By Vladimir Marchenko
In recent months, sleep quality has worsened in many countries around the world. For the record, no more than 25% of US residents felt fresh and rested in the morning, while among the British, only 11% could boast of regular, sound sleep. Insomnia caused by Covid and other anxieties can seriously harm health, the consequences of which will affect even when pandemia is over. So how to get back to a good deep rest?
What is insomnia
Insomnia is a regular violation of the falling asleep process, the duration of sleep, its steadiness and quality. The disorder reveals itself as a subjective feeling of lack of sleep, despite external factors (time and conditions) may correspond to normal sleep. Periodic sleep disorders or nightmares occur in almost everyone. Sure if we are talking about isolated cases, then there is no reason for concern. But it is much worse if insomnia becomes a common thing and sound sleep - a rare exception.
Three extents of insomnia are conditionally distinguished: mild, moderate and severe. Sleep disturbance of up to 3-4 weeks is considered as severe insomnia, and if it lasts more than a month it is labeled as chronic insomnia. In any case, strengths are not restored during the night and in the morning a person usually notes feeling tired, increased drowsiness, bad mood and performance.
When having insomnia, a malfunction of human biorhythms occurs, namely circadian rhythm`s. An organism that has been tuned for 24-hour cycle ceases to alternate the phases of sleep and wakefulness. For example, in the evening, blood pressure and temperature do not decrease, while stress hormones continue to be produced, etc. The body cannot adapt to this mode and starts to malfunction.
What causes insomnia
There are several dozen reasons which can cause sleep disorder. In most cases it is combinations of them which lead to the disease. The main reasons of insomnia usually are:
- stress, depression, neurosis, mental illness;
- physical pain diseases;
- shift work schedule, including night work;
- violation of the rules of sleep hygiene;
- malnutrition, overeating at night;
- abuse of caffeine and alcohol;
- snoring and apnea.
The prevalence of insomnia factors in a particular category of people depends on age, gender and health status. If in schoolchildren insomnia is often caused by the prolonged use of a smartphone or a nightly videogame session, then in pregnant women the reason is most likely a heartburn or other disorders of the digestive tract.
Diagnosis of sleep disorders
Determining the real causes of insomnia can only be performed by a medical professional and after a comprehensive testing. Diagnosis involves evaluating the psychological and physiological parameters of sleep in order to make the right conclusion. Usually it consists of several stages.
1. Anamnesis. The specialist conducts a survey of the patient, examines his medical record, his past and chronic diseases, sleep conditions, injuries, heredity. This helps to identify the causes of sleep disorders and think about the possible hidden signs of another disease.
2. The sleep diary. For some period (from 2 weeks to a month), a person who suffers from lack of sleep sets up a personal sleep diary. He notes information about the duration, depth of night sleep, drowsiness throughout the day, the exact time of going to bed and waking up, and nightly waking up occurrences. Records are kept for some time before and after therapy, which is necessary for the correction of treatment measures.
3. Tests and general examination. For a more accurate identification of insomnia causes, a typical biochemical blood test and other procedures prescribed by a doctor are necessary.
4. Polysomnography. This is the most reliable method for diagnosing insomnia and its forms. During the study, which is carried out during sleep, special apparatuses are used to fix sleep parameters, including the state of the brain using EEG, eyes, muscles, the cardiovascular system using ECG, nervous and respiratory systems, body position, leg movements, etc. Data comes from electrodes attached to the patient’s body, and then the parameters are recorded in a computer. By the end, the specialist studies the hypnogram of the patient's condition, determining the quality and number of phases and stages. This helps to pinpoint the cause of sleep disorder.
Conventional insomnia treatments
Modern medicine offers an extensive list of solutions to get rid of the "night tormentor". Most often, an integrated approach is recommended, in which the optimal set of components is selected for the patient.
The easiest way is treatment with medications. These are usually potent drugs that are prescribed only by the attending physician and only in a certain dosage. Sleeping pills, for example, removes common symptoms, but does not cure the disease itself. Tranquilizers are more serious means that are involved in the regulation of the nervous system. In any case, prolonged medication is not recommended.
Folk remedies may also help and can be used along with medicines. These are aromatic baths with such relaxing gifts of nature as conifer needles, decoctions of herbs, massage based on aromatic oils, as well as physical activity no later than three hours before bedtime.
The attending physician may prescribe such procedures as magnet therapy or acupuncture. It is important to establish a schedule and hygiene of sleep along with this, i.e. to go to bed and get up at the same time, choose a comfortable mattress, bedclothes, rid the bedroom of excess noise and light, take a warm shower before going to bed. Sleep schedule and hygiene are integral elements of cognitive-behavioral therapy for insomnia (CBT-I).
