.

“I Play Solitaire on My iPad at Night”

Screen time at night not just a temptation for teens. A grandmother I met the other day wondered if playing solitaire on her iPad in the middle of the night was contributing to her insomnia and making it harder to fall back to sleep.

I replied that it might be. Humans are most sensitive to the effects of blue light when our brains least expect it: late in the evening, at night, and early in the morning. The most intensive source of blue light is the sun. But the self-luminous screens of computers, iPads and iPhones emit blue light, too, at wavelengths that suppress melatonin. TV screens also emit blue light. But proximity to a light source matters. We position ourselves much closer to handheld devices and computers than we do to TVs, so the newer devices are more likely to interfere with sleep.

There’s an App for That

If you can’t bear to part with your iPad at night, there are ways to protect yourself from the light it emits. Dr. Craig Canapari recently posted an article containing helpful advice, and I’ll summarize it here:

  • Manually dim screens on devices at night
  • Visit Just Get Flux to download free software that automatically adjusts the color temperature of your computer screen according to the time of day
  • Get “night mode” software for your tablet or smartphone. The display will appear as white text on a black background.

You can also wear blue light-blocking glasses at night. A new study of teens shows that blue-blocker glasses with orange lenses allow for normal melatonin secretion and sleepiness to develop at night regardless of time spent looking at screens. But expect to pay more for these glasses than for a cheap pair of sunglasses with orange lenses. Cheap glasses will block blue light and other colors, too, so they won’t work well indoors.

Last but not least, use dim red lights as nightlights. Red light is least likely to suppress melatonin secretion and shift the rhythms of your body clock.

Soak Up the Rays During the Day

In the daytime, on the other hand, exposure to blue light is beneficial. Not only does it boost your attention, speed your reaction time and elevate your mood. It also helps you maintain a regular sleep/wake cycle.

But as the days grow shorter, you may miss out on daily exposure to the sun, a critical source of blue light. If you work in a windowless office, warehouse, or power plant and you commute in the dark, the daily resetting of your body clock enabled by sunlight does not have a chance to occur. Your circadian rhythms may go off track and your sleep take a turn for the worse.

A study just published in PLoS One illustrates this neatly. It was conducted at a polar base station at a time of year when crew members got no daily exposure to sunlight. Here’s what the researchers found:

  • When the subjects were working in standard indoor lighting for 2 weeks, they experienced a significant, 30-minute delay of melatonin secretion in the evening, and a decrease in sleep duration.
  • Working in blue-enriched white light for 2 weeks, they did not experience the delay in melatonin secretion. They slept longer and experienced a greater sense of wellbeing and alertness during the day. Daily exposure to blue-enriched light made the difference.

If you regularly miss out on the sun, consider investing in a light box, which will give you the daily dose of blue light your body needs. Better yet (but maybe something of a long shot), suggest the installation of blue-enriched white light at your workplace. The fact that it enhances work performance could sweeten the idea for the boss.

Have you noticed a seasonal pattern to your insomnia, where in the wintertime it tends to grow worse?

Late-Night Sweets and Your Sleep

Insomnia is big business these days, and not just for Big Pharma. Insomnia Cookies, the chain of late-night bakeries located in campus towns across the East and the Midwest, is opening up a new store every few months.

A sweet bedtime snack delivered right to the doorstep: now there’s a concept Dr. Atkins would have frowned on. But what effect would eating a late-night treat have on students’ sleep?

A high-carb diet may harm sleep, but an occasional treat near bedtime won't have much impactInsomnia is big business these days, and not just for Big Pharma. Insomnia Cookies, the chain of late-night bakeries located in campus towns across the East and the Midwest, is opening up a new store every few months.

I’ve wondered what’s behind the name of this store and its appeal. Are the cookies intended as a sort of high-octane fuel for students cramming for exams? Or are they supposed to assuage the food cravings of students who are anxious because they can’t sleep? Lots of things in life are not as complicated as I imagine them to be.

“It’s called Insomnia Cookies just because we stay open so late,” said Josh, second-in-command at a store near my house. “We’re open till 3 a.m. every day.”

