It was originally published April 19, 2018. According to the American Sleep Association, up to 70 million Americans have a sleep disorder, nearly 40% unintentionally fall asleep during the day at least once a month and nearly 5% have nodded off while driving at least once. Insomnia is the most common1
sleep disorder, with 10% of American adults struggling with chronic insomnia and 30% reporting occasional or short-term insomnia. Interestingly, insomniacs will often insist they've not slept a wink all night, even though they've actually been sleeping. Researchers have now discovered there's a reason for this discrepancy in experience, and it has to do with consciousness. In a nutshell, even though the brain is sleeping, insomniacs remain consciously aware, and therefore believe they've not slept at all.
Many Insomniacs Remain Conscious Even When Asleep
Daniel Kay, a psychology professor at Brigham Young University in Utah who led the study, told Medical News Today, "… [Y]ou can be consciously aware and your brain [can] be in a sleep pattern. The question is: What role does conscious awareness have in our definition of sleep?" Traditionally, it's been believed that sleeping involves the absence of conscious awareness, but Kay's team was able to conclude that this is not categorically true. To investigate the role of consciousness during sleep, the team analyzed the sleep patterns and subjective experience of 32 people with insomnia and 30 who reported sleeping well. Once the participants were deemed to be asleep, based on their brain patterns, a radioactive tracer was injected into their arms. Using brain imaging, the researchers were able to examine neurons that remained active during sleep, and their exact locations. The following morning, the participants were asked about their subjective experience of their sleep. Medical News Today explains the results:
"The study found that people with insomnia who reported that they had beenawake, even when the polysomnography showed otherwise, had increasedactivity in brain areas associated with conscious awareness during thedreamless phase of sleep — that is, nonrapid eye movement sleep …23
[I]t is normal during the process of falling asleep for the brain to send inhibitoryneurons that make people less and less consciously aware until they've reacheda state of deep sleep. However, what the findings of the new study suggest isthat people with insomnia may not feel as though they're asleep until their brainexperiences a greater inhibitory activity in areas that are linked to consciousawareness."
Normal Sleepers May Not Get as Much Sleep as They Think
As noted by the authors, "Brain activity in the right anterior insula, left anterior cingulate cortex, and middle/posterior cingulate cortex may be involved in the perception" of insomnia. People who reported sleeping well turned out to have increased activity in the same areas of the brain as insomniacs. The reason for this is because your brain goes through "an inhibition process" when you fall asleep, gradually lowering your conscious awareness. While insomniacs require a greater level of inhibition before their consciousness recedes, many good sleepers report falling asleep long before their brainwaves indicate that they're actually sleeping. This is basically the reverse situation of insomnia: Good sleepers lose conscious awareness at a very low level of inhibition, making them believe they fell asleep much faster than they actually did, based on their brain patterns.
Mindfulness Meditation Recommended for Insomniacs
So, if you struggle with insomnia, frequently feeling you haven't slept a wink, what can you do? Kay says, "In patients with insomnia, processes involved in reducing conscious awareness during sleep may be impaired. One of the strategies for targeting these processes may be mindfulness meditation. It may help the patients inhibit cognitive processes that are preventing them from experiencing sleep." Practicing "mindfulness" means you're actively paying attention to the moment you're in right now. Rather than letting your mind wander, when you're mindful, you're living in the4
moment and letting distracting thoughts pass through your mind without getting caught up in their emotional implications. You can add mindfulness to virtually any aspect of your day — even while you're eating, working or doing household chores like washing dishes — simply by paying attention to the sensations you are experiencing in the present moment. Mindfulness meditation, on the other hand, is a more formal practice in which you consciously focus your attention on specific thoughts or sensations, and then observe them in a nonjudgmental manner. This is just one type of meditation; there are many forms available. Transcendental meditation, for instance, is one of the most popular forms of meditation, practiced by millions of people around the world. It's simple to perform. Simply choose a mantra that has meaning for you, sit quietly with your eyes closed and repeat your mantra for a period of about 20 minutes, twice a day. The idea is to reach a place of "restful" or "concentrated" alertness, which enables you to let negative thoughts and distractions pass by you without upsetting your calm and balance. Some aspects of mindfulness, mindfulness meditation and other forms of meditation overlap. For instance, focusing your mind on your breath is one of the most basic, and most rewarding, relaxation and meditation/mindfulness strategies there is. To learn more about meditation and the different forms of practice available, see " Meditation Connects Your Mind and Body ."
Common Factors That Keep You Awake
Aside from the possibility that you're simply misperceiving your inability to sleep, certain environmental factors can make it more dificult to fall asleep. This includes such things as: Your pillow being too hot — A cool pillow, and more importantly the room temperature overall, will decrease your core body temperature, which induces drowsiness. In one study, insomniacs equipped with a cooling cap fell asleep within5
- high blood pressure
13 minutes — three minutes faster than normal sleepers — and remained asleep 89% of the night. Reader's Digest suggests placing your pillow in the freezer for a few minutes before bed to cool it down. Starting a new medication — A number of different drugs can cause insomnia, including blood pressure medications, antidepressants and steroids. Oftentimes, this side effect can be ameliorated by changing the time at which you take the drug. Beta-blockers, prescribed for high blood pressure and/or arrhythmia, for example, are typically best taken in the morning instead of at night. Pets — As much as you love your fur babies, if they're hogging your bed or filling it with hair, consider keeping your pets out of your bed. According to one Mayo Clinic study, while some find their pets help them sleep better, approximately 20% of pet owners admitted the animal disrupted their sleep in one way or another. Cold feet — While cooling your head induces sleep, cold feet can keep you tossing and turning. The solution: Wear socks to bed. Exhaustion — While exhaustion is frequently confused with tiredness, the two are not the same. When exhausted from stress or overwork, your brain tends to be on high alert. This "cognitive popcorn" can make it dificult to fall asleep, no matter how exhausted your body is. Rather than falling into bed right away after a long day, try winding down, allowing your mind to settle before trying to fall asleep.
