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The Dangers of Learning to be an Insomniac

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The Dangers of Learning to be an Insomniac

May 05, 2023

Chronic sleep deprivation can adversely affect work and family, and should be taken seriously. Focusing on insomnia in women, neurologist and sleep specialist Chris Jones, MD, talks about the dangers of learning to be an insomniac. Kirtly Jones, MD, questions him about sleep aids and therapies, managing stress and letting go of compulsions.

Episode Transcript

Dr. Kirtly Jones: "I didn't sleep a wink last night." Or at least, that's what I used to hear from my patients often. Women suffer from insomnia, but it's not always something that we address as completely as we should.

Today on The Scope, we're going to be talking with Dr. Chris Jones, who is a neurologist and a sleep medicine specialist about a common condition - insomnia. So welcome, Chris, to the studio.

Dr. Chris Jones: Thank You.

Insomnia Causes, Symptoms, and Prevalence

Dr. Kirtly Jones: Let's talk a little bit about insomnia. It certainly was very prevalent in my menopause practice, but can you tell us a little bit about what insomnia is, maybe how common it is?

Dr. Chris Jones: Insomnia is very common, particularly among women. It's on the order of 5-10% of the general population.

Dr. Kirtly Jones: Women mostly come to their primary care doctor, and say, "Won't you write me a prescription for . . .", you pick, whatever kind of drug their friends are getting, or that they have already tried from their mother. What about prescription drugs for insomnia?

Dr. Chris Jones: Well, there's no question that they work, at least for the first six months, year, maybe a year and a half. Long-term, the best outcomes are with talk therapy, cognitive behavioral therapy for insomnia by an expert in insomnia treatment.

Dr. Kirtly Jones: Where does Insomnia come from for the average, let's say, woman? Do you have some ideas about this?

Dr. Chris Jones: There are certainly some genetic factors. It runs in families. Of course, it's more common in females, as you pointed out. So, we think that's a big part of it, but socioeconomic status and chronic stress are also a common ingredient.

Dr. Kirtly Jones: Well, certainly there are situations where women have something on their mind, there's an acute event. I think that all women will say that there's been a time, maybe when they had a newborn, or when there was an acute event in their family. They worry about a kid, or their job, which is insomnia for a short period of time. What about people who have really struggled with sleep all of their life?

Dr. Chris Jones: The current paradigm is that the precipitating event could be a happy one. Your kid is getting married, for example, and the new spouse is wonderful. But, it was a big emotional deal, and mom didn't sleep very much in the days leading up to the wedding, or the next day. Then, the insomnia got perpetuated partly by learning to associate her bed with not sleeping.

Dr. Kirtly Jones: So, once you've started not sleeping, then you become afraid of not sleeping, and it's really hard to sleep when you're anxious about it.

Dr. Chris Jones: That sleep performance anxiety, just makes it all the more difficult to fall asleep.

Sleeping Pills: How Do They Work and What are the Risks?

Dr. Kirtly Jones: So what do the common sleeping pills do? Do they really put you to sleep in an actual sleep state? Or do they just make you forget that you're awake?

Dr. Chris Jones: They do promote sleep by inhibiting the wake up system. That's true. They lose effectiveness over time, and in the meantime, they alter sleep structure, and a somewhat lightened sleep.

Dr. Kirtly Jones: There were some big cases in the United States, very famous people who had been taking sleeping pills, and then drove the next morning, or drove in the middle of the night, and got in accidents. What are the consequences, maybe, daytime consequences of nighttime sleeping medicine?

Dr. Chris Jones: It's mostly the nighttime consequences, the so-called parasomnia, or dangerous sleep walking, either sleep walking off a balcony, or out into traffic that is the major risk at night. There's very little risk the next day with the current short acting sleeping pills, of falling asleep driving, for example.

When to Seek Professional Medical Help for Insomnia

Dr. Kirtly Jones: So, if someone is having difficulty with sleeping and her mom didn't sleep that well, and was up all night, shouldn't she just pass it off, or what should she do? What's our take home here?

Dr. Chris Jones: She should take it seriously. This is a neurological, psychological, social condition. It needs to be evaluated by a professional insomnia expert if it really is consistent, recurrent, and you're feeling lousy the next day. You really need to take it seriously, because statistically your job performance, your driving safety, and your social performance with your family is going to be degraded by the insomnia.

Dr. Kirtly Jones: For women who have had insomnia for most of their life, they might think there's nothing that can be done. Their doctor won't give them sleeping pills anymore, or they've heard that those are kind of dangerous, so they just want to put up with it. Is there evidence that actually, there's something you can offer?

Dr. Chris Jones: Yes, absolutely. At the University Health Care Sleep Center, the insomnia clinic professionals use inside-oriented problem solving techniques and mindfulness to tamp down the insomnia and gradually unlearn the association between the bedroom situation at night, and their insomnia.

Dr. Kirtly Jones: So the answers are, if you've had difficulty sleeping, getting asleep, or staying asleep for more than just a couple of weeks, it may associated with something, if it's long term, if it's interfering with your daily work, with your relationships, with your sense of your wellbeing, talk to a sleep specialist. Start with you family doc perhaps, but we have sleep specialists here at the University of Utah Health Care who can get you through it.

Dr. Chris Jones: I would just add that many insomniacs are compulsive and want to do everything just perfectly. So they're perfectionists that can . . . compulsive so that the last thing to suffer is often the family, managing the family situation, the kids, and the job. In the meantime, they feel emotionally overwhelmed, and cognitively overwhelmed, and physically tired. It's just a matter of time before that manifests at the work place and in the home environment.

Dr. Kirtly Jones: This is Doctor Kirtly Jones and we've been talking about insomnia. Ladies, you need to take good care of yourself before you take care of others. Get some help and thank you for joining us on The Scope.

 

updated: May 5, 2023
originally published: January 22, 2015