Jan 8, 2015

Interview Transcript

Announcer: Questions every woman wonders about her health, body, and mind. This is, "Am I Normal?" on The Scope.

Interviewer: So it takes you a long time to go to sleep. Now, the first question, is it really hours, or does it just feel like hours?

Dr. Jones: So the average time to get to sleep is about a half an hour, if you're sleepy and you're going to bed on time. We all know that there are times in our lives when we really didn't want to go to sleep and someone sent us to bed, and it wasn't our time yet. So the first question is: Is it your chronotype? Are you fighting your chronotype?
So what's a chronotype? People are morning people or evening people, and some people are very morning people and some very evening people. So let's pick the very evening people who feel like they're the very most productive at 10 o'clock at night, and they start getting sleepy about 1:00. If you make them go to bed at 10:00, they won't feel sleepy, and it may take them hours to go to sleep. All adolescents are, by development, night people. So you want your teen to go to sleep at 9:30 or 10:00 to get their 8 or 9 hours of sleep so they can get up at 6 o'clock and walk the dog and go to high school. Well, all over the world, teenagers are owners of the night, and they sleep in the shade. This is true in the Kalahari Bush, this has been true among the natives of the Amazon, and it's certainly true right here in Salt Lake City. So, if you are a night person by virtue of your age, an adolescent, or by virtue of your chronotype, and you are going to bed at 10:00 because you know you have to get up at 6:00, but normally you're not sleepy until 1:00, it would be normal for you not to feel sleepy.
Number two would be you've got something on your mind. All of us have had times where we can't go to sleep because we're so worried. We're worried about a loved one. We're excited about a trip. We're worried about ourselves. We're not feeling very well. That's appropriate.

Now, what about those people who are feeling tired and exhausted, and they're not sleeping very well, and they can't go to sleep? Are these people what sleep doctors call primary insomniacs? Meaning they have a hard time going to sleep, and they have a hard time sustaining sleep, and they've been that way most of their lives. That isn't considered normal. These are not people for whom sleeping pills is the right answer.

So the question is: If you're taking hours to fall asleep, should you take sleeping pills? And the answer mostly is no. Sleep aides can be very helpful when you've had a big trip to the other side of the world and your clock hasn't caught up yet. It may be helpful on the plane going over or when you get back and your clock hasn't reset to take sleeping pills. But the best way to reset your clock is get lots of morning bright light and exercise. That's the way to set your clock. Sometimes melatonin can help too.

If you're a chronic insomniac, should you take sleeping pills to help you sleep? And the answer is no, because number one, they can be physically addictive. Number two, they're psychologically addictive, meaning, I [don't want] my sleeping pill and I'll never go to sleep last night. And you start getting upset about your sleep. And sleep is the one thing that the harder you work on it, the less likely you are to be successful.

So many of the sleeping pills that you get from your doctor are actually drugs that belong to the valium or benzodiazepine family, and they do relax you and make your eyes close, but they don't always make normal sleep. Sleep is a very active process where you're laying down the best and most important memories of the day, and sleeping pills can interfere with that.

So for the chronic insomniac, the answer is not sleeping pills, but cognitive behavioral therapy for insomnia, CBTI. So there are good ways and good people who can help you work your way through what might be a lifelong habit of insomnia.

If you find yourself that it's harder and harder for you to go to sleep and you're awake for hours, first do you have something on your mind? If you do, try to work on it now, try to write it down, and know that when you go to sleep, you can't really work on that. Your brain may be working on it, but you can't do it in your awake state.

Two, alcohol may help you fall asleep, but it makes you wide awake about four hours to six hours later. So alcohol isn't a good sleeper.

If you have to work and play at a time that isn't your natural chronotype, I'm so sorry for you. It's important to try to say, "If I go on vacation, I would always stay up until 2:00 and get out of bed at 10:00," and you're trying to fight that by going to bed at 9:00 and getting up at 6:00 because you have to be at work at 7:00. You'll have to figure out exactly what you're going to do with your life because you'll fight this forever, and going to sleep at 9:00 may be hard for you. If you're someone with insomnia that you've always had, that's where a sleep center and a cognitive behavioral therapist can help you reshift your work so that you can sleep better. But I don't think the sleeping pills are the right answer.

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