How to manage the problems of insomnia ?
By taking a treatment ?
First reflex, but not the best thing to do...
In fact, the sleeping pills only act on the awareness of the events :
That phenomenon explains why some people keep on using the same medications during years although all the studies confirm the exhastion of their effect.
Most of the medications used to sleep present, though, several disadvantages :
The advertisements from the sleeping pill pharmaceutical companies (designed for the prescribers) often claim "good results" and a high satisfaction index issued from partly truncated studies.
In fact, in tested volunteers (sometimes recruted in a population of chronic insomniacs), the shortening of sleep onset latencies or of the duration of the arousals recorded in the start of the treatment never persists longer that a few weeks intake.
These results may not be published in France because the maximum authorized prescription time is limited to four weeks.
But the sales curves show that the prescription of these products is often renewed over years.
The attempts of withdrawal face the problem of the physical and psychological addiction.
It is the rebound insomnia which consists in a temporary worsening of the sleep difficulties some time after the cessation of the sleeping pill (sometimes up to one or two months later).
The pharmacological dependence is very strong. Withdrawal symptoms have been described several months after full stop. It is caused by the mechanism of action and by the high concentration of "psycho-actives" in the brain. (Refer to the site about the withdrawal of BZ, on the page with the external links (English website)).
As for any toxicomania, the phenomenons of tolerance, getting accustomed, addiction, have a very harmful effect on the individual, and that, precisely at the moment when he becomes aware of his problem.
That insomnia of rebound incites the insomniac to return to his/her medications and that personal failure reinforces his/her feeling of helplessness. That is the psychological dependence.
Some associations of sick persons turn against the initial prescriber. (See the above mentioned link)
Two conditions determine the probabilities of success of a withdrawal :
- The approach is guided in order to help the subject to take control again over his/her nights through personal management. The sick person is no longer a victim who feeds useless regrets, but a manager of his/her sleep who learns to feel responsible for and in charge of his/her own destiny.
- The aim is not be to heal every insomnia, because one bad night of sleep from time to time is normal (or even beneficial) from time to time.
- The program must help to diminish the consequences of difficulties of which a part will probably remain. «A healed insomniac is a bad sleeper who has learned to no longer make a problem of it».
The insomniac has learned to use resources that a good sleeper doesn’t even imagine (that can be compared to, for example, ride a bike with one wheel). The organism can remember it at any time and use these new skills.
That program requires a couple of efforts and a bit of discipline.
The procedures and the instructions must remain very simple and direct but the application of the whole program is the key to success.
Commitment over time : it all depends of the duration and the severity of the sleep problem, of the presence of physical and psychological problems and above all of your own motivation.
Insomnia is the result of a long process that takes root long before the first "sleepless nights".
The duration of the program depends of the way that will have to be made to review certain very old thought patterns.
One must not expect a quick enhancement or results in one week or two. The problem with sleep is probably already very old (and probably even more than a sick person believes it is). A commitment of several weeks or months is very little compared to what he/she has already been through.
In a second tense, the patient decides to proceed to experiments on his/her sleep. The sleep/wake diary allows to observe their result in a scientific manner.
From a very subjective perception of sleep, the sick person goes over to a more correct objective observation.
NB : a typical characteristic of insomnia is the feeling that sleep is out of control.
To fill out the Sleep/Wake diary mobilizes the patient in a positive way. It allows him/her to understand that he/she can become again the master of his sleep.
The components of this treatment have been the subject of a lot of research : the treated people have enhanced their sleep both in quality and efficiency.
Sometimes, several months of efforts have been necessary to obtain that enhancement.
The success of the program depends a lot of the seriousness and the discipline of the subject. It is a demanding therapeutic method that can’t be bought in a pharmacy ...
The important thing is to manage to gradually retrieve a feeling of trust in one’s sleep by getting rid of all the awakening thoughts and behaviors which contribute to ensure the continued existence of the vicious circle of insomnia.
In these conditions, recovery can be complete and definitive.
One feels regret for something he/she does not control.
The insomniac is somewhat like a victim of the weather in his nights.
He/she doesn’t control the climate. He/she is happy when the weather is nice (and when, for once, he/she had a good night’s sleep) and suffers when it rains (and he/she has to get up after a night of torture).
He/she feels more and more helpless and dreads his/her nights of insomnia more and more and more.
One can regret that the rain falls on a wedding day, for example, but no remorse is felt against a thunderstorm.
One feels remorse against something one is responsible for.
A good sleeper feels fully responsible of his/her sleep. In case of a bad night, he knows the causes and consequences of what happens to him/her and is totally able to take the rectificative actions when it occurs.
Someone who has never had problems with sleep often reacts the good way, without knowing it, with "common sense". (He/she is concerned with none of the items of the sleep disorders screening questionnaire
The former bad sleeper had to learn to do so.
The healing of insomnia sometimes requires that transition from regret to remorse.
NB: "Autonomy" : the use of its own laws; from the greek autos : "oneself, itself" and nomos : "the law". Autonomy is the ability to fix one’s rules of living. The treatment of insomnia is the return of the autonomy regarding sleep.
See the other articles about insomnia on the website :