Updated:
Save
Maria Teresa Matey suffers insomnia for 20 years, but has never seen a specific medical consultation or a sleep specialist. “I have discussed it with my doctor on occasion when I have gone for other reasons, but I have never gone expressly for insomnia.” According to the Spanish Sleep Society, “insomnia is the most common sleep disorder in the general population and one of the most common reasons for consultation in sleep units. Its prevalence varies from 5% to 50% of the general population, being more prevalent in females. Not being able to sleep undoubtedly affects our body and mind, in the short and long term. It can even cause serious diseases such as cancer or diabetes.
But it has a solution: we must not resign ourselves to living like this.
With the development of modern life, especially that of the last hundred years, despite no longer having predators around us and benefiting from better health and more medicines to heal us, we sleep less, both in developed countries and in those in developing countries, writes Marcelo Soi, a pharmacist and dietician specializing in the treatment of insomnia, in his book ‘Turn off Insomnia’. We must not accept insomnia as something inevitable, not even in the mature stage. At the first symptom, a specialist should be consulted. The repair of this disorder goes through a global reconsideration of all the factors that our way of life includes.
The metaphor Marcelo Soi uses is that “sleep is a kind of natural magnetic resonance that your body performs during the hours of rest. During this, the immune system – which is stronger, more powerful and more alert at night – is activated to repair tissues, eliminate toxins and fight infections, so not doing so can have serious consequences for the health of the suffer.”
Insomnia can be considered a very disabling pathology It affects many aspects of daily life. The neurologist Celia García-Malo, deputy medical director of the Sleep Research Institute in Madrid, defines it as “a 24 hour sickness, since, during the day, people who suffer from it also present symptoms such as irritability, lack of energy, concentration or memory problems and a long etcetera». As María Teresa Matey confirms, it is not only suffering the moment of not being able to sleep, but also the consequences that it has the next day on our performance. “When I was younger it didn’t affect me as much, I was even surprised to be able to have so much daily activity having only 5 hours of sleep. But for about 5 years, if I sleep badly, during the day I am very tired and generally with a headache.
As for his causes, Asier Gómez, specialist in Neurology at the University Clinic of Navarra, details that we must consider psychological (stress, anxiety), metabolic (menopause, thyroid), pharmacological (excitatory medications), chronic pain (arthritis, cancer), neurological pathologies ( Alzheimer’s disease) and other sleep pathologies (sleep apnea syndrome, for example). In some people there may be a confluence of several causes, as is the case of María Teresa . “My lack of sleep and rest is related to hormones and age, since it has worsened with menopause. But also for personal reasons; that is to say, worries and way of being: I am a person who somatizes my worries a lot and, although my head is tired and asks me to sleep, my body does not relax».
Insomnia as a symptom
In most cases, insomnia is considered the first manifestation of a nervous disorder caused by anxiety and/or depression. According to Soi, it is an exposure to some psychological problem: «We cannot forget that insomnia is a manifestation of an inner struggle, and if we only think about sleeping without resolving this struggle, we will only scratch the surface. The first thing to do is find out the source of the problem. Understand what is happening in our body to be able to remedy it and not just patches through medication or supplementation of sleep hours.
However, for Miguel Ángel Sánchez González, a specialist at the Jiménez Díaz Foundation’s Sleep Unit, the cause is not so important to treat the disorder. “The cause is the least of it. If we understand by cause that original trigger that started the process. A concern, a stressful situation, an exam, a dismissal, a promotion, an illness, a backache. Today we believe that, whatever the original cause, it is the most interesting, because it is what we can intervene on, but what is really important are the factors that perpetuate the process».
We usually, Gómez explains, divide insomnia into three large groups: «For conciliation, which is the difficulty to fall asleep; maintenance, difficulty maintaining a continuous sleep, appearing multiple awakenings throughout the night; and waking up early, coming out of sleep before the usual time, early in the morning, without being able to sleep any longer afterwards».
When to consult?
All the specialists consulted affirm that detection is a fundamental factor in the fight against insomnia. For Asier Gómez, “if we suspect that we suffer from a problem of stress or low spirits that limits our daily activity, we should not hesitate to put ourselves in the hands of professionals in the field, both psychologists and psychiatrists.”
Also for García-Malo, the first and most important recommendation is to consult as soon as possible. “A person who has insomnia must be properly evaluated to identify the cause and correct it.” For Dr. Sánchez González, “if insomnia affects your day-to-day life, see a specialist as soon as possible.” And he adds, “now, if what you want is to sleep straight every day like when you were 16, you better not insist because if you’ve turned 40 that’s not going to happen.”
THE ENEMIES OF THE DREAM
To avoid this disorder, it is essential to lead a lifestyle that is quite the opposite of what ultra-technological society imposes on us. Sedentary lifestyle, stress, lack of socialization, excessive workload or even the absence of it, exposure to artificial lights and the blue of devices are situations that favor the risk of suffering insomnia. «Sleep hygiene -says Celia García-Malo- covers many aspects that can be regulated to improve sleep. If we had to cite some important aspects, they would be regularity in sleep schedules, incorporating moderate physical activity on a regular basis, avoiding doing it in the last hours of the day, and ‘disconnecting’ from stimuli, both mental and light, a couple of hours before the moment we go to sleep. They are basic rules that we do not always comply with, but knowing them is important. We must also educate our children in this way to prevent sleep disorders in children.
Marcelo Soi explains that adolescents, due to their metabolic circumstances, are at high risk of suffering from social jet lag, since their way of life tends to be nocturnal and yet society imposes strict daytime schedules on them. There are countries, such as Australia and the US, that are considering delaying the class schedules of the institutes, since the performance in these is low, due to the lack of rest. The jet-lag socialfor the author, «causes among young people a greater risk of depression, anxiety, abuse of exciting substances and insomnia».
how much should i sleep
Regarding Sleep Hygiene, González adds that “it is very important to reserve about 8 hours each day to sleep. We cannot pretend, speaking of the ultra-technological world, to always be producing, cornering the dream. Sleeping less than 7 hours each day is known to be a causal factor in heart attacks, strokes, obesity, diabetes, immune system dysfunction and accidents. I like to think of the day divided into two 12-hour parts. A part of twelve hours must be to have four hours of activity cessation, relaxation, self-care, at the end of the day, and eight to sleep».
The risks of medication
Spain is one of the countries in the world where more people resort to benzodiazepines for sleep. We must be clear when they are needed. «Drugs of the benzodiazepine type (lorazepam, diazepam, bromazepam etc.) in chronic use impair sleep, cause insomnia. They are very good drugs for occasional use, but they should not be used every day for long periods of time. In addition, in older people they increase the risk of falls and affect cognitive capacity,” according to González.
To which Dr. Celia García-Malo adds that “medication is not something generic, it must be individualized on whether its use is necessary or not, and for how long. The high consumption of hypnotics and anxiolytics in Spain is a reflection that things are not being done well, and we must rethink how to redirect this situation.
sleeping exercises
Laura Gotor, psychiatrist at Hospital La Paz in Madrid and Director of the Mental Health Center of the Tetuán district, points out that practicing simple mindfulness exercises before going to sleep can help to fall asleep and stay asleep and progressively lower the FR medication dose, despite that it is a complicated moment due to the tiredness of the day or lack of concentration. For María Teresa Matey it is a useful exercise, but she cannot practice it when she goes to sleep. “I have practiced mindfulness and it has helped me relax and feel my worries in a different way, but I admit that I do not practice it much to sleep because I need a lot of concentration and, at bedtime, I am not in a position to meditate.”
See them
comments