When Anxiety or an Overactive Mind Keeps You Awake
One of my favorite tools for resolving anxiety that contributes to insomnia is the Emotional Freedom Techniques (EFT), which combines tapping on certain points of your body with verbal statements that help pinpoint the underlying issues. In the video above, EFT therapist Julie Schiffman demonstrates how to tap for sleep. EFT helps to release worries, fears and even physical symptoms that stand between you and a good night's sleep by reprogramming your body's reactions to many of the unavoidable stressors of everyday life, making it easier to take them in stride.67
When stress triggers are reduced, you will naturally sleep better. In 2012, a triple blind study found that EFT reduced cortisol levels and symptoms of psychological distress by 24% — more than any other intervention tested. This is enormously significant, as there are few things that will destroy your health faster than stress. Researchers at the American Academy of Sleep Medicine discovered that how you cope with stress might have an even greater impact on your sleep than the number of stressors you encounter. They also found that mindfulness therapies worked best for suppressing the "mental chatter" that inhibits the onset of sleep. Lead author Vivek Pillai, Ph.D., wrote, "While a stressful event can lead to a bad night of sleep, it's what you do in response to stress that can be the difference between a few bad nights and chronic insomnia."
Avoid Sleeping Pills for Insomnia
To learn more about the ins and outs of sleep, and lots more tips and strategies to improve your quality and quantity of your rest, please see " Sleep — Why You Need It and 50 Ways to Improve It ." Whatever you do, avoid sleeping pills. Not only do they have extremely limited benefits, the side effects can be quite severe. Take Belsomra, for example, a next-gen type sleeping pill that acts on a neurotransmitter called orexin "to turn down the brain's ‘wake messages.'" The company's own clinical trials showed the drug allowed people to fall asleep an average of six minutes sooner than those taking a placebo, and stay asleep 16 minutes longer. More than 1,000 consumer complaints against Belsomra have been filed with the U.S. Food and Drug Administration, with complaints ranging from lack of effectiveness and next-day drowsiness to sleep paralysis, heart problems and suicidal ideation. One in 5 reports claim the drug made them the opposite of sleepy. Other research has found sleeping pills like Ambien, Lunesta and Sonata reduce the average time it takes to fall asleep by about 13 minutes compared to placebo, while8910
increasing total sleep time by about 11 minutes. Interestingly, participants believed they had slept longer, by up to one hour, when taking the pills. This is thought to be due to anterograde amnesia, which causes trouble with forming memories. When people wake up after taking sleeping pills, they may, in fact, simply forget they'd been unable to sleep. Sonata is also associated with addiction. Studies have also shown that use of sleeping pills increase your risk of death and cancer. To learn more about the hazards of sleeping pills, see Dr. Daniel Kripke's e-book, "The Dark Side of Sleeping Pills."
Natural Sleep Remedies
Fortunately, there are far safer options. While you work on addressing the root causes of your sleep problems, temporarily using a natural sleep aid may help you get to sleep easier. Following are a handful of alternatives: • Melatonin — In scientific studies, melatonin has been shown to increase sleepiness, help you fall asleep more quickly and stay asleep, decrease restlessness, and reverse daytime fatigue. Melatonin is a completely natural substance, made by your body, and has many health benefits in addition to sleep. Start with as little as 0.25 milligrams (mg) and work your way up in 0.25 mg increments until you get the desired effect. • 5-hydroxytryptophan (5-HTP) — One of my favorite sleep aids is 5-HTP. 5-HTP is the hydroxylated form of tryptophan. It easily passes your blood brain barrier when it is converted to serotonin (thereby giving mood a boost) and then to melatonin (enhancing sleep). I believe this is a superior approach to using melatonin. In one study, an amino acid preparation containing both GABA (a calming neurotransmitter) and 5-HTP reduced time to fall asleep, increased the duration of sleep and improved sleep quality. • Valerian root — Studies have found valerian root helps improve the speed at which you fall asleep, depth of sleep (achieving deep sleep 36% faster ) and overall111213141516
quality of sleep. Start with a minimal dose and use the lowest dose needed to achieve the desired effect, as higher dosages can have an energizing effect in some people. Typical dosages used in studies range between 400 mg and 900 mg, taken anywhere from 30 minutes to two hours before bed. • Chamomile tea — This herb is typically used in the form of infusions, teas, liquid extracts or essential oils made from the plant's fresh or dried fiower heads. It has sedative effects that may help with sleep, which is why chamomile tea is often sipped before bed. • Cannabidiol (CBD) oil — Another alternative is to take CBD oil. By bringing tissues back into balance, CBD oil helps reduce pain, nerve stimulation and muscle spasm. It also promotes relaxation and has been shown to improve sleep.
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