Solving the problem of sleepless nights

By Annapurni Narayanan

As party-goers revel through Centretown’s streets, sheep trudge through Alana’s head.

Night after night, Alana lays awake in her bed, staring at the ceiling in the quiet blackness.

“For me, insomnia is difficulty falling asleep.” Alana refuses to give her real name, for fear that there is a stigma attached to her condition. “I can’t get my thoughts out of my head, too much is going on and I don’t know how to deal with it.”

Insomnia makes getting out of bed every day a challenge. “My hands would shake, because my body was just exhausted,” Alana says.

She’s not alone.

Roughly 3.3 million Canadians suffer from insomnia, says Dr. Carmen Meakin, a general practitioner currently specializing in psychiatry at the University of Ottawa. But, she says, this number is probably underestimated.

One of the criteria for diagnosing chronic insomnia is that a person has difficulty falling asleep, staying asleep or is not refreshed after sleep for a period longer than one month.

However, insomnia is usually only clinically relevant if the lack of sleep is resulting in behaviours like fatigue, poor concentration or irritability during the day, Meakin says.

Alana says her insomnia began two years ago, triggered by the stress of an unmanageable work load at university. She continues to have bouts of insomnia, usually during exam time.

During a sleepless night, Alana tries everything to fall asleep. “I eat and I can’t fall asleep and then I exercise and I can’t fall asleep and then I do some yoga and I can’t fall asleep,” she says waving her hands in frustration.

“If someone complains they have insomnia, they will normally see their family physician who will try to determine if they need to be referred to a sleep specialist,” says Dr. Francine Roussy Layton, a clinical psychologist who works in the area of sleep at Hébert & Associates located at Somerset Street West and Elgin Street.

When there does not appear to be a physiological cause for insomnia, cognitive behavioural therapy may be helpful, Roussy Layton says.

In assessing the situation, she says she looks for behaviours or thoughts that could be maintaining the insomnia.

“Sometimes what happens is we develop bad habits around sleep and we develop anxiety around sleep,” Roussy Layton says.

Behaviour therapy can include simply changing our habits, Roussy Layton says. One example is to get out of bed and engage in activities that are relaxing, if it appears that it will take a while to fall asleep. Then the bed becomes associated with sleep and not with worry.

“There’s a lot of human variation and in sleep, it’s quite huge. I mean some people get away with only needing six hours of sleep, other people get away with needing 10,” Roussy Layton says.

“Some people can have a double espresso at 8 o’clock at night and not have it affect their sleep at all. Some people can’t even have a double espresso in the morning.”