In The Habit Of Being Awake At Night

Most instances of long-term insomnia begin with a stressful life problem.  In the case of a nice 50 year old woman I met yesterday, the problem began with her neighbors 3 years ago.  She had always slept pretty well before then and she had no medical disease, major anxiety or depression.  Then, her next door neighbor began to make a lot of noise at night. 

Every night for a couple of months she was awakened by the noise of cars, music, talking, and general activity, usually between midnight and 2 am.  This was very upsetting to her, partly because of having to get up at 530 am for work, and partly because her relationship with the neighbor became so unpleasant.  A few times, she called the police. 

After a little while, she asked her doctor for a sleeping pill.  Eventually, she began taking clonazepam 1 mg and zolpidem 10 mg every night, which helped quite a bit.  She found another house on a quiet street and moved.  After a total of 6 months the noisy neighbor problem was history. 

Unfortunately, the insomnia continued.  If she didn't take the sleeping pills she would lie awake for hours and she couldn't stand the frustration of being awake at night.  She worried about her job performance and her dependence on the sleeping pills.  Even with the pills she was waking up in the night, and began to go to bed earlier so as to get extra chances at sleep. 

Her type of insomnia is called by various names:  primary insomnia, conditioned insomnia, or psychophysiologic insomnia.  Once the brain is in the habit of being frustrated, awake, or upset while in bed trying to sleep, the habit can last forever.  After all, the brain's main function is to learn, and her brain learned that the bed at night was an unpleasant place.  Many sleep specialists believe that this negative conditioning process between the passive act of falling asleep and the bed environment is the cause of most insomnia. 

Our nice lady needs to slowly discontinue the sleeping pills under a doctors direction, and re-train her brain to sleep.  This is a long process for most people, involving sleep restriction, cognitive behavioral therapy, relaxation techniques, daytime bright light, and a healthy daytime lifestyle.  Most people can get better sleep by using a combination of these therapies and a lot of encouragement and motivation. 

-- Sleep Well Tonight with 90% Success Rate! --