Without Sleep

“In the morning you beg to sleep more, in the afternoon you are dying to sleep and at night you refuse to sleep”

Insomnia could be described as having persistent problem falling and staying asleep. It can be caused by poor sleeping, habits, depression, anxiety, and lack of exercise, chronic illness or certain medications. Symptoms include difficulty falling or staying asleep and not feeling well rested. A common cause of insomnia is stress. Concerns about work, school, health, finances or family can keep your mind active at night making it difficult for you to sleep. Stressful life events such as death or illness of a loved one, divorce or a job loss can also cause insomnia.

In Psychological explanations (cognitive components such as worries, rumination and behavioral aspects of classical conditioning), are used to describe the experience of insomnia which has developed because people now have a sleep pattern that interferes with good sleep habits.

Types of Insomnia

1. Acute Insomnia – this occurs from a few days to a few weeks and is the most common. It is usually caused by environmental factors that disrupt your sleep e.g noise, light, unfamiliar bed, surroundings (hotel or new home), physical discomfort (pain or inability to assume a comfortable position), certain medications, illness, jet lag.
2. Chronic Insomnia – this may be primary or secondary and can be caused by the following:

• Medical conditions (diabetes, sleep apnea – when you briefly stop breathing during sleep.
• Mental health conditions – depression and anxiety
• Medications – chemotherapy, anti-depressants
• Caffeine and other stimulants
• Lifestyle factors – frequent travel, jet lag, rotating shift work

3. Onset insomnia – trouble initiating sleep
4. Maintenance Insomnia

• Difficulty staying asleep or waking up too early and having trouble getting back to sleep.
• Worry about not being able to fall back to sleep and not getting enough sleep.
• This worry then interferes with sleep further creating a vicious cycle

This is caused by:

• Sleep apnea
• Asthma or other respiratory conditions
• Restless leg syndrome
• Periodic limb movement disorder

5. Behavioral Insomnia of Childhood

• Sleep Onset – results from negative associations with sleep such as learning to go to sleep by being rocked or nursed, it includes having a parent present or watching TV while falling asleep.
• Limit Setting – involves a child’s refusal to go to bed and repeated attempts to put off going to sleep. E.g scream, cry, ask for hugs and kisses, asking for a drink, asking to go to the bathroom or to read them another story.
• Combined type – occurs when a child has negative association with sleep and resists going to bed because of a lack of limit setting by a parent or caretaker.

This can be resolved with a few behavioral changes such as creating a healthy sleep routine or learning self-soothing or relaxation techniques.

The risks and side effects of Insomnia

• Decreased performance at work or school
• Increased risk of accidents
• Increased risk of depression and other mental health conditions
• Increased risk of chronic medical conditions

Prevention

1. Keep your bedtime and wake time consistent from day to day including weekends.
2. Stay active – regular activity helps promote a good night’s sleep
3. Check your medications to see if they contribute to insomnia
4. Avoid or limit naps
5. Avoid or limit caffeine and alcohol and don’t use Nicotine
6. Avoid large meals and beverages before bedtime
7. Make your bedroom comfortable for sleep and only use it for sex or sleep.
8. Create a relaxing bedtime ritual such as taking a warm bath, reading or listening to soft music.

Cognitive Behavior Therapy for Insomnia

1. Stimulus Control Therapy – this helps to remove factors that condition your mind to resist sleep. You are coached to set a consistent bedtime and wake time, avoid naps, use the bed only for sleep and sex, leave the bedroom if you can’t go to sleep within 20 minutes only returning when you are sleepy.
2. Sleep Restriction – lying in bed when you are awake can become a habit that leads to poor sleep. This treatment reduces the time you spend in bed causing partial sleep deprivation, which makes you more tired the next night. Once your sleep has improved, your time in bed is gradually increased.
3. Sleep Hygiene – changing basic lifestyle habits that influence sleep such as smoking or drinking too much caffeine late in the day, drinking too much alcohol or not getting regular exercise. It also includes tips that help you sleep better such as ways to wind down an hour or two before bed time.
4. Sleep Environment Improvement – keep your bedroom quiet, dark, and cool, not having TV in the bedroom and hiding the clock from view.
5. Relaxation Training – this method helps calm your mind and your body, it includes meditation, imagery, muscle relaxation and others.
6. Remaining Passively Awake – paradoxical intention, involves avoiding any effort to fall asleep, paradoxically worrying that you can’t sleep can keep you awake so letting go of this worry can help you relax and make it easier to fall asleep.

What has the word of God told us about sleep?

1. Proverbs 3:24 – “when you lie down, you will not be afraid, when you lie down your sleep will be sweet”
2. John 14:27 – “peace I leave with you, my peace I give to you not as the world gives do not let your heart be troubled and do not be afraid”
3. Matthew 11:28 – “come unto me all you who are weary and burdened and I will give you rest”
4. Psalm 3:5 – “I lay down and slept yet I woke up in safety for the Lord was watching over me”
5. Psalm 46:10 – “be still and know that I am God”
6. Matthew 6:34 – “so don’t worry about tomorrow for tomorrow will bring its own worries todays trouble is enough for today”
7. Psalm 116:7 – “return to your rest my soul for the Lord has been good to you”
8. Psalm 4:8 – “I will both lay me down in peace and sleep for thou Lord only makest me dwell in safety”
9. 1 Peter 5:7 – “casting all your anxieties all your worries once and for all on Him because He cares for you affectionately and cares about you watchfully”

How do you use these Bible verses?

1. Highlight the verses in your bible and refer to them often.
2. Cut up paper and write the verses down one at a time then tape them to a mirror in your bathroom or put them on the fridge where you can see it.
3. Read them out loud when you see them each day
4. Memorize the verses you love most.

“It is a common experience that a problem difficult at night is resolved in the morning after the committee of sleep has worked on it” John Steinbeck