Trying to put insomnia problems to rest
Millions of Americans doubtless used that extra hour setting our clocks back to get a little extra sleep - an option NOT available to chronic sufferers from insomnia. For them, fiddling around with the clock offers no relief at all. Our Sunday Morning Cover Story is reported now by Susan Spencer of 48 Hours:
Nightfall in Louisville, Kentucky ... weary citizens soon will snuggle up in their nice, warm beds, ready for a restful night's sleep.
Good luck with that!
A new study done by Bert Sperling of ("The Best and Worst Places to Live" fame) names Louisville as the number one city when it comes to sleeplessness.
"People who live here report having an average of nine days monthly without restful sleep," said radio show host Terry Meiners.
It's not a distinction Louisville wants, but it doesn't surprise Meiners: "I drove to work this morning at 5:15 and I saw 30 people out for a run, and a few people sitting on benches. I wasn't intrigued by the people running, but the ones sitting on benches really blew my mind. Why aren't you home in bed?" he laughed. "What, are you waiting for the diner to open? Go back to bed! They'll have pancakes at 7:30."
But WHY is it so hard to sleep here?
Some theories: Louisville has a huge UPS hub, a lot of people work the overnight. THEY'RE obviously not sleeping.
There's a giant construction project blocking a major bridge, forcing commuters to spend hours in traffic - when they should be in bed.
And that's not the only stress: Louisville ranks high in unemployment and divorce.
But then, of course, there are folks like Meiners: "I'm one of those people who does wake up about 3:30 in the morning. I don't know why. But I start tumbling through what I'm going to do the next day."
We've all been there, occasionally. But what if night after night? You put on your jams, get into bed, turn out the lights, but no matter how many sheep you imagine out there, waiting to be counted ... you simply cannot fall sleep.
A Sunday Morning poll found half of all Americans has trouble sleeping at least once a week - and more than a third (33%) more often than that.
"These are people with insomnia, they have the time to sleep but can't sleep - three or more times per week, a month or longer," said psychologist Wendy Troxel of the University of Pittsburgh Sleep and Chronobiology Center. She says 20 to 30 million American adults suffer true insomnia.
"How do they stand it? I mean, there's nothing worse!" said Spencer.
"Yes, we have all experienced this once or twice, or around stressful times," said Troxel. "But when you think about what it's like to experience it nightly over months and months and years and years, it truly is crazy-making."
In one demonstration, doctors at the Center hook people up to monitors and study their brains while they sleep. What they've found is eye-opening:
"If we bring them into the lab, they may say that they didn't sleep at all, but we'll have data to suggest that they DID sleep," said Troxel. "Now this doesn't mean that they're lying, though. It just means that their experience of sleep is part of the problem. Even when we objectively show that they're sleeping, it still doesn't FEEL like sleep."
Troxel's colleague, Dr. Daniel Buysse, says insomniacs' brains are hyper-aroused. So, while the brain of a good sleeper shuts down at night, an insomniac's brain is always ON - no matter what time of day.
"So it could actually be that when people with insomnia report being aware of their environment, being awake all night, they may actually have increased activity in some brain regions despite the electrodes on their head appearing to be asleep," said Buysse.
All that brain activity comes at a price. A recent Harvard study found that insomnia costs the U.S. work force $63.2 billion annually.
"We know that people with insomnia have worse functioning at work," said Buysse. "There have been some studies that show that they have more sick days and have higher health costs. It increases the risk for subsequent conditions like depression, anxiety disorders and even substance use."
It's enough to keep you up at night - and that goes double for women, who are twice as likely as men to have insomnia.
Troxel's studies have shown a nightly battle of the sexes can claim plenty of casualties.
"What we do know is that a sleep problem in either partner causes relationship problems for both," she said.
Which - in a vicious cycle - then causes MORE sleep problems.
"When you're lying next to a partner that may actually cause vigilance and anxiety, that would likely disrupt sleep," Troxel said.
"Have you been able to quantify the idea that good relationships make for good sleep?" asked Spencer.
"Women who are higher in marital happiness have significantly lower risk of having insomnia as compared to women who are unhappily married or unpartnered women," she replied.
The quest for that elusive sleep leads right to the medicine cabinet. Americans spent roughly $2 billion on sleep aids last year, filling some 60 million prescriptions.
Troxel describes America's relationship with sleeping pills as a "love-hate" relationship: "There's this kind of mystical quality in many Americans' minds about the power of sleeping pills, and who needs them, how long can we use them, and what they actually do."
Despite the fact, she says, that sleeping medication does NOT do what people think.
"They are not going to knock you out," Troxel said. "So if you take a sleeping medication at 9:00 p.m., even though you're really not feeling sleepy, it's not going to do anything for you. Because sleeping pills work by kind of going with the natural flow. They kind of tip you over your natural sleepiness, over the edge to help you fall into sleep, but they are not going to take you from a state of wide-awakefulness to sleep."
Thirty-year-old Jamie Del says she tried sleeping pills, and everything else, for the insomnia that has plagued her since high school.
"Definitely, there's anxiety involved, and almost the feeling of dread at night," said Del. "Because I would anticipate waking up and being tired and not being able to fall asleep at all hours of the night."
Del is sleeping much better today, thanks to Dr. Buysse. But at first his approach baffled her:
"He recommended minimizing the time I spent in bed, and I didn't understand how this was going to work, because I felt I needed to be in bed a longer time so I could get enough sleep," Del said. "But what he did was move my bedtime later. And I had a specific wake-up time as well. But it definitely has helped my body to get on a cycle."
So, basically, sleep deprivation can be used to treat insomnia? "Exactly right," Buysse said.
And when compared with sleeping pills, THAT actually works better long-term.
"So you make them stay awake a longer period of time - so what, they're just pushed to the level of exhaustion?" Spencer asked. "I like to think of it as increasing their sleep drive," Buysse laughed, "increasing their natural sleep drive."
But if that sounds like torture to you, you can always just move your bed ... say, to Honolulu, the city now ranked #1 as the best place in the country for a good night's sleep.
Sleep, Troxel said, is "a good thing. A good night of sleep feels so good. A good night of sleep affects everything."
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