To treat the disorder, changes in habits are essential, such as sleep hygiene and less contact with screens at night.
With a meeting in the morning, I had done everything I could think of to overcome my latest bout of insomnia and sleep.
I exercised, had an early dinner, had time to relax, read a few chapters until I felt drowsy, and gently closed my eyes.
When I woke up in the middle of the night, it was like someone opened a browser I had forgotten I had minimized and all the tabs started reloading. What if it rains when I get married next year? Did I anger my friend when I asked for help with pet care? I really should try harder to stay in touch with family. Am I taking too much time off? Or not enough time?
Before I knew it, I was like a zombie. I eventually managed to get some sleep, but my sleep was constantly interrupted by my tossing and turning. As soon as the first rays of sunlight came through my bedroom window, I gave up.
I'm one of 1 in 10 people who have chronic insomnia , said Shalini Paruthi, co-director of the Center for Sleep Medicine and Research at St. Luke's Hospital in Chesterfield, Missouri, and spokeswoman for the American Academy of Sleep Medicine.
Chronic insomnia is when a person takes more than 30 minutes to fall asleep or go back to sleep up to three times a week for more than three months — which, as a result, impacts their day with symptoms such as problems concentrating or mood swings, he explains. Rachel Salas, professor of neurology at Johns Hopkins University School of Medicine in Baltimore.
There are several helpful methods for treating the condition, including correcting sleep hygiene and practicing cognitive behavioral therapy specifically for insomnia. But this takes weeks to take effect.
What do you do on those nights when you just know sleep isn't coming – or, at least, not without a fight?
Why do you have insomnia?
The first step is to identify where the insomnia comes from, said Paruthi, who is also an associate professor at Saint Louis University School of Medicine.
Sometimes insomnia can arise with major life changes, such as grieving a loved one or experiencing a medical event, the expert added. Insomnia can often go hand in hand with stress, anxiety and depression .
But that doesn't mean the condition doesn't deserve treatment or will simply go away when the pain, stress or illness goes away, Paruthi said.
“Insomnia is a real disorder,” she said. “You have to treat both for that person to regain full mental health.”
It is also possible that insomnia is caused by restless leg syndrome. The condition affects many people but is often underestimated as a cause of insomnia, Paruthi said.
A feeling of restlessness and wanting to move your arms, legs or torso is a state of hyperarousal and can prevent a good night's sleep, she said.
Many people go undiagnosed because they don't have the words to describe what's happening to them, and it can go unnoticed because it's not always just the legs that are affected, she adds.
If that's the case, she recommends getting up, walking around the house, and doing some stretches to ease the restless feeling before trying to sleep again.
Do you stay in bed?
Don't let the bed become a place associated with long stretches of sleep stress, said Salas, who is also a sleep neurologist at the Johns Hopkins Center for Sleep and Wellness.
The worst thing someone with insomnia can do is stay in bed and not sleep.
If you worry, check your phone or watch TV in bed, your brain receives conflicting messages about the purpose of your bed, Salas said.
Instead, try doing your normal bedtime routine, then go to bed at bedtime and give yourself about 15 to 20 minutes to fall asleep — don't look at the clock, just estimate, advises Salas.
If you haven't fallen asleep by then, use a flashlight other than your phone to go to another room and do another activity until you start to feel sleepy and try to sleep again.
Does this mean that if you're not sleepy at your set bedtime, you shouldn't go to bed at that time? Salas said no.
Most people quickly think, 'Well, I'm not sleeping. I’m just going to stay awake and go to bed when I’m tired,'. But now you’re dealing with the variability of bedtime and wake-up time. And we know from studies that people, even if they sleep 10 hours, if they go to bed at different times and wake up at different times, they can actually function as a sleep-deprived person.
Activities that promote sleep
Everything you do in the moments you get out of bed needs to be relaxing and follow good sleep hygiene, said Paruthi.
Salas recommends that her patients listen to classical music or nature sounds to help the brain make the association with sleep. Or you can read a book that isn't very interesting or magazines with short articles by flashlight, she added.
This is not the time to do laundry or start checking work emails, Salas said. Remember, this is about teaching your brain that it's time to relax.
If you're trying all the best practices but are still having trouble sleeping, there are effective over-the-counter and prescription medications you can check with your doctor to help you through particularly rough nights, Paruthi said.
If you sleep seven to nine hours and still feel tired during the day, there may be an underlying sleep disorder that you need to treat, Salas said.
That's the worst thing, because we know that sleep is definitely important not just for memory and cognition, but for immunity as well and all sorts of other things,” she said. “I would say if you notice that you're getting enough sleep but you're still tired, dragging yourself out, and having trouble during the day, it's time to talk to your doctor.
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