The Sleep Problem

It is highly surprising to realize how many of us suffer from sleep problems that are lingering and chronic. It is especially alarming since we are now aware of the immense importance sleep has on our health, and know that almost every aspect of our life is influenced- for the better or the worse- by our sleep.

Sleep effects, among other things, the strength of our immune system, cognitive abilities such as memory and concentration, it also helps protect from heart disease, dementia and cognitive impairment as we get older, and even has cancer-fighting enhancing effects. Simply put, it is a health-promoting, empowering and enhancing function that helps restore and strengthen our body, and we should therefore make sure we sleep well, and enjoy a high-quality sleep that keeps us refreshed and healthy.

Unfortunately, for as many as 50% of people in our western world society, this is not the case. Research has shown that around half of adults in western countries report having insomnia, and half of them experience it on a regular basis. It means that one out of four adults do not enjoy a full, good-night sleep, on a regular basis.

What is insomnia?

Insomnia is defined as difficulty falling to sleep and maintaining it. If the person takes more than half an hour to fall asleep, it is called “sleep onset insomnia”. If the person wakes up during the night and cannot fall back to sleep in less than 30 minutes, or wakes up way too early than intended and cannot resume sleep, it is called “sleep maintenance insomnia”. Another form of insomnia is when one does not recall having trouble falling to, or maintaining sleep, but feels more tired in the morning after the night is over. When this happens for more than 3 months, on 3 or more nights a week, combined with daily impairment such as drowsiness, agitation, lack of concentration, depressed or angry mood, it is called chronic insomnia.

While insomnia may occur for many of us during stressful or pleasurable life events such as: changes at home, relationships or work, the birth of a child, the passing away of a loved one, an acute disease, episodic pain, and any other stressful or medical event that is limited in time, for some, insomnia will persist beyond the resolution of the specific stressor in life, and develop “a life of its own”.

A woman at her forties, who is a professional singer, shared with me during a medical consultation that she has had a big show a few weeks prior to our meeting, and that she had difficulty sleeping on the days prior to her performance. I then assured her that this is very normal and she shouldn’t worry about it, since it will resolve itself without any intervention. But for chronic insomniacs, this kind of advice will most probably not help, since there are other mechanisms involved in perpetuating the condition over the long run.

As a medical doctor, it was very surprising for me to realize how few patients report suffering from insomnia. They would normally describe their problems, and disregard their sleep. Only after I ask in the consultation about sleep quality and duration, and ask them how satisfied they are with their sleep, the truth of it will be revealed: “You know, I actually sleep not so well in the last 6 months. It started when I needed to change my position at work and ever since I sleep only around 4-5 hours every night.”

In current times, with the Covid-19 pandemic effects, many people will admit that since around the beginning of it, they experience life-disrupting sleep problems.

So, why then, so few people who are inflicted by insomnia seek out help from their doctors?

The truth of the matter is that most people think they have only two options: either take sleeping pills, or just ‘learn to live with it and try to cope’. Many patients, and most judiciously, do not want to become reliant on sleep medications.

They are right because of three important points.

The first point is the possible negative effects of these medications. It is widely researched and known, that sleeping pills are prone to make one dependent upon them, impair day time alertness, increase the likelihood of accidents and falls (which is especially concerning in seniors, who are more exposed to fractures due to these falls), increase the risk of developing memory problems and Alzheimer’s in people over 60, and increase all-cause mortality (which means in simple words- people who take sleeping pills tend to die earlier from many causes compared to those who don’t).   

The second point is that these drugs are actually not so effective. Many of them have been proven by research to add on average only 10 minutes of sleep per night, and even though people who take them think they sleep more, it is mostly because of the amnesic effects they have- they simply don’t remember they were awake during the night. And to make things even worse, when stopping slipping pills one may find out they did not cure the problem, which then comes back as intensely as before. And in other instances, there is even a worsening or ‘rebound effect’. 

And the third point is that there are safe, effective, and drug-free solutions that are widely accepted and scientifically proven. These solutions are so effective since they not only try to deal with the symptoms of insomnia, but rather aim to treat its cause, which enables a lasting effect and improvement that only grows more over time.

Around twenty years ago, scientists and clinicians began realizing the learned mechanisms that are at the core of insomnia, and owing to this understanding cognitive and behavioral techniques were developed to help people unlearn it. The result being many people recovering from insomnia and enjoying normal sleep duration and quality once again.  

This solution, known as CBT-I (Cognitive Behavioral Therapy for Insomnia) is so effective, that it is considered today as the gold standard of treatment for insomnia by the medical establishment. Through a set of structured steps, one learns how to change thoughts and behaviors that cause insomnia and replace them with sleep-promoting ones. These steps are learned alongside relaxation techniques, dispelling of wrong perceptions of sleep, and taking care of a warm and relaxing sleep-promoting environment. As a consequence, one strengthens the sleep mechanism in the brain and body – which is changeable and trainable by nature – and heals insomnia effectively.

If you are suffering from a bad sleep, you might be asking yourself at this point why is it that you’ve never heard of these solutions. Well, sad as it may be, when methods are not propelled by a multi-billion industry such as the pharmaceutical industry, there are much less funding for advertisement, so people hear less about it. And secondly, it is widely known that it takes around 20 years on average for novel methods to reach the attention of the general public. But the good news is, that once you’ve heard of it, the solution is at hand.

If you suffer from sleeping problems, and insomnia in particular, there is a viable way that can help you regain your normal sleep. I believe that knowing that, is in itself a first step towards cure. And like many others that have used these techniques and knowledge, you can too, enjoy again a refreshing, uninterrupted and revitalizing sleep.      

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