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You toss and turn all night, rarely get a full night of sleep and feel miserable the next day. You think you’re an insomniac, which leads to stress. And that stress about not sleeping can lead to even more health problems, a new study has found.
“When you believe you have insomnia, that is fuel for worry,” Dr. Kenneth Lichstein, director of the Sleep Research Project at the University of Alabama and an author of the paper, told TODAY. "Most of those problems are due to worry."
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Lichstein reviewed several studies that address "insomnia identity," which is whether people think of themselves as insomniacs. Those who do experience more health problems, such as high blood pressure, depression, anxiety and poor daytime functioning. A small group of people believe they are insomniacs, even though they don't actually experience poor sleep.
“The people who perceive they have insomnia identity — it doesn’t matter if they have poor or good sleep — have high daytime impairment with anxiety, depression,” Lichstein said.
Why would people who see themselves as insomniacs experience poorer health?
It’s not clear, but it's consistent with other ways people think of health. Pain sufferers who identify strongly as having chronic pain experience depression and pain more severely than those who think of pain as something that happens to them, said Michelle Drerup, a clinical psychologist at the Sleep Disorders Center at Cleveland Clinic.
Some people who experience poor sleep, but do not strongly identify with being an insomniac, experience fewer health problems, the paper also found.
“People who are non-complaining poor sleepers have this positive attitude that I think is worth studying. What can we learn about coping?” Lichstein said.
But experts stress insomnia is not a figment of the imagination.
“It’s not all in their heads,” said Martica Hall, a professor of psychiatry at the University of Pittsburgh, who was not involved with the research. “That is the worst thing a doctor can say.”
Is it insomnia or a bad night of sleep?
Anywhere from 30 to 40 percent of the population complain of some insomnia symptoms, but do not have insomnia disorder, said Drerup.
“A bad night of sleep is not the same as clinical insomnia disorder. A bad night of sleep occurs when we have a situation of high stress. We are wired that when there is something bad going on in the world, we keep ourselves awake,” said Jennifer Martin, a clinical psychologist and associate professor of medicine at UCLA.
But clinical insomnia, which affects 10 to 15 percent of the population, is more specific.
“If bad sleep goes on for more than three months, happens three times a week, and is severe enough that it affects how people function during the day, it is chronic insomnia disorder,” Martin said.
Women are affected more than men.
Insomnia occurs in one out of every 10 men and one in every five women, with experts unsure why women suffer from it more, Martin noted. Perhaps it's because they are the primary caregivers to children and later experience hormonal changes of menopause, but the research isn’t definitive, she said. While older people once experienced insomnia at higher rates, Martin said more people 25 and younger are complaining of insomnia.
Many people with insomnia rely on prescription sleep medications, but cognitive behavioral therapy for insomnia (CBTI) can effectively help people quash their insomnia.
“The benefit of talk therapy is that it lasts longer,” said Hall. “When they take medication and they stop it, insomnia comes back ... Medication treats the symptoms, but not the underlying problem.”
But the findings on insomnia identify might mean that clinicians need to modify CBTI.
“If you see yourself an insomniac … treating the disorder means letting go of what you are,” said Martin.
That could be challenging. It's hard for people to change how they think of themselves, but it could be key.
“How would their life be different if they gave up the idea they had insomnia?” said Lichstein. “When a person with insomnia has a bad night of sleep, it is a confirming event. When they have a good night of sleep they think it is an aberration.”
Lichstein believes more research needs to be conducted to truly understand insomnia identity, its impact on health, and how to best treat it.
Tips for better sleep:
• Make a transition from your work day to your evening: Do something relaxing in the hour or so before bed, so you can wind down. Perhaps try a brief meditation.
• Try keeping a notepad next to your bed to capture any ideas you want to remember the next day.
• Turn off your devices at least one hour before bedtime. Lights from phone and tablet screens at night can wreck the circadian rhythm, your body's internal clock.
• Keep your bedroom cool: The best temperatures for slumbering are between 60 and 67 degrees.
• Make sure you move during the day: People who got 150 minutes of moderate to intense exercise every week slept better, one study found.
• If worrying keeps you up, take 15 minutes during the day to vent all your stresses. Write down problems in a journal so you don't bring them into the bedroom and let them disturb your sleep.