Prepared by Sigfried and Susan Othmer, ca 1990-1995
How many of us lie awake at night, with ruminating thoughts, unable to fall asleep? Or we finally nod off, only to reawaken and cannot get back again.
According to the American Academy of Sleep Medicine, about one in three suffer from Insomnia at least periodically. Insomnia persisting for over a month is considered a chronic condition, affecting 1 in 10.
Night after night, unable to sleep, we may become anxious, or fearful about getting to sleep, making the situation worse. Disturbed sleep is often a reaction to stressors, or trauma, causing the problem to spiral.
According to LENS founder Dr Len Ochs, sleep disturbance may involve a pervasive, underlying CNS dysregulation, characterized by delayed sleep onset, or DFA, nocturnal awakening ( broken sleep), or waking unrefreshed, daytime sleepiness and fatigue.
Disrupted sleep can be a consequence of Anxiety, PTSD, Panic Attacks, chronic stress and tension, emotional, mental or physical pain. LENS therapy can address these multiple factors and conditions by helping patients in regulating their autonomic nervous system and balancing of their EEG.
A broader-based approach to alleviating Insomnia would aim to quieten the reticular formation with mindful focusing and non-judgmental awareness of our thoughts, feelings and sensations, giving rise to diminished activity in brain areas associated with anxiety. Visualizing more realistic expectations can calm the amygdala, reduce ruminating and fearfulness. Treating the pre-frontal cortex with EEG biofeedback can help reduce anticipatory anxiety.
Sleep hypervigilance may involve lack of, or disturbed slow wave or restorative sleep, REM sleep, circadian rhythms or insufficient total sleep. Cortisol, the adrenal hormone associated with chronic stress is elevated. Elevated Cortisol enlarges the amygdala, the brain’s ‘watch dog’, causing fear, anxiety. Increased time lying awake, hypervigilant, reduces restorative slow wave and total sleep. Anxiety is associated with DFA, Depression, early awakening and inability to return to sleep.
Ageing may trigger sleep anxiety, with multiple awakenings and anxiety about returning to sleep, leading to anxiety, insomnia spiralling.
Strategies for reducing sleep anxiety include: resetting time markers for sleep phase disorders, as in ‘night owls’, helping reset circadian rhythms; removing your clock from view; turning off electronics at least 30-60 minutes before bedtime to reduce exposure to blue light; plus giving oneself some quiet time as a regular practice before packing it in.