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
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.