March 13, 2020 is World Sleep Day

Let’s talk about chronic insomnia. The causes might surprise you.

If you find yourself struggling to get out of bed and function normally after losing an hour sleep on the weekend, don’t feel bad – you’re not alone. One hour might not sound like a big deal, but believe it or not, studies have actually found an increase in both car accidents and heart attacks the Monday after Daylight Saving Time. Kind of like having jet lag, it can throw off our circadian rhythm – that’s the body’s 24 hour biological clock that helps tell us when to sleep, when to wake, and regulates so many of our hormones and biological processes, from hunger and weight gain to cortisol, melatonin and even the microbiome. Fortunately, most people and their circadian rhythms adjust to the one-hour time change after a day or two without too much difficulty.

But if you are like most people, you also might be experiencing what’s known as “social jet lag” on a regular basis. Enjoying your days off, you probably stay up late on weekends and sleep in a bit later to catch up on sleep. Makes sense in the short term, right? Unfortunately, the reality is that an irregular sleep-wake routine, among other things, can take its toll on the circadian rhythm and – over time – lead to chronic insomnia.

Why is it so hard to recover from chronic insomnia?

Up to 45% of the world’s population struggle with sleep. What most people don’t know is that many of the things we typically do to catch up on sleep (napping? sleeping in? going to bed early?) turn out to be the very things that can cause a short-term bout of insomnia to become a chronic, long-term and serious problem. Sadly, insomnia is one of the few things in life where the harder we try, the more we fail. The worse it gets, the more desperate people become for sleep. It might be crazy-making, but you should know that it’s not all in your head. While anxiety and depression can certainly cause insomnia, it’s also the case that insomnia causes anxiety and depression. Improving sleep can go a long way in improving both. But when we don’t know what to do, our sleep regulation systems tend to become disrupted, creating a vicious cycle, often a serious, long term problem – one that leaves people feeling like their ability to sleep has become broken, with life spiralling out of control.

It’s not your mattress

Bring on the wild goose chases. Studies in both Canada and the U.S. have estimated the average annual cost of chronic insomnia at close to $5,000. Yes, $5,000 per year – per person! That’s largely lost productivity and earnings, but also – in desperation – people frequently resort to sleep aids, such as alcohol (worse yet, U-Dream), or visits to naturopaths and acupuncturists. If that doesn’t work, let’s buy another pillow (or 5) or a new mattress.

Another little known “fun fact”: according to research, sleep hygiene – on it’s own – is largely ineffective. Yes, you read that right. There’s a reason it seems like nothing works – for long.

Of course, there’s nothing wrong with many of these strategies, at least those that don’t come with dangerous or unpleasant side effects. Some might be relaxing. Can’t hurt. Some might even help a bit in the short term. But if they’re not addressing the actual causes of chronic insomnia, it’s likely too little, too late.

There are many causes of short-term sleep problems, but only two causes of chronic insomnia: disrupted sleep regulation systems and conditioned arousal.

There is a way out

The American College of Physicians strongly “recommends that all adult patients receive cognitive behavioral therapy for insomnia (CBT-I) as the initial treatment for chronic insomnia disorder.” ~ American College of Physicians (2016)

Fortunately, there is an approach – backed by a significant body of research – found to be safe, effective, and long lasting. That’s why Cognitive Behavioural Therapy for Insomnia – aka CBT-I (not your regular CBT btw) – is considered the “gold standard” in insomnia treatment. CBT-I is not a magic pill. (Spoiler alert: there isn’t one). Rather, it involves learning how our sleep regulation systems work, how they can become disrupted – think social jet lag, for example – and the behavioural and other strategies that can help strengthen the sleep regulation systems, such as the circadian rhythm. When it comes to sleep, knowledge really is power. And the first step in regaining some control over ability to sleep well is learning how to re-train the brain for efficient, deep, quality sleep once again. Many people even find that with better quality sleep, they need less quantity than they thought.

Yes, this is good news: you don’t need to live with chronic insomnia. There is a way out.

CBT-I “has been found to be as effective as prescription medications are for short-term treatment of chronic insomnia. Moreover, there are indications that the beneficial effects of CBT, in contrast to those produced by medications, may last well beyond the termination of active treatment.” ~ National Institutes of Health State-of-the-Science Conference Statement on Manifestations and Management of Chronic Insomnia in Adults

Feel crappy for a day or two after Daylight Savings Time? To avoid prolonging insomnia, don’t try to catch up on the lost hour of sleep. Ride it out and you’ll get your sleep and circadian rhythm back on track soon enough.

March 13, 2020 is World Sleep Day. Sounds like a great time to start regaining your quality of life by learning how to sleep well again.