I asked Josh if they get a lot of business late at night.

He nodded. “We get the bar-crawler crowd. And our last delivery goes out at 2:45.”

A sweet bedtime snack delivered right to the doorstep: now there’s a concept Dr. Atkins would have frowned on. But what effect would eating a late-night treat have on students’ sleep?

The Sugar High: Myth or Reality?

Despite continuing talk about the “sugar high” that afflicts kids who eat too much Halloween candy (a meta-analysis published 20 years ago found little evidence that the burst of energy kids seem to get after eating sweets is actually attributable to sugar), it’s unlikely that eating a cookie at bedtime will have much impact on your sleep. (Unless, that is, you eat the entire box of thin mints.)

Your body converts all carbohydrates—whether in the form of vegetables, grains or snacks–into glucose and then transports it via the bloodstream to cells throughout the body for use as energy. Most desserts are high in simple carbohydrates such as sugar and white flour, which the body metabolizes rapidly. So they may initially give you a burst of energy that would not be conducive to sleep.

But that burst of energy—if and when it occurs—is relatively short lived.

  • In one study of adults, eating a candy bar resulted in subjects reporting increased energy and reduced tiredness after 1 hour but greater tiredness and reduced energy after that.
  • In another, while 400 ml of fructose—the form of sugar found in fruit and honey—delayed the onset of extreme drowsiness in drowsy subjects by 20 to 30 minutes, 400 ml of glucose had no more effect on drowsy subjects than water.

I’ve combed the journals for other information about the acute effects of sugar on sleep but have come up empty handed. So it’s safe to assume that while a sweet treat is not exactly soporific, neither will it likely keep you up.

Chocolate and Sleep

What about desserts containing chocolate? Here, insomniacs are on shakier ground. If you crave a sweet at bedtime and you’re really caffeine sensitive, you’d be better off going with a snickerdoodle than a chocolate chip brownie.

But the amount of caffeine in chocolate is far less than the amount in coffee and popular energy drinks. While a 12-ounce cup of Starbucks coffee contains 260 grams of caffeine and an 8.4-ounce can of Red Bull contains 80 grams, a 1-ounce square of dark chocolate contains only 12 grams. Milk chocolate contains less caffeine, and white chocolate, much less.

A High-Carb Diet

An occasional late-night treat may not affect your sleep. But habitually indulging your sweet tooth is a risky business. Apart from the fact that eating lots of simple sugars may cause you to gain weight (and being overweight increases your risk of developing type 2 diabetes), a high-carb diet does not square with stable, high-quality sleep.

Two large studies that recently came out of Japan showed that

  • Women who ate few vegetables and lots of sweets and noodles were significantly more likely than others to report poor quality sleep, and
  • People whose diets were lowest in protein and highest in carbohydrates reported poor sleep-wake regularity.

A macadamia cookie at midnight is not going to hurt your sleep. But avoid making a habit of it if you love figure and your sleep.

If you get late-night food cravings, what do you eat?

Sleep at College: Here’s How to Get Enough

Off to college soon (or know of someone who is)? You’re probably looking forward to interesting classes, good friends, and the freedom to live away from the prying eyes of Mom and Dad. Heady prospects, all three! But you’ll also face some challenges. Getting enough sleep may be one.

But college life doesn’t have to be disruptive to sleep. By planning ahead, you can get the sleep you need whether you’re inclined to get up early or burn the midnight oil. Here’s what you can to do get a better night’s sleep away from home.

Make sure you sleep well at collegeOff to college soon (or know of someone who is)? You’re probably looking forward to interesting classes, good friends, and the freedom to live away from the prying eyes of Mom and Dad. Heady prospects, all three! But you’ll also face some challenges. Getting enough sleep may be one.

Sleep at college was a challenge for me: growing up in a quiet home, prone to occasional bouts of insomnia, I was unprepared for life in a dormitory. The dorm was a place where rock music and partying ruled—no matter that some of us had early morning classes. Often I struggled with insomnia. That I could see, the world was divided into two tribes: early risers and night owls. Living so close together was a pain in the neck!

