For those with insomnia, however, the stressor appears to be the lack of sleep, and the desire for sleep becomes a stressor in itself. In other words, the fixation on getting sleep leads to feelings of stress over not falling asleep, which begins a vicious loop. According to a model first proposed by Kales et al. in 1976, patients can develop a conditioned fear of not being able to sleep, which puts them in a state of hyperarousal when they attempt to fall asleep. This makes their inability to sleep a self-fulfilling prophecy.
Insomnia is the most common sleep condition in the world, with half of adults globally reporting occasional episodes. Chronic insomnia, though far less prevalent, affects as many as 10 to 15 percent of the adult population.
Though these sleep problems are extremely common, the neurobiological mechanisms behind insomnia are not entirely understood. Research suggests that emotional stressors do play an outsized role in contributing to sleep problems, and it is well documented that mood and anxiety disorders are common comorbidities with insomnia. This seems like common sense. Emotional arousal, whether due to a state of anxiety or because of intrusive thoughts, makes it difficult to relax, thereby inhibiting one’s ability to either initiate sleep or get back to sleep after waking.
In 2016, Samantha Harvey began to lose sleep. She tried everything to appease her wakefulness: from medication to therapy, changes in her diet to changes in her living arrangements. Nothing seemed to help.
The Shapeless Unease is Harvey’s darkly funny and deeply intelligent anatomy of her insomnia, an immersive interior monologue of a year without one of the most basic human needs. Original and profound, and narrated with a lucid breathlessness, this is a startlingly insightful exploration of memory, writing and influence, death and the will to survive, from “this generation’s Virginia Woolf” (Telegraph).
When the five sleep factors were collapsed into binary categories of low risk vs. high risk (reference group), early chronotype, adequate sleep duration, free of insomnia, and no frequent daytime sleepiness were each independently associated with incident CVD, with a 7%, 12%, 8%, and 15% lower risk, respectively (Table 3). Early chronotype, adequate sleep duration, and free of insomnia were independently associated with a significantly reduced risk of CHD; while only adequate sleep duration was associated with stroke.Cardiovascular disease (CVD), including coronary heart disease (CHD) and stroke, is among the leading causes of mortality globally.1 In addition to traditional lifestyle behaviours, emerging evidence has implicated several unhealthy sleep behaviours were important risk factors for CVD.2,3 For example, short or long sleep duration,4–9 late chronotype,10,11 insomnia,12–17 snoring,18,19 and excessive daytime sleepiness20,21 were associated with a 10–40% increased CVD risk.
Sleep problems may decrease the likelihood of recovery from chronic low back pain (LBP) over the long term and those who have musculoskeletal pain on top of insomnia have an even lower possibility of recovery, a study has found.
“The probability of recovery [from LBP] is especially low among persons who often/always experience sleeplessness and who also suffer from co-occurring musculoskeletal pain,” the researchers write.
The study took place over more than 10 years and also found the likelihood of recovery from chronic LBP decreased further among people with muscle and joint pains, in addition to sleeplessness.
The researchers conducted a prospective cohort study that included 3712 women and 2488 men aged at least 20 years who participated in the HUNT study, one of the largest, longest running health studies in Norway. HUNT began in 1984 and has data on over 120,000 participants.
Beyond the constant tossing and turning of a sleepless night, it might surprise you to know that insomnia is affecting a fair hunk of the Australian population. A recent study released by the Sleep Health Foundation found that 15 per cent of us suffer from chronic insomnia disorder, and very few people are choosing to access help.
Professor Robert Adams, Professor in Respiratory and Sleep Medicine for Flinders University, and lead researcher for Chronic Insomnia Disorder in Australia study for Sleep Health Foundation
Dr Moira Junge, health psychologist specialising in treating sleep disorders, board member for Sleep Health Foundation