Sleep Series: Insomnia (Part 1)

Sleep Deprivation or Insomnia?

Raise your hand if you know what sleep deprivation feels like. Yeah, that’s what I thought. Everyone (who isn’t under the age of 10) has some experience in this area. Sleep can get messed up by a lot of things: nasal congestion keeping you sneezing all night long, last minute cramming before a test, getting-married-in-the-morning jitters, that bad life decision to watch a horror movie before bed, and the general state of teenage existence. Most of these are fairly situational. No one crams for a test after the test. Colds last no longer than 2 weeks. And teenagers grow up . . . eventually. 

Sleep Deprivation (common symptoms): 

  • Short-term and long-term memory problems

  • Difficulty focusing and/or staying on task

  • Increased mood swings, anxiety, depression, and short temper

  • Clumsiness and accidents

  • Weakened immune system

  • Increased risk of illness

  • Hormone imbalances

  • Weight gain

  • High blood pressure

Short bouts of sleep deprivation are okay. Most of us can handle a day or two of crankiness and grogginess (although our friends and family might disagree). Long-term effects can be a bit trickier and, frankly, disabling. That’s when sleep deprivation becomes insomnia.

Insomnia: 

  • Difficulty falling asleep

  • Difficulty staying asleep

  • Early waking (i.e., not getting enough sleep)

  • Disruptive sleep

  • Negative impact on daily life

  • Minimally occurring 3 days per week

  • Lasting 3 months or more

What it really comes down to, though, is not some sort of stuffy diagnosis, but rather you don’t feel rested after a night’s sleep. Unfortunately for us chronic pain sufferers, 60% to 80% will eventually battle insomnia symptoms. I’m sure you can guess why. It’s hard to sleep when you are in pain.

Pain Sensitization

As if trying to sleep while in pain wasn’t difficult enough, sleep deprivation also increases the body’s pain sensitivity. Think of pain like music (probably heavy metal or opera) and someone just cranked up the loudspeakers. No one is sure why this happens, or even how it happens, but there have been multiple studies that show that it does happen.

 To illustrate: you have a spike in pain sometime in the middle of the night, thus you don’t sleep well. The next day the pain continues, worse than usual, because your sensitivity to it has increased. When you finally go to bed, you don’t sleep well again because the pain is keeping you awake. Thus starts a downward spiral of pain – disruptive night – worse pain – sleepless night – even worse pain – at this point why bother with bed?

My Battle with Insomnia

I was in college when I first started having trouble sleeping (unsurprisingly, I’m sure). The pain made it difficult to fall asleep. My neighbor’s nighttime partying habits made it difficult to stay asleep. My class schedule made early mornings a necessary evil. But I chose to ignore the decline of my health in favor of good grades.

WARNING. THIS IS A CASE OF DO AS I SAY AND NOT AS I DO. (Which all parents know is a silly thing to say and children will do whatever they please anyway.)

Regardless, I survived college and graduate school with a massive sleep debt that increased as my pain worsened. There were nights in which I stared at the darkened ceiling until 3am before drifting off, nights in which a pain flare startled me to wakefulness, and nights in which I could not sleep at all as wave after wave of agonizing pain ripped through my body. Not to get overly dramatic or anything. The longest I ever went without sleep was for 3 nights, at which point you can expect the visitation of hallucinations (mine, oddly, took the form of random pop music – never let it be said that the brain lacks for creativity).

 

Continued in Sleep Series: Insomnia (Part 2) – Help is on the Way!