College life doesn’t have to be so disruptive to sleep. By planning ahead, you can get the sleep you need whether you’re inclined to get up early or burn the midnight oil. Laura McMullen in US News & World Report recently offered advice on how to sleep well at college. Here’s mine.

If You’re an Early Riser

Especially if you’re a light sleeper or one who needs a solid 8 to 9 hours, you’ll need to be prepared to deal with unwanted noise at night. You can

  • Arm yourself with silicone earplugs
  • Use a device that creates white noise. Small fans work well, as do white noise generators that can be purchased online or at stores like Best Buy. My brother swears by his SleepPhones, also available online.

A bigger challenge for early risers may be negotiating with roommates for the conditions you need to get a good night’s sleep.

  • Be up front about the situation from the start. Tell your roommates you’ve got an early class and need the place to be quiet and dark by 11 p.m. Ask them please to text rather than talk on the phone, or to wear a headphone while watching TV.
  • If friendly negotiations don’t do the trick, then request a move–the sooner, the better. Ideally you’ll know of another person looking for an early-bird roommate or someone who’s likely to be considerate of your needs. If not, interview prospective roommates about their habits at night. Given a choice of location, avoid rooms near high-traffic areas like bathrooms and stairways.

If You’re a Night Owl

Noise won’t be such a problem if you’re naturally inclined to stay up late. But you may find that your sleep preferences are out of sync with daily life on campus. Your circadian rhythms are delayed, so you’ll tend to be sound asleep when early morning classes begin and you may not feel truly alert until much later in the day. (A young night owl I know claims he doesn’t really hit his stride until 6 p.m.)

To get the sleep you need and feel alert during the day,

  • Make strategic use of bright light. Light is your friend in the morning but a foe at night. When you get up in the morning, open the curtains and turn on the lights. Spend time outside if you can. In the evening, keep lighting low. Avoid computer screens and other light-emitting devices for an hour or two before going to bed.
  • Check with your doctor about using over-the-counter melatonin supplements. Taken around dinnertime, they enable people to fall asleep earlier than normal—at midnight, for example, rather than 1 or 2 a.m. (For details, see this blog or watch this video trailer.)
  • Schedule your classes later in the day. If you slept through 8 o’clock classes in high school, chances are you’ll sleep through early morning classes at college. You may be older, but circadian rhythms remain fairly consistent.

Arrange for active days and restful nights as best you can. If you still find yourself dropping off to sleep in class, catch some shut-eye in the middle of the afternoon. Ten- to 30-minute naps can do wonders for your stamina and put you on top of your game.

Bedtime for Brianna: Get It Right!

A new study examines the relationship between melatonin secretion and children’s sleep patterns.

Early bedtimes set by parents can backfire, putting children at risk for insomnia.

If baby cries when you put her to bed, you may be putting her to bed too earlyPeter, who owns a bookstore, is convinced his insomnia began because of his parents’ insistence that he go to bed too early.

“Being forced to go to bed when I wanted to stay up was really hard,” he said. “It was a physical sensation: all I wanted to do was be up and moving around. Instead I had to lie quietly in bed. It got me in the habit of thinking a lot. Now my problem is that I just can’t turn my mind off.”

A new study that examines the relationship between melatonin secretion and children’s sleep patterns suggests that bedtimes set by parents can put children at risk for insomnia. The influence starts as early as toddlerhood.

“This study is the first to show that a poor fit between bedtimes selected by the parents of toddlers and the rise in their evening melatonin production increases their likelihood of nighttime settling difficulties,” said lead investigator Monique LeBourgeois of University of Colorado Boulder in an interview with ScienceDaily.

Importance of Melatonin Onset

The hormone melatonin is a key player in the body’s sleep system. In adults, melatonin secretion begins about two hours before we feel sleepy enough to nod off. But the timing of melatonin onset varies a lot from person to person and is determined mainly by our genes. So some people like to go to bed early while others like to stay up late.

