Inside the Mind of an Insomniac

By Lauren Joffe, New York University

Can’t sleep? Catch up on much-needed z’s with these expert tips for remedying what may seem as an incurable case of insomnia.

You have loads of school stress, a buzzing social life and other unexpected issues -- and your mind is racing! All … night … long. Instead of snoozing, you’re totally sleep-deprived. You toss. You turn. You drink warm milk. Yet, it’s 3 a.m. and you’re way too acquainted with the cracks in your ceiling. If you can’t seem to snag some quality shut-eye, these tips will have you snoozing before that next sheep can make it over the fence….

Do You Have Insomnia?
According to neurologist Dr. Fran Weiner, insomnia affects many U.S. college students. Dr. Weiner defines insomnia as “the inability to obtain the amount of sleep needed for optimal functioning.” She says the condition is not a disease, as many would assume, but instead a symptom of another problem. There are three different forms of insomnia: transient, acute and chronic.

• Transient “Usually, transient insomnia, which lasts for several days up to a few weeks, is the most common in college students,” says Dr. Weiner. “It results from recent stress or changes in the environment, such as an unfamiliar sleep environment, stress from a particular situation, caffeine, alcohol, stimulant abuse, nicotine, or in some cases, a recent medical illness.” While transient insomnia is a fleeting condition, sufferers often have recurring bouts. The resurgence of sleepless nights can depend on various life circumstances, such as an upcoming test, a recent move, or worry over new friendships and relationships.

• Acute When people exhibit sleepless nights for three weeks to three months, they have acute insomnia. Usually, these sufferers find it not only hard to fall asleep, but when they are sleeping, it is difficult to remain in this state throughout the entire night. This poor sleep quality causes daily functioning to fall below normal performance levels. For students, acute insomnia is typically caused by stress, atmospheric changes (temperature, noise, etc.) or recent caffeine withdrawal.

• Chronic The final type is classified as chronic insomnia -- that is, when insomnia lasts for at least one month or longer. Such insomnia can be caused by depression, anxiety, constant stress or discomfort at night. Ironically, it is normal for sufferers of chronic insomnia to demonstrate increased awareness, almost as if life is passing by in slow motion. Attention Fight Club fans: Does Edward Norton’s sleep condition ring a bell here?

Effects of Insomnia
New York University junior Julie Gold (whose name has been changed to protect her privacy) suffers from acute insomnia. For two months now, Gold has had problems staying in a sleep state -- unlike many who cannot fall asleep. “The second I close my eyes, I will be ‘asleep.’ Unfortunately this nap-like state is as far as it will ever go. I tend to wake up at about 45-minute intervals -- sometimes briefly, sometimes for extended periods of time before I go back to sleep. It’s like I’m always napping but never actually sleeping.”

Knowing that sleeping aids like Ambien are highly addictive, Gold chooses to stay away from prescribed medications. The result? “For the most part, it's incredibly annoying, especially when my insomnia affects how I function in life. I have become very anxious as a result of not sleeping. I honestly feel trapped. Sleep will cure the exhaustion, but I can't seem to get that far.”

And like many other insomnia sufferers, Gold finds that lack of sleep negatively affects her daily functioning, from school performance to concentration levels: “Even though I manage to power through my work a lot of the time, more often I end up not thinking straight in the early evening because I am so exhausted. It becomes frustrating when I can barely put together coherent sentences, let alone study for economics.”

This self-described “incoherence” once got Gold locked out of her apartment in the middle of the night. Frustrated with her inability to sleep, she decided to take a walk to help clear her head. She accidentally left her keys inside and was left sitting in the lobby until the early morning.

Dr. Weiner affirms that sleep deprivation is a significant problem. So can you make up for lost sleep, say, by catching an occasional nap? “One can try to add additional short periods onto his amount of sleep,” says Dr. Weiner. “However, trying to sleep an extensive period the next night is not the answer, as irregular sleep patterns can cause other symptoms as our body is used to a 24-hour clock.

Sleep Hygiene: Good Habits
Dr. Weiner uses the term “good sleep hygiene” in reference to certain behaviors that will help students like Gold fall asleep and stay asleep. “Stress and anxiety are a very common cause of insomnia, especially in college kids,” says Dr. Weiner. “I recommend students that are experiencing anxiety to try and follow ‘good sleep hygiene’ the best they can. Then, they can pinpoint the underlying cause of their sleep problems.”

• Sound the alarm Have a standardized wake time every day, classes or not. “Although the number of hours people sleep varies greatly, from two to three hours for some to 10 to 12 for others in a 24-hour period, normal average amount of sleep is considered about seven to eight hours,” says Dr. Weiner.

• Quiet time Limit the amount of time you are in bed, meaning if you are having difficulty going back to sleep after waking up, get out of bed and try a “quiet” activity, such as reading. Gold agrees with this advice, saying, “Almost every night, I have a routine of drinking chamomile tea and listening to relaxing music before I try to sleep. This sometimes helps calm the anxiety I've built up.”

• You snooze, you lose Avoid napping during the day. Naps affect something called the circadian rhythm, your body’s 24-hour schedule. You might think of this as your “inner clock,” which affects when and how well you sleep. Keeping naps at a minimum will help this rhythm stay on beat so you don’t mess up your sleep/wake cycle.

• Happy hour Avoid stressful activities in the evening. Yes, that means not cramming for your accounting midterm an hour before you head to bed! Worrying about stressful things like exams or personal finances will only make it more difficult to calm down before bedtime, and therefore, it will be harder to fall asleep.

• Snack attack Don’t eat too close to bedtime because certain digestion patterns can cause the body to stay awake, even if you want to hit the sack.

• Buzzkill Avoid caffeine after approximately 2 p.m. and avoid alcohol altogether. Do you know alcohol actually produces only three to four hours of good sleep and is usually followed by increased wakefulness the second half of the night?

Bottom Line
Let’s be real … it is unlikely that you will be able to follow all, if most, of these steps every night. But applying a few of them may end the nightmare that insomnia can be. Don’t undermine the importance of sleep, as getting the recommended eight hours a night is beneficial to your weight, skin and concentration -- things I know almost every college student cares about.

According to Dr. Weiner, “Students must realize that sleep is so important because it is a restorative function for probably every aspect of the body. REM sleep is thought to be involved in memory consolidation and is thought to affect brain development.” This would explain why insomniacs like Gold often struggle to perform at an optimal level.

Left untreated, chronic insomnia can lead to obesity, attention deficit disorder (ADD), high blood pressure and depression … just to name a few! If you continue to have problems sleeping, talk to your doc about seeing a sleep specialist for an evaluation. And with that, I wish you good luck and good night.