Insomnia

 

The origin of the word, insomnia, is from Latin in- (without) + somnis (sleep).  Etymologists remark on the varied meanings of the prefix “in-“ with the formation of, in some cases, opposite meanings for the same or similar words.  Similarly, they remark on the use of a number of different consonant endings for the meaning “not or without” such as ir-, il- and ig-: and, by the substitution of u- or e- for I- in some cases. Un- is usually used for native words, and i- or e- for anglicized Latin or Greek words.

The usual meaning of insomnia is “chronic sleeplessness”. 

There seem to be two forms of insomnia.  In one type the individual cannot fall asleep at night, and in the other individuals awake and cannot get back to sleep.

My wife has the former, and has had it since I have known her (late teens on), and I have the latter, starting in my middle forties.

Insomnia is a vexing affliction.  As a medical student I was struck by the number of elderly men and women who complained of it.  There didn’t seem to be much information on the cause or mechanism of insomnia.  Some thought it might be from the chronic pain that the elderly often have due to degenerative arthritis or some other condition, but that didn’t seem to be the only cause.  Underlying psychological causes are common.  In many cases these are transient as the mind works through some loss or dilemma and eventually comes to a resolution. In many cases insomniacs will say something like, “I can’t stop thinking about things”, or “I can’t turn my brain off”.

Among the causes of insomnia are:

“Disruptions in circadian rhythm

May be due to jet lag, job shift changes, environmental noise and high altitudes

Psychological issues

 

    Depression, bipolar disorder, psychotic disorders and anxiety disorders

    Medical conditions involving chronic pain

    Hormone shifts during menstruation

 

Other factors like sleeping next to a snoring partner, parasites, genetic conditions, overactive mind, and pregnancy”

 

My wife has tried all sorts of things that are encouraged as good sleep hygiene such as lying down at the same time, keeping the bedroom dark and quiet, and resisting turning on the light and reading to fall asleep.  She can’t resist this last thing.  She often reads on her tablet which is thought to be a bad habit because the light emitted excites your brain to wakefulness.  However, I will wake many times during the night to find the light on, the kindle in her hands, and her sitting up asleep.

In desperation she has turned to Ambien, a sleep aid.  She has tried, in the past, a nightcap, antihistamines, and various other medications.  Ambien works, but it can cause elderly people to get up, fall, and break things. 

 

For me the problem is different and has changed over time.

I used to awaken for no apparent reason and lie in bed, in the dark, with everything in the world going through my head.  I tried thinking through the things that were problems; problems at work, problems in a relationship, or world problems.  This proved fruitless and seemed to make me wider awake.  I was soon writing essays in my head.

I tried counting sheep.  I might as well have been counting prairie dogs; I had no experience with either.  I next turned to working with numbers in my head.  This turned out to be a good exercise for a couple of reasons.  I have never been good with numbers.  I learned multiplication tables late, couldn’t handle large numbers easily, and even had trouble adding larger numbers in my head.  What I found was that that difficulty kept me from thinking of other problems, and I eventually fell asleep.  The other benefit was unexpected.  I got much better with numbers.

At first I would do things like pick a number, double it, double that and so forth out to the point that I couldn’t keep up with the numbers.  I’m now in six figures when I start losing track of where I am.  I worked simple algebra problems in my head and those became more complicated with time.  I tried finding the square root of non-perfect squares.  That proved to be a real challenge and I gave it up because there is usually a long or repeating fraction that I couldn’t keep up with.

I found some things about numbers that I, either never new, or had forgotten.  The sum of two even numbers is even.  The sum of two odd numbers is even.  Only the sum of an even and odd number is odd.  From that I came to realize that in adding a string of numbers one can count the number of odd numbers in the string and if it is odd, the total has to be odd.

The product of even numbers is even.  The product of odd numbers is odd, and the product of an even and odd number is even.

I found that chronic pain isn’t the only reason the elderly have trouble sleeping; nocturia is another cause.  As men age their prostates continue to grow and eventually the bladder doesn’t completely empty causing it to fill earlier than as a youth, and the bladder becomes less distensible so a feeling of fullness comes on quicker.

So, it’s almost 2:00 am local time, and I woke a little before 1:00 am, made a trip to the bathroom, and then sat down at the computer.  Bad move.  Here I am writing, bright light in my eyes, waking my brain, waiting for sleepiness to come.

