The Shape of the Water Stain
With my eyes heavy from exhaustion, I roll over and glance at the clock for the eighth time tonight: 2:37am. As I turn back over, my thoughts echoing stresses from the day I just survived, I sigh in desperation. It’s only Wednesday, and despite my intense fatigue and futile attempts, for the third time this week, I cannot fall asleep.
While I study the shape of the water stain on my ceiling, I try to imagine how many hours I have spent staring at that same spot and how many hours of sleep I have lost over the years. It’s maddening. How can I be so incredibly tired but still find it nearly impossible to fall asleep? When I do finally fall asleep, why do I wake up still feeling exhausted?
Why does this keep happening to me?Insomnia is acommon sleeping disorder that causes perpetual sleeplessness, and millions of people suffer from this disorder every day. According to Dr. David N. Neubauer of the Department of Psychiatry at Johns Hopkins University School of Medicine, “thirty percent ofadults experience insomnia at least occasionally, and ten percent have persistent insomnia.
” Furthermore, women, elderly people, and those with specific medical conditions are even more susceptible to the effects of insomnia. Routinely experiencing an insufficient amount of sleep has been linked to many extremely dangerous side effects.
As stated by the United States Centers for Disease Control and Prevention, adults with sleep insufficiencies are at a high risk for developing chronic diseases such as hypertension, diabetes, depression, and obesity, as well as cancer, increased mortality, and reduced quality of life and productivity (“Insufficient Sleep”).
In the book, Sleep Disorders and Sleep Deprivation, written for the National Academy of Sciences by the Committee on Sleep Medicine and Research, Harvey Colten and Bruce Altevogt note, “compared to healthy individuals, those suffering from sleep loss and sleep disorders are less productive, have an increased health care utilization, and have an increased likelihood of injury,” and alarmingly, “almost 20 percent of all serious car crash injuries in the general population are associated with driver sleepiness.”
With an estimated 50 to 70 million adults in the US suffering from chronic sleep disorders (Colten and Altevogt), this issue and its side effects continue to grow even more concerning.Possible CausesBehavioral IssuesOne possible cause of insomnia are behavioral issues. In the book Adolescent Insomnia, Dr. J. R. Morrison, a professor of counseling, and Brian Storey, a research assistant at the University of San Diego, explain that, “behavioral issues that cause insomnia include ‘lifestyle’ problems that are not conducive to sound sleep.”
Examples of such habits include irregular bedtimes and rising hours, long naps during the day, and use of stimulants like coffee, tea, and other caffeinated beverages. Irregular bedtimes and excessive napping alters a patient’s internal clock and makes it difficult for their brain to decipher whether it is the appropriate time for sleep or not.
Additionally, The National Sleep Foundation states that, “certain substances and activities, including eating patterns, can contribute to insomnia.” In the article, “What Causes Insomnia?” the NSF mentions that consuming stimulants such as caffeine and nicotine, as well as alcohol and heavy meals can cause sleep disruption. Ingesting or using any of these substances creates high levels of brain activity.
A hyperactive brain can make it extremely difficult to fall asleep and remain asleep.Even though lifestyle choices are considered to be a very prevalent cause of insomnia, there are certain researchers who believe otherwise. In the Medical News Todayjournal, Peter Crosta, who studied at Columbia University, says that “[T]here is often an underlying medical condition that causes chronic insomnia.”
He continues to explain that lifestyle choices should not be considered a true cause of insomnia. Crosta believes that insomnia is not based on decisions that a patient makes for themselves, and it is solely based on medical factors alone.Chronic Medical ConditionsAnother potential cause for insomnia are chronic medical conditions.
The National Sleep Foundation gives examples of these medical issues; those include “nasal/sinus allergies, gastrointestinal problems, endocrine problems, arthritis, asthma, and parkinson’s disease.” These certain medical conditions create symptoms like crippling pain, runny nose, constant coughing, difficulty breathing, and tremors.
Such symptoms make it nearly impossible for patients to be able fall asleep and stay asleep.In the article, “Ask Yourself 8 Questions,” in the Current Psychiatryjournal, Dr. David N Neubauer, describes how, “pain or discomfort caused by a medical condition may undermine sleep quality.” Neubauer goes on to explain that, “certain cardiovascular, pulmonary, endocrine, rheumatologic, and orthopedic disorders are associated withinsomnia.”
Essentially, he is saying that these medical conditions can cause symptoms that would make insufficient sleep more likely. Although these medical conditions causing insomnia is a widely accepted theory, J. R. Morrison and Brian Storey mention in their book, Adolescent Insomnia, that they believe that, “poor sleep is a learned habit,” as opposed to something caused by a medical condition. They explain that this theory is based upon how people can examine and adjust their sleeping habits and cure their insomnia.
They do not believe that this would be possible if it were truly caused by those specific medical conditions.Psychological DisordersAnother possible cause of insomnia is an underlying psychological disorder. The National Sleep Foundation has found that “Insomnia can be caused by psychiatric conditions such as depression and anxiety.”
Based on their studies, they have found that patients with major depressive disorders are at a much higher risk of developing insomnia. Furthermore, they described that certain symptoms of anxiety, such as tension and excessive worrying, cause high levels of brain activity which leads to chronic sleep deprivation.In the book Adolescent Insomnia, Dr. J. R. Morrison and Brian Storey discuss and explore several different aspects of insomnia.
Morrison and Storey state that “psychological factors [of insomnia] include anxiety and depression.” The pair go on to explain that people who deal with anxiety often struggle to initially fall asleep, while those with depression tend to frequently awaken early in the morning and find themselves unable to fall back asleep.
In either scenario, the psychological issue clearly creates a condition where the person is unable to gain sufficient sleep.Even though the evidence seems unambiguous, there is a possibility that psychological issues are not at the root of insomnia. “Although many people believe that psychiatric disorders such as depression and anxiety cause insomnia, the reverse may actually be true,” argues Henry Olders, an assistant professor of psychiatry at McGill University in Montreal.
Olders bases his claim off of research done by The National Institutes of Mental Health. Their studies found that, “the risk of developing new depression was 39.8 times higher for insomniacs than for those without sleep problems.” Essentially, both the NIMH and Henry Olders have found that insomnia leads to an onset of depression and anxiety, as opposed to the other way around.
Considering the results of this study, there is no way to fully conclude that insomnia is actually caused by psychological disorders.The most likely cause of insomnia is behavioral and lifestyle choices. There are more people in the United States that drink excessive amounts of caffeine, smoke cigarettes, and eat heavy meals before bedtime, than people with serious psychological or medical conditions.
This means that most people with insomnia, most likely have made specific lifestyle decisions that caused it. If we do not do anything about the climbing rates of insomnia, our society will experience a higher rate of sleep deprivation. This will add to an already growing rate of motor vehicle accidents due to drowsy driving, as well as other sleep deprivation related disasters. On top of that those struggling with insomnia will e
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