“I can’t sleep …”
Insomnia – that’s what counting sheep is for. Insomnia is sleeplessness, not being able to fall asleep. According to the American Academy of Sleep Medicine, between 30% and 35% of adults have occasional insomnia, with brief episodes. Another 15-20% experience short-term insomnia (three months or less). And 10% have chronic insomnia, lasting more than three months with three or more instances per week.
An Ancient Ailment
For thousands of years, people have sometimes been unable to sleep. A classic case is in the ancient story of Daniel in the lions’ den. After Daniel was thrown into the den, the king stayed awake all night worrying about Daniel. Many years later, the king of Persia could not sleep one night, so he had a clerk read official records to him.
Trying to Sleep by Counting Sheep
As long as there have been people who could not sleep, ways of getting to sleep have been suggested. According to Wikipedia, for over four hundred years a solution has been to count sheep. Identical sheep pass by, climbing over the low spot in a fence or wall. The insomniac counts each one, one-at-a-time. And 2,400 years ago, a Persian king thought that hearing official records read in a monotone voice would make him sleepy. These methods count on repetitive boredom to put the sleepless sleeper to sleep.
Why can’t I sleep?
What causes insomnia? Many organizations and individuals offer many reasons why people can’t get to sleep. One cause that is high on all the lists is worry. Worry robbing people of sleep is evidently a very old problem, as seen in the story of Daniel.
Two other causes are light and sounds. These depend greatly on the sensitivity of individuals to these stimuli. Some people can fall asleep during a rock concert with a light show, while others are kept awake by the slightest sound and dimmest gleam. Most of us are somewhere between.
The main reason for light sensitivity is that our bodies are hard-wired to sleep at night and be active during the day. However, our circadian (night-day) cycles can be conditioned to sleep later or earlier.
As to sound, part of us is able to respond to alerts, which is why we use alarm clocks. Sounds can wake us up so we can respond to a threat. Most people become accustomed to every day sounds and are alerted by unusual sounds or sudden silence. For many persons, this is one reason they have trouble falling asleep in a strange place – the sounds are different.
When sounds keep us awake, it helps to keep the house and the room quiet. White noise can mask some of the annoying sleep robbers. However, some beds and mattresses are noisy, especially coil box springs and certain innerspring mattresses (Bonnell and offset) that have a tendency to squeak. Continuous coil, pocket coil and foam mattresses do not squeak. Some slatted frames squeak, and others are quiet.
Older adjustable beds were notorious for being noisy, but most newer models are quieter. Also, a complaint about earlier models of air beds was the noise of the air pumps. Newer models, such as Air-Pedic beds, have low-noise or quiet pumps. If an adjustable bed or airbed is waking up you or your partner with noise, it may be time to consider replacing the bed or the motors.
Closely related is motion. News stories tell about people shaken out of sleep by strong earthquakes, but it doesn’t take a quake to wake us up. It can be kids bouncing on the bed early Saturday morning. More commonly it is the other person turning over or getting out of or into bed. When some people get into bed and try to position themselves to be comfortable, it can feel like a quake on the other side of the bed.
We can’t prevent earthquakes, but we can minimize or eliminate partner disturbance with our mattress selection. Some mattresses transfer motion from one side of the bed to the other more than others do. Notorious for partner disturbance are Bonnell coil and continuous coil innersprings. Pocket coils isolate motion, as demonstrated in the classic Beautyrest bowling ball ad. Foam mattresses are also famous for motion isolation, especially latex and memory foam. The very property that gives memory foam its memory also keeps it from transferring motion from one part of the mattress to another.
Our own states of health and physical conditions affect our ability on one hand to sleep, and on the other hand to be alert. For instance, the pain of fibromyalgia and osteoarthritis can make it hard to get to sleep, then when we do, it interrupts that sleep. Chronic back pain and neck pain are common culprits in insomnia.
Painful injuries are another sleep-robbing culprit. For most of us, this is a temporary condition, but for some the pain goes on and on with permanent damage. Among other pain-causing conditions are scoliosis (curvature of the spine), spinal stenosis (narrowing of the spinal canal), and disc degeneration (which causes pinched nerves).
The mattress can be a solution – or at least a help – for insomnia caused by pain if it reduces or eliminates pain. To do this, it eases pressure and provides full support.
Our bodies are not made of straight lines like a box, but of curves. This is especially true of the spine, which curves forward at the neck and low back and curves rearward at the chest and hips. To this is added the sideways bulges of the shoulders and hips.
