What kind of insomniac are you?

It’s 4 a.m. and the sky is pitch black. It’s a moonless night. I listen to my husband and daughter’s soft even breathing. She still occasionally crawls into our bed in the early hours of the morning and cuddles up to us. I don’t mind. In fact, I like it. Some day soon she’ll decide she’s too old to come into our room and I’m going to miss this little cuddle bug that takes over my pillow and steals all the blankets. 

Tonight, she’s kicked them off. It’s been unusually hot and our AC isn’t working. She’s managed to find a way to lie horizontally across the bed, taking over my pillow and half of her father’s, seeking the cooling effect of the leather headboard.  I watch them sleep for a while, then get up. I can’t sleep and I don’t want to read or write in bed for fear of the light waking them up.  I pad into the living room guided by the glow of our patio lights that spills in through the patio doors.

A soft whirring sound draws me to the dining room. Boo our hamster is running, running, running on her exercise wheel. I like having the company of our little nocturnal pet in the middle of the night. I walk over to her cage and lift the lid. She crawls up into my hand and tickles my fingers with her whiskers as I cuddle her. She’s a great little buddy for my middle-of-the-night insomnia. 

Boo and I may be the only ones awake in my home, but I know we’re far from the only ones tiptoeing around in the middle of the night. Fifty to 70 million Americans report having some kind of sleep disorder , insomnia being the most common of those.  And 30% of adults report having occasional insomnia, while 10% report having chronic insomnia. Assuming there are approximately 250 million adults in the United States, that’s anywhere from 25 to 80 million people who are sleepless on any given night. That’s a lot of people counting sheep, or watching the clock while time marches on. 

There are three types of insomnia: Onset Insomnia, Acute Insomnia and Chronic Insomnia. 

ONSET INSOMNIA

Onset insomnia is trouble falling asleep when you go to bed at night. This type of insomnia can be short term or chronic and it’s often a symptom of anxiety disorders. Here’s the rub – it’s pretty common for people who have a hard time falling asleep to ALSO wake up in the middle of the night and have difficulty getting back to sleep. In fact, two-thirds of people with onset insomnia also have middle-of-the-night insomnia and wake up in the middle of the night, with more than half of them having trouble falling back to sleep – again. 

ACUTE INSOMNIA

Acute insomnia, also known as short-term or stress-related insomnia, is short-term sleeplessness that can last from a few days to a few weeks. It’s the most common type of insomnia and its sufferers are growing in numbers.  According to an April report by Express Scripts, a prescription provider, the use of anti-insomnia, anti-anxiety, and antidepressant medications spiked by 21% between February and March 2020 when the World Health Organization declared Covid-19 a global pandemic. 

Short-term insomnia is often caused by stress varying from routine stressors such as job loss, grief reactions, and divorce and usually lasts less than three months. The global pandemic has created a perfect storm of job loss, grief and divorce. According to the Department of Labor more than 20 million Americans lost their jobs in April, 2020, bringing the unemployment rate to 14.7%, up from 4.4% in March. By May, 2020, that number had gone up to more than 40 million. 

It’s been almost six months since American cities locked down to slow the spread of the corona virus.And although there has been some job growth in recent months and that unemployment in the US is now above 10%, that growth hasn’t been nearly enough to erase the extreme losses. 

And that’s just job losses. Hundreds of thousands of people are still grieving and reeling from the friends, co-workers and family members they’ve lost to Covid-19. (The CDC predicts that 196,000 to 207,000 total COVID-19 deaths will be reported by September 19, 2020).

And, finally, although tracking divorces since the onset of the global pandemic is difficult since the courts in some counties like Los Angeles, have been closed and that there’s been no electronic filing except for emergencies, numbers are definitely up. According to Legal Templates, a firm that provides legal documents online, sales of their Divorce Agreement have gone up by 34% during the COVID-19 pandemic with marriages crumbling three weeks into quarantine and newlywed separations doubling from 10 to 20 %. And, as courts reopen, the number of couples seeking a divorce could climb to 50%.

So, after six months of living in the midst of a global pandemic, with all the job losses, grief, and difficult living conditions precipitating divorces,what was at fist acute, or short-term insomnia for many insomniacs, has now become chronic.

CHRONIC INSOMNIA

Insomnia is considered chronic if you have trouble sleeping at least three days a week for at least a month. In some cases, chronic insomnia can last years. Like acute insomnia, this type of insomnia is often a result of anxiety or stressful life events like the death or illness of a loved one, a job loss or habits that disrupt sleep such as irregular bedtime schedule, eating, using screens and basically doing any activity before bed that interferes with your sleep cycle. 

In my case, the middle-of-the-night sleeplessness I experience, (the insomnia that prompts many of my 4 a.m. musings), falls under both the Acute and Chronic Insomnia categories. Acute because it comes and goes, and chronic because it’s been happening at least three days a week for more than a month. Throw in some onset insomnia a few times a month, for good measure, and you’ve got yourself someone who spends a lot of time stewing about sleep, researching how to get better and more sleep, and testing out healthy ways to deal with wakefulness when the rest of the world is sleeping.  

LONG TERM EFFECTS

Whether you suffer from onset, acute or chronic insomnia, lack of sleep or disrupted sleep patterns, means that you are currently, often or chronically tired. Long term effects can include a lower performance on the job or at school, a slowed reaction time while driving, therefore making the sufferer at higher risk for having car accidents, mental health disorders, such as depression or anxiety, substance abuse and an increased risk of developing long-term diseases or conditions like high blood pressure and heart disease. 

TREATMENTS

The good news is that most types of sleep disorders can be treated. The first step is to consult your doctor or a qualified sleep specialist for a diagnosis and to ensure that your insomnia isn’t being caused by an underlying medical condition. Having chronic diseases such as diabetes, kidney disease, lung disease, Alzheimer’s, heart disease or a mental health condition such as depression or anxiety disorder can cause sleeplessness. Changes in sex hormones in men and women as they age can also cause sleep disturbances. (Don’t you just love getting older?)

Once your past medical history and a physical exam have been done to eliminate other conditions that could be the cause of your insomnia, you’ll likely be asked about your sleep history. This will include questions about your sleep habits (or sleep hygiene), medications, alcohol, nicotine and caffeine intake, as well as your sleep environment. 

In my next few posts, I’ll be looking at healthy and natural ways to get better sleep, explore the concept of sleep hygiene (which has nothing to do with personal hygiene), test out home remedies, sleep apps, sleep diaries and more.

What kind of insomniac are you? Have you seen a sleep specialist? What’s your go-to home remedy?

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