The time of night that this happens is important.  If it is early in the night I can get back to sleep with plenty of time to get a good night’s sleep, but late in the night I am sometimes doomed to be awake for the day.  I need to adopt my wife’s habit.  She goes to the bathroom, returns without really opening her eyes, and can go right back to sleep.  I am forbidden from talking to her if I’m awake.  That’s good for both of us.

When I was working, waking after 3:00 am gave me that sinking feeling that I was probably up for the night and would be sleepy at work all day.  I have the luxury now of sleeping late, if need be, in most cases.  I really think that there is some “primary” brain issue with insomnia.  Before I began getting up at night to go to the bathroom my mid-sleep wakefulness seemed cyclical.  I would wake every night for a week or two and then have a similar period of sleeping through the night.  Also, when I was young I didn’t need an alarm clock.  I would tell myself that I needed to be up at 5:30, say, and wake the next morning at that time or a minute or two before.  Those days have been gone for decades, now.

 

Apnea is the cessation of breathing, and hypopnea is diminished breathing.

I recently had a sleep study and the conclusion is that I have mild obstructive sleep apnea.  The VA sleep department feels that I can benefit from CPAP (continuous positive airway pressure).  I haven’t been fitted yet.  I’m not looking forward to CPAP.  Of course, I did some reading about OSA (obstructive sleep apnea).  For moderate to severe OSA the conclusion is pretty clear that CPAP can give great relief from daytime sleepiness and even lower blood pressure.  The conclusion isn’t so clear for mild OSA.  Wearing the mask and being hooked up to the machine might help my mate sleep because one of the reasons for her sleeplessness is my snoring.

I just yawned; time to go back to bed.  I get my hair cut at 11:00 am which gives me plenty of time to get enough sleep.

Views: 54

Comment by Rodney Roe on May 17, 2019 at 12:00am

Pleasant dreams.  Incidentally, dreaming happens during REM sleep.  We have to get through the other phases of sleep in order to get to REM.  Waking before getting to REM decreases dreaming and that isn't good.

Comment by Steel Breeze on May 17, 2019 at 5:41am

prescription; whiskey.....lots...

Comment by Rosigami on May 17, 2019 at 8:20am

I have had trouble falling asleep all my life. These days, it doesn't matter so much because I don't have that many mornings where I have to be up and out. I still get up around 6:30, no matter what.  I have never needed an alarm clock.
A nap or at least a lie-down in the late afternoon helps, if I don't manage enough sleep at night. 
I am guilty of reading in bed if I can't sleep. It's really not a terrible thing. I also have tried math, and it helps. I loved your observations about how numbers behave! Did you know that every multiple of 9, if you add up the value of all the digits, always comes out to 9? One thing that works for me, instead of computation, is to count backwards from a high number, timing each number with a breath. Everything slows down nicely, and I often find myself drifting off. (Also counting backwards in Italian if I am really awake hahaha)
If all else fails, I just get up and go into the studio to paint for a few hours. I can get through a day on a couple of hours' sleep if I have to.

Comment by Rodney Roe on May 17, 2019 at 8:50am

Rost, I have always been my most creative early in the morning, before anyone but the birds are up. It is peaceful and solitary.

Comment by Anna Herrington on May 17, 2019 at 8:50am

Ugghh, I feel your pain, chronically not getting a restful sleep is really tough on the body and mind...

and those CPAP things... how does one get restful sleep with that contraption on? and isn't it noisy?? 

Good luck. I can fall asleep anywhere but like you wake up in the middle of the night. My rather weird solution just arrived one day after a trip to the animal shelter, it's my very odd black cat who shows up when I wake up at 3am and drapes herself across my stomach and purrs. !!! but if I focus on that purring I can drop back off to sleep pretty well... this cat will have to live forever, never had another cat do anything remotely so kind for a human.  : )

Don't forget caffeine as a factor in poor sleep. If I do not drink any caffeine at all, even first thing in the morning I sleep well that night. But that's no fun, no caffeine. I'm down to drinking white tea, least amount of caffeine, but, I tend to drink it all day.  *shrug*  I guess sometimes we pick our dilemmas.

Comment by Rodney Roe on May 17, 2019 at 12:59pm

Anna, I have never been careful about caffeine.  I have noticed that drinking tea later in the day seems to be associated with waking during the night.  Tea is supposed to have more stimulants than coffee; less caffeine, but other things like theobromine are stimulants.

The little bit of reading I did about this suggests that insomnia is as big a problem as I remember, and the number of "sleep aids" on the market support that claim.

Comment by J.P. Hart on May 18, 2019 at 2:37pm

Research

REJOICE

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