I’m so exhausted at the end of the day and I fall asleep straight away, but I wake up at least 4 times every night and struggle to go back to sleep. Is this considered insomnia?
A great question emailed through this week and in a timely fashion too I might add; as the insomnia issue has come up a few times with clients over the last couple of weeks.
In regards to the question; yes this is considered insomnia, maybe not how you typically see it depicted (tossing and turning for hours unable to sleep all night style).
The Journal of Clinical Sleep Medicine(1) defines the term Insomnia with the following diagnostic criteria:
(1) difficulty falling asleep, staying asleep or non-restorative sleep;
(2) this difficulty is present despite adequate opportunity and circumstance to sleep;
(3) this impairment in sleep is associated with daytime impairment or distress; and
(4) this sleep difficulty occurs at least 3 times per week and has been a problem for at least 1 month.
The question relates to a “sleep maintenance” problem whereas not falling asleep when you first go to bed is called “sleep latency.”
Both types of insomnia share many of the same causes — some of them are: eating too late at night, high stimulation before going to bed from drink, food, or technology, stress or worry, or an irregular sleep routine. Sleep maintenance problems are also linked to a biochemical imbalance in melatonin and serotonin.
In brief this is what happens:
The pineal gland secrets melatonin in the evening when the sun has set.
The National Sleep Foundation, says melatonin levels normally start rising about 9 p.m. This is in response to darkness and should stay elevated until dawn, when daylight prompts the pineal gland to stop producing. If you are not exposed to bright light in the day or to darkness in the evening, our melatonin levels are likely to stay
low(2) This means that even though you go to sleep initially, a busy mind can wake you up before it’s experienced deep sleep. Unfortunately, one of the downsides of a technology driven and artificially lightened world means it can trick our brains into thinking it is always daytime.
Try this Sleep Hygiene routine and see if it helps:
Decide on a time that you can go to bed at regularly - for most adults between 9 and 10pm is a great option. If you have been under long term stress cortisol can naturally surge around 10pm so if your not in bed in the dark this can give you a second wind so lets prevent that.
Avoid stimulating food and drinks in the evening - this includes alcohol to 'wind', any form of caffeine, sugary foods and drinks. You should make sure you've eaten your main meal at least 3 hours before going to bed. This enables your body to rest rather than focus on digesting food.
Invite the night into your home by dimming the lights, unplugging your gadgets - yes turning of the WIFI is a great option at least an hour before bed. Make sure there are no technology devices in the bedroom. Watching T.V or scrolling the net is not a 'wind down' activity.
If you find you are prone to worry or have an overactive mind when you get into bed set aside a specific time to write down your worries. This gets them out of your head and then you can put steps into action to get rid of them. This means they won’t circulate round and round in the wee hours of the morning. I love the quotes: "Worrying doesn't take away tomorrows problem's, but it does take away today's peace" Randy Armstrong and "Worry is like a rocking chair - it gives you something to do but doesn't get you anywhere" Van Wilder
Practice breathing exercises to reduce stress and promote sleep. This is the one way you can stimulate your parasympathetic nervous system - the branch responsible for rest and digest and healing. Simply breathe in over the count of 5, hold for 3 seconds and breathe out over a count of 7 letting everything go with the out breath.
The restorative yoga pose of lying on your back with your legs up the wall is also supportive of restorative sleep. Try this for 10 mins just before you head to bed with a 20 breathe cycle like explained above.
According to Traditional Chinese Medicine (TCM), there is an organ clock that is associated with each organ and when it is functioning optimally with the most energy. There are 12 organ systems and 2 accessory systems that are represented by this clock. This is beyond the scope of this article but I have seen in my own experience by following a good sleep hygiene routine and treating the specific organ correlated with the awaking time in the night almost 100% of insomnia problems have resolved. This is something that should be looked into if the Sleep hygiene routine doesn't help at all.
Sleep deprivation is the worst kind of torture so I hope this information will help you achieve restorative sleep with sweet dreams