The mattress not only supports the sleeper, but is to be a cushion, making room for the parts of the body that stick out. At the same time, the smaller parts need support, so while the mattress is pushed down by a large part (such as the hips), it should push up on a recessed part (such as the low back). The degree and manner in which the mattress should yield depends on the size and weight of the sleeper, the sleeping position, and the sleeper’s physical conditions.
The least adaptable mattress types for meeting these needs are two kinds of innerspring mattresses, Bonnell coils and continuous coils. They are more suitable for back sleepers, less suitable for stomach sleepers, and least suitable for side sleepers. The mattress types that best adapt to the shape and weight of the body are memory foam, latex, and pocket coil mattresses.
Pocket coils are springs. They may conform, but the compressed coils still put pressure on the body. In fact, as a coil is compressed, its resistance increases. This will be better for some people than others. For some, the resistance of compressed coils puts too much pressure on painful joints. For them, the solution lies in specialty sleep (non-coil) mattresses.
Latex foam has been used in mattresses since the 1930s. Its use increased after the introduction of memory foam in 1991 and memory foam’s subsequent popularity. Latex is more resilient than memory foam, meaning that when the weight of compression is lifted, latex foam quickly returns to its uncompressed shape – this is called “rapid recovery” – while memory foam holds the impression for several seconds. Also, latex foam is not temperature sensitive like memory foam, so it yields to weight alone (immediate response), not waiting until it is warmed.
The immediate response allows sleepers to get immediate relief, and the rapid recovery makes it easier for them to change position or get out of bed, an advantage for many persons. However, the resilience of latex maintains some pressure on joints, which may be a problem for more sensitive persons.
Memory foam was developed specifically for pressure relief, and it has the added benefit of support for the lower back (lumbar). Memory foam is heat sensitive, becoming softer as it warms up. This is why it retains the body impression a while after the weight is removed. It also means that it is firmer when cold.
The denser the memory foam, the more heat sensitive it is; and the lighter it is, the less heat sensitive. This means that lighter memory foam has a quicker response when a sleeper lies down on it. It also means that lighter memory foam does not absorb as much heat. This is why most memory foam mattresses now have lighter memory foam atop denser foam (following the lead of the Tri-Pedic mattresses). The top layer conforms sooner, and the lower layer has longer-lasting pressure relief. For sleepers with pressure-sensitive joint pain, this helps them get to sleep more quickly and sleep better.
For sleepers with fibromyalgia, this may not be enough. They need more resilience combined with the memory foam conformity. Dr. Swartzburg designed the Fibro-Pedic mattress for persons with fibromyalgia. It has a layer of latex beneath the memory foam. The resilience of the latex lets them move when needed without the ridges of the firmer memory foam in the second layer.
Another internal cause of insomnia is melatonin deficiency or an imbalance between serotonin and melatonin. Both of these are made from the same amino acid, L-tryptophan. The mela- in melatonin refers to the dark – it is produced by the body’s pineal gland when light changes to dark. This is nature’s way of getting us to sleep at night.
Melatonin deficiency could be the result of a hormonal disorder, but with modern indoor lighting, the culprit is often too much light late into the night. This is complicated by the use of electronic devices with lit screens, such as computers, smart phones, and television. Melatonin supplements can be taken, and this is advised if you have an inability to produce enough. A more natural way is to dim the lights long enough before bedtime to stimulate melatonin production and release.
For many persons, sleep apnea is a cause of insomnia and/or interrupted sleep, not to mention creating snoring which interrupts other persons’ sleep. The Memory Foam Mattress Blog articles “Sleep Apnea and Hypopnea” and “Snoring Solution: Look to the Pillow” discuss this in detail and show how mattresses, pillows and adjustable beds can help.
Nasal allergies keep many people awake. They may also lead to sinus infections as micro-organisms breed in excess mucus. Sinus pressure can be felt in the brain and may cause a headache. Lying down lets sinuses drain into the post nasal passage and into the throat, where the mucus causes coughing and tracheal congestion. Itching and other unpleasant sensations of allergic reactions can keep the sleeper awake or interrupt their sleep.
Allergic insomnia can be combated by treating the allergies with antihistamines, and decongestants can relieve sinus pressure and hinder production of excess mucus. Expectorants (such as guaifensin) thin mucus, making it easier to expel.
Making the room and bed allergen-free prevents allergies or keeps from making them worse. Keep the bedroom dusted, and use an air purifier. Change the furnace or air conditioning air filter frequently. Wash bedding and air out the pillows. Avoid allergy-causing sprays.
