Sleeping Through Insomnia

The National Cancer Institute estimates that 12 percent to 25 percent of the general population and about 45 percent of people with cancer experience sleep disturbances. Worry and depression are the most common contributors to insomnia in otherwise healthy people. Pain and some cancer treatments, especially regimens containing mind-rewing steroids can also interfere with sleep. And if you talk to people who are experiencing hot flashes and night sweats from early onset menopause, they will tell you a thing or two about insomnia. Lack of sleep quite literally messes with your head. Taken to the extreme, sleep disturbances can cause disorientation, depression, even delusional or psychotic behavior. 

We see much higher levels of depression, stress, and anxiety in people with chronic sleep problems. These symptoms are particularly pernicious in that respect because they can entrap you in vicious cycles. Stress and anxieties interfere with sleep, as anyone who has 

This may be one of the great evolutionary mysteries in all of science, though sleep is as important to our survival as nourishment, and as cognitively essential as the ability to form memories and make sense of the world. 

Mammals sleep for at least two reasons. One is to become physically restored. For this purpose, we actually do not need to sleep per se, but only to hold still for several hours so that the connections 

In one fascinating study from Harvard Medical School, fifty-six college students initially learned five pairs of information. What the students were not told was that each pair contained an embedded hierarchy of patterns. The researchers wanted to see which group could best make judgments about how the information related to each other in the hierarchy. 

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Use naps properly. Naps are usually a healthy and stress-relieving practice. But if you have insomnia, avoid naps until you can sleep through the night—no matter how tired you get. If you re not concerned about insomnia, stick to twenty- to forty-five-minute naps in the middle of the day. If your bedtime is 11 p.m., for instance, you should restrict naps to the time between noon and 3 p.m., or you might have trouble falling asleep. 

The focus of this section will be the prevention of sleep loss through the use of sleep-promoting medications. Choice of sleep medications will not be considered, as others have thoroughly discussed this issue (6). Short-acting benzodiazepine receptor agonists are generally the type of medication recommended for the treatment of transient insomnia and chronic primary insomnia, and as adjunctive therapy for secondary chronic insomnias. 

The results of a 1-year open extension of two randomized, double-blind studies of zaleplon have been reported (9). In 316 older patients who took zaleplon nightly from 6 to 12 months and were then followed through a 7-day singleblind, placebo-controlled, run-out period, the safety profile was similar to that observed in a short-term trial in an equivalent population. The data also suggested that therapy for up to 12 months produced and maintained statistically significant improvement in time to persistent sleep onset, duration of sleep, and the number of nocturnal wakenings. Withdrawal was not associated with rebound insomnia. The authors concluded that placebo-controlled, double-blind trials are needed to confirm these results. 

Valerian originated in Europe and Asia, where it has been used for more than 1,000 years for a variety of purposes but primarily to treat insomnia and anxiety. Valerian preparations, derix ed from the root of the plant, contain active chemicals that collectively appear to enhance inhibitory neurotransmission through the GABA system. Valerian is not well studied, but several reports support the claim that it reduces sleep latency and improves sleep quality, albeit with many of the same side effects associated with benzodiazepines (Julien, 2005 Spinella, 2001). 

Insomnia may contribute as well. We ve all experienced a night where an inability to fall asleep or stay asleep left us exhausted and irritable the next day. Some cancer drugs, such as steroids, can wire you up and spark insomnia. And if you re going through menopause, hot flashes and night sweats can further interfere with a good night s sleep. 

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