About 25 percent of toddlers and preschoolers have problems settling at bedtime: trouble falling asleep, tantrums, or coming out of the bedroom repeatedly to ask for attention. LeBourgeois and her colleagues wondered if these behaviors might be related to differences in the timing of melatonin secretion.

They enlisted the participation of 14 families with children ages 2 ½ to 3 to find out. To ascertain when the toddlers’ melatonin secretion began, the researchers collected saliva samples over a period of 6 hours by getting them to chew on dry cotton rolls while playing games.

What They Found

Melatonin onset did vary among the children, with the average onset occurring at about 7:40 p.m.–about 30 minutes before parent-preferred bedtimes. Once in bed, the toddlers whose secretion started early fell asleep fairly soon. But those put to bed before their rise in melatonin took 40 to 60 minutes to fall asleep.

“For these toddlers, laying in bed awake for such a long time can lead to the association of bed with arousal, not sleep,” LeBourgeois said. “This type of response may increase children’s lifelong risk for insomnia over time.”

Help Your Child Settle Down at Night

  • Postpone bedtime for 30 minutes to an hour. Your child will then wake up that much later in the morning.
  • Establish a consistent bedtime routine.
  • Turn lights down in the evening. Light exposure blocks secretion of melatonin in adolescents and adults. So dimming lights in the evening may help trigger earlier melatonin secretion in toddlers.
  • Turn lights up full force in the morning. Exposure to bright light upon awakening helps adults get to sleep earlier at night, and it may have the same effect on tots.

Can you trace your sleep problems back to childhood? If so, what do you think triggered them?

Is Insomnia a Heritable Trait?

My friend Lisa passed word of my book, The Savvy Insomniac, on to a friend, whose first question, Lisa reported, was this: Did I think insomnia was genetic?

Environmental stressors can trigger insomnia: everything from childhood abuse and loss of a parent to financial worries and divorce. Behaviors and attitudes can give rise to persistent sleep problems as well. Less well understood are the biological underpinnings of insomnia, yet research suggests they exist.

adolescent-twinsMy friend Lisa passed word of my book, The Savvy Insomniac, on to a friend, whose first question, Lisa reported, was this: Did I think insomnia was genetic?

Environmental stressors can trigger insomnia: everything from childhood abuse and loss of a parent to financial worries and divorce. Behaviors and attitudes can give rise to persistent sleep problems as well. Less well understood are the biological underpinnings of insomnia, yet research suggests they exist.

Take the growing body of family and twin studies looking at the contribution of genetic factors to chronic insomnia. All suggest that vulnerability to insomnia is a partially inherited trait. Genetic factors account for between 37 and 57 percent of the variance in susceptibility to stress-related sleep problems and insomnia, according to studies published in 2008 and 2006.

Which Aspects of Sleep Are Inherited?

The timing of sleep is apparently quite dependent on our genetic make-up. Two genes in particular—called CLOCK and PER3, expressed in different forms in different people—prompt some of us to nod off soon after dinner and others to stay up till 1 or 2 a.m.

A new twin study conducted on adolescents in Australia (25 pairs of identical twins and 41 pairs of fraternal twins) suggests the genetic contribution to other aspects of sleep is strong as well, at least in adolescents. Researchers found that genetic factors accounted for a high percent of variance in these traits:

  • Time it took to fall asleep, 83 percent
  • Total sleep time, 65 percent
  • Wakefulness after falling asleep, 52 percent.

“There is a strong genetic influence on the sleep-wake patterns of 12-year-old adolescents,” the researchers conclude.

Managing Insomnia

An array of genetic factors may affect our sleep and increase our susceptibility to insomnia. But there are ways of working around the liabilities. I’ll recap three important ones you’ve probably heard of before:

  1. Maintain a regular sleep-wake schedule. Even if your bedtime fluctuates, get up at the same time every morning.
  2. Avoid naps.
  3. Get regular exercise.

Insomnia sufferers may never become gold medal sleepers. But despite our limitations, there’s a lot we can do to improve.

What do you think causes your insomnia: genetic factors, life experience, lifestyle choices, or some combination?