Joyful Musings
By Joy Birnbach Dunstan, MA, LPC, MAC
joy@dunstan.org
To Sleep, Perchance to Dream...

     We all need sleep as much as we need food, water and air, yet for many people, sleep is an illusive commodity. While it is in no way life-threatening, insomnia can be distressing, frustrating, exhausting and can make you feel like you’re going crazy.
     When necessary, we can sacrifice sleep to meet other demands on our time, but we pay a high price for the privilege if we do that too often. The body finds ways to get the rest it needs, even if it means risking your life while you’re doing things that require your full attention, like driving. Not enough shut-eye can affect us physically, mentally and emotionally. It disturbs our ability to learn, our skills, our memory, stamina, health and safety. Most of all, it affects our mood: chronic sleep disruption appears to be the single biggest trigger for depression.
     Depression, in turn, as well as anxiety, are frequent causes of insomnia. Insomnia can also cause headaches, muscle pain and a host of other ills.
     Everyone has a troubled night sometimes, or even a run of them, but it’s what we do in response to it that determines whether we wind up with chronic insomnia. It turns out that the best thing to do in response to a bout of sleeplessness is often nothing at all. It will pass shortly on its own. Resorting to medications, while helpful in the short-term, can create rebound insomnia, i.e. your sleeplessness returns with a vengeance when you try to discontinue the meds.
     Insomnia is not an illness in its own right; it is generally a symptom of something else. Sometimes the cause isn’t immediately obvious, but the following list includes some possibilities: 1) State of mind - anxiety, depression, worry, anger, grief; 2) Change - moving to a new house (or country!), starting or ending a job; 3) Environment - noise, discomfort, time zone change; 4) Pain and other medical conditions - heart, stomach, digestive and breathing problems, high blood pressure, arthritis to name a few; 5) Recreational drugs and diet - including nicotine, caffeine, alcohol, amphetamines, and many other drugs as well as high-sugar and high-protein foods at bedtime; 6) Prescription and other drugs—diuretics, diet pills, beta-blockers, stimulants, some contraceptives and herbal preparations (sleeping pills and tranquilizers can actually cause sleep disturbance); 7) Aging - hormonal fluctuations and other effects of aging can disturb sleep.
     What can you do about sleeplessness? Before resorting to medications, try some of these simple strategies: Change Your Environment —A well-ventilated room and a comfortable bed—not too hard, not too soft—are essential. If light from a streetlight or other source troubles you, use curtains or blinds to block it out. Noise can be hard to avoid here in Mexico. Roosters, dogs, cohetes all do their best to keep you awake. Use earplugs if it’s noise you can’t do anything about. Use relaxation exercises to calm yourself and take your mind off it. Keep a radio/tape player by your bed and play soothing music to mask other noise.
     Change Your Lifestyle—Cut out or cut down on all stimulants. These include coffee and tea, alcohol, nicotine, cola drinks, high-sugar foods, and diet pills, as well as stimulating action-packed TV before bedtime. Relax mentally and physically for an hour before bedtime hour. Drink a cup of warm milk, take a warm bath, do some yoga or meditation before turning in. Establish a regular routine that gives you 7-8 hours sleep. Stay up until a reasonable bedtime even if you feel sleepy earlier. If you’re a late sleeper, force yourself to get up earlier. Regular exercise in the morning or afternoon (never at night) greatly improves sleep.
     Mental Strategies—Don’t take your worries to bed with you. Deposit them mentally or really into a “worry box” for a more appropriate time. Make a list of the things on your mind then forget about them. Replace negative thoughts with positive ones, e.g. “I can sleep/get back to sleep.” Count sleeping sheep (the traditional jumping sheep may actually keep you awake).
     Above all, don’t worry or get angry about not sleeping; that only makes it worse. Sweet dreams everyone!
     (Ed. Note: Joy is a practicing psychotherapist in Ajijic. Phone 766-4265 for  comments about psychological issues. Email joy@dunstan.org.)