Elevating the head with a pillow, wedge or an adjustable bed will make breathing easier by lessening post-nasal drainage. When using a pillow, keep the neck in line with the backbone – a special consideration for side sleepers.
Our behavior, especially habits, can lead to insomnia. What and how much we eat can cause digestive disturbances, the bedtime churning and growling that keeps us awake or rudely awakens us. But there are other habits that rob us of sleep.
Caffeine is used by many of us to finish waking up in the morning. Therefore, it makes little sense to drink caffeinated beverages, whether hot or cold, too close to bedtime. Most sleep advisors tell us to have at least a two-hour window between drinking coffee, tea, or caffeinated soft drinks and going to bed. Three or four hours is better.
Alcohol may be a relaxant, but it is also a depressant. Using alcoholic beverages to relax just before bedtime may help someone get to sleep, but it can degrade the quality of sleep and leave the person unrested and sleepy during the following day. Since our brains do much of their reprogramming while we sleep, bedtime alcohol will also affect us mentally, take the edge off.
Irregular bedtimes are the cause in many cases of insomnia. Having a regular bedtime and a regular waking time properly calibrates our circadian rhythm. This makes it easier both to get to sleep and to wake up. If you go to bed the same time each night, you are more likely to awaken the same time each morning without an alarm clock. You will also wake up more rested, since the body has completed its essential sleep cycles. More on this is in the articles “A Time to Sleep – Part 1” and “A Time to Sleep – Part 2”.
Pre-bedtime activities affect how fast we fall asleep and how well we sleep.
Exercise that increases our pulse rate enables us to relax more after. Many sources advise exercise about an hour or half hour before going to bed.
Using screen devices (television, computer, smart phone or tablet) too close to bedtime makes it harder for many of us to get to sleep. Part of this is the effect of intense light on the pineal gland (which is affected by the eyes). [Participate in our “Screen vs. No Screen” survey]
Soft, soothing music or natural sounds (such as a seascape) with lowered lights condition us for sleep.
Our state of mind is a key factor in when and how well we sleep. The old remedy of counting sheep is an effort to get the mind to stop calculating long enough to relax. Worry can keep the brain going, sheep or no sheep. Some sleep advisors suggest writing out our worries 1-3 hours earlier so our minds can set the matter aside long enough to fall asleep.
This post can only partly cover the subject of overcoming insomnia. There are many causes and many ways of dealing with it with varying measures of success. Entire volumes have been written on the subject; this is only an overview. Below are a few additional resources for further study.
Wikipedia, “Counting Sheep” – https://en.wikipedia.org/wiki/Counting_sheep
WikiHow, “wikiHow to Count Sheep” – http://www.wikihow.com/Count-Sheep
The Sun, “Counting sheep helps … and six other myths about sleep that you truly believe” – https://www.thesun.co.uk/living/1234254/counting-sheep-helps-and-six-other-myths-about-sleep-that-you-truly-believe/
National Sleep Foundation, “What Causes Insomnia?” – https://sleepfoundation.org/insomnia/content/what-causes-insomnia
Mayo Clinic, “Insomnia” – http://www.mayoclinic.org/diseases-conditions/insomnia/home/ovc-20256955
Medical News Today, “Insomnia: Causes, Symptoms, and Treatments” – http://www.medicalnewstoday.com/articles/9155.php
Web MD, “A Overview of Insomnia” – http://www.webmd.com/sleep-disorders/guide/insomnia-symptoms-and-causes#1
American Academy of Sleep Medicine, “Insomnia Awareness Day facts and stats” by Thomas M. Heffron (Mar 10, 2014) – http://www.sleepeducation.org/news/2014/03/10/insomnia-awareness-day-facts-and-stats
Spine Heath, “11 Unconventional Sleep Tips: How to Get to Sleep and Stay Asleep” – http://www.spine-health.com/blog/11-unconventional-sleep-tips-how-get-sleep-and-stay-asleep
National Sleep Foundation, “Healthy Sleep Tips” – https://sleepfoundation.org/sleep-tools-tips/healthy-sleep-tips
Huffington Post, “15 Science-Backed Ways To Fall Asleep Faster” by Sara Schwartz (https://aga.grandparents.com/) – reposted on http://www.huffingtonpost.com/entry/15-ways-to-fall-asleep-faster_us_55dde3e7e4b04ae497054470