Q & A: Is What I’ve Got Insomnia?

Recently I was telling a new acquaintance about my book.

“Insomnia?” she said. “How do you define that? My problem is that I wake up several times every night. Does that qualify as insomnia?”

dont-knowRecently I was telling a new acquaintance about my book.

“Insomnia?” she said. “How do you define that? My problem is that I wake up several times every night. Does that qualify as insomnia?”

“That depends,” I replied, and then I rattled off the medical definition of insomnia: trouble getting to sleep or staying asleep, awakening too early, or nonrestorative sleep; and distress or impairment in key areas of functioning during the day. “Do you feel impaired during the daytime?”

“I have a lousy memory,” she said. Then she launched into a litany of lost remembrances: trips taken, family gatherings, books read. The relationship of sleep and memory is a hot topic these days and she was curious: did her longstanding memory problems and frequent wake-ups mean she was suffering from insomnia? (And if she could get rid of the wake-ups, would her memory improve?)

First Impressions

A good diagnostician or sleep specialist would interview her further before reaching a conclusion; I am neither of these things and don’t pretend to be.

Yet my impression was that—whether or not her symptoms would meet the medical definition of insomnia—she didn’t have a lot to worry about. This woman owns a successful business with stable roots in the community where she lives, and she’s endowed with a vibrant personality, fabulous communication skills, and energy to burn.

Most insomniacs I know present a different picture and tell a different story. Asked about their daytime symptoms, and they talk about everything from fatigue and exhaustion to moodiness and brains that limp along in second gear. Memory impairment, too, is a common complaint, and it’s certainly one of mine.

More Information

Appearances can be deceiving, yet my sense was that if this woman would be given a diagnosis of insomnia, she had a rather mild case. She confirmed this a minute later when she told me what she does when she wakes up at night. “I roll over,” she said, “and I fall right back to sleep.”

I felt a sharp stab of envy: what wouldn’t any red-blooded insomniac give, when we wake up at 2 or 3 a.m., to be able to roll over and fall right back to sleep?

I kept the thought to myself, though, and made a suggestion about how she might improve her sleep. And about this, I’m a believer: no matter the shape and size of a sleep problem, there are probably ways to make it better.

But the memory issue? There’s a question scientists may be working to answer for a long, long time.

What kind of insomnia do you have, and do you experience any negative effects during the day?

Sleep Hygiene: Revisiting the Rules

A few weeks ago I blogged about managing insomnia by doing whatever works. It turns out that sleep experts (some of whom also struggle with insomnia) flaunt a few rules of good sleep hygiene themselves—regardless of recommendations they make to us.

exercise-nightA few weeks ago I blogged about managing insomnia by doing whatever works. It turns out that sleep experts (some of whom also struggle with insomnia) flaunt a few rules of good sleep hygiene themselves—regardless of recommendations they make to us.

You’ve heard that insomniacs are not supposed to read, eat, or watch TV in bed? Sleep expert David N. Neubauer has a qualified view on this.

“I think the ‘no reading in bed’ rule makes sense for chronic insomniacs,” Neubauer, associate professor at Johns Hopkins University School of Medicine, is quoted as saying in an article in Huffington Post, “but I find reading relaxing. I feel like I can put the book down when I get tired.”

Dr. W. Christopher Winter, medical director of the Martha Jefferson Hospital Sleep Medicine Center in Charlottesville, Virginia counsels his patients to work out early in the day. Yet he himself gets more of a benefit from exercising at 10 or 11 p.m. He also takes daytime naps—another thing insomniacs are routinely advised to avoid.

How Much Stock Should You Put in the Rules of Sleep Hygiene?

The suggestions you see in magazines and on the web exist for good reasons. Either they’re validated by scientific studies—such as the rule about going to bed and getting up at the same time every day—or based on observations made by clinicians, such as the advice to get up and do something when you can’t sleep rather lying in bed awake.

But each and every rule may not have value for all insomniacs. How could it be otherwise, when the sleepless are such a motley crew? Some of us have trouble getting to sleep; others, trouble staying asleep. Bad nights leave some insomniacs with short tempers; they leave others of us with brains that rattle along in second gear and never reach cruising speed.

Such a diverse array of symptoms implies to me that the causal mechanisms of our insomnias are probably different. So how could remedies proffered to the masses be uniformly beneficial to all?

Overall, I think we’re wise to pay attention to the rules of good sleep hygiene. But we’re also wise to experiment and find what works best for us.

Which rules of sleep hygiene are helpful to you, and which are not?