New methods of dealing with insomnia
Such non-medical methods include psychological and behavioral attitudes that contribute to the normalization of sleep. Their main difference from traditional methods is that they are suitable for both adults and children and have almost no contraindications. Relaxation training, or progressive muscle relaxation involves a person in constant straining and relaxing muscles from head to toe, which contributes to phased relaxation. This also includes meditative and breathing techniques. It can help to gradually reduce the effects of stress on the mind and body and to provide relaxation not only at night.
Biofeedback teaches you to control your body’s physiological activities: heart rate and blood pressure. Sensors attached to the body are configured to monitor a pulse for a further learning of the patient to control it by himself. Individual programs are usually developed within these methods.
Sometimes sleep restriction therapy is used. This approach suits people whose professions allow you to slightly experiment with sleep. It is targeted on cases where people spend too much time in bed and thus experience problems with falling asleep. Therapy itself implies cutting the time spent in bed for 15-30 minutes per day. As a result, it is reduced to 4-5 hours, in which a person begins to really sleep soundly. Then the time again gradually increases until it reaches the standard hours in accordance with the age of the patient.
Another auxiliary action may be listening to sounds for ASMR (Autonomous sensory meridian response). This is an atypical sensory phenomenon of human perception, characterized by a sensation of pleasant tingling in the back of the head and shivers running up and down the spine.
ASMR insomnia treatment
This reaction can occur on audio, visual and audiovisual stimuli. Less commonly, it occurs as a response to smell or touch. Speaking of sounds, triggers are usually simple and typical sound effects - turning paper pages, combing hair, eating, sounds of fire, rain, street noise, scratching surfaces with nails, etc. Whisper is the most popular one.
There are many ASMR videos on YouTube. They affect all people differently - from an apathetic reaction to euphoria that promotes relaxation. Perception also depends on the quality of the recording. The fluctuation in the levels of perception, in turn, is associated with the parameters of brain activity in different people. This is confirmed by a 2017 study “Sensory determinants of the autonomous sensory meridian response (ASMR): understanding the triggers”.
They found out that the sounds must be as realistic as possible. Also almost half of the participants in the study were able to concentrate on two or more triggers simultaneously.. Low-frequency sounds are associated with more intense sensations. The choice of triggers really varies among different people, but in general the sounds should be natural, low-frequency and without background music.
Researchers have also found a connection between ASMR and misophonia (negative reaction to such sounds as champing or heavy breathing). Certain sounds can cause irritation, anger and anxiety, so it is important to choose those that will only deliver pleasant and relaxing responses.
Accurate data of a positive association between ASMR and sleep problems has not yet been obtained. However, the number of users using sounds to quickly fall asleep is growing. A 2015 study ”Autonomous Sensory Meridian Response (ASMR): a flow-like mental state” says that 98% of 475 people surveyed used sound effects to relax, and 82% to treat sleep disturbances. How does this happen?
1. The level of stress and emotional stress is reduced. In 2018, a study ”More than a feeling: Autonomous sensory meridian response (ASMR) is characterized by reliable changes in affect and physiology” confirmed that watching specially selected videos provide not only ASMR, but also reduces stress. Affective and physiological reactions (decrease in heart rate) in ASMR-sensitive people were noted. Interestingly that, along with a sense of calm, an exaltation was also observed, which once again indicates the complexity of the ASMR nature.
2. Improving mood and getting rid of pain. The 2015 study above also confirmed relieving anxiety and symptoms of depression. These are the two main factors that affect sleep quality. In general, this is a two-way street, because poor sleep, in turn, causes anxiety and apathy, so you need to approach this problem from all angles. Some of the patients even confirmed a short-term relief from physical pain.
The exact causes of insomnia and ways to overcome it can be established only after a comprehensive analysis by a specialist. Most often, this is a combination of stress (from recents - the fear of Covid), worries about the future and disturbances in sleep hygiene. Treatment of insomnia is achieved both by traditional drug and non-drug methods, as well as using new methods. One of the most unusual and requiring minimal involvement is the audiovisual content causing ASMR.
Although the nature of the occurrence of ASMR has not been fully understood and does not suit some people, it is obviously popular, and its effectiveness has been proved by recent scientific studies. At least 50% of users experience a positive effect, and approximately 80% use the ASMR effect to treat sleep disturbances and uplift. If you are regularly getting anxiety, then consider using ASMR content to prevent insomnia. Also, if you are an iOS user, you can try out the Hypnopedia application with built-in relaxing sounds of nature and inspirational affirmations which are played automatically during certain stages of your sleep. It does not have obvious contraindications for age, gender or state of health, but it helps to relax and walk briskly towards a new day. Click here:Ссылка App Store