Do you lie awake worrying about not getting to sleep? Do you take sleeping pills because you know that you will not sleep without them? Whether you suffer from mild or chronic insomnia, our guide shows how to cure insomnia, and offers you the prospect of sound, refreshing sleep without any drugs.
Strictly speaking, insomnia means complete sleeplessness, which is a very rare condition. There are three types of chronic insomniacs: pre-sleep insomniacs, mid-sleep insomniacs, and post-sleep insomniacs.
- Pre-sleep insomniacs. There are millions of people of this type to whom the simple act of falling asleep at the beginning of the night has become a torment. Unable to get to sleep, they lose sleep mostly by worrying about sleeplessness.
- Mid-sleep insomniacs. These have no difficulty in getting to sleep, but wake up suddenly after two or three hours, and lie awake in the middle of the night.
- Post-sleep insomniacs. These get to sleep easily and enjoy it for five or six hours, but they wake up in the early hours of the morning and are unable to get to sleep again.
This very common complaint may be subdivided into three categories, according to its origin: (1) inability to relax, (2) morbid anxiety, and (3) overreliance on sleeping pills.
Pre-sleep insomnia due to inability to relax: The basis of this insomnia, as of all psychological disorders, is fear. This fear the sufferers try to deny, or repress, or sometimes convert into bodily symptoms in the form of tense muscles.
They refrain from taking sleeping pills, but are unable, or have forgotten how, to relax. Worry about not sleeping is more important here than fear about other matters.
The conquest of this type of insomnia is in two stages.
First, you must understand that there is no need to deny your fear; that you need not be ashamed of your limitations, anxieties, or guilt; and that you must gain control of fear by a free discussion of your problem with relatives and friends. Finally, you must learn to tackle the day-to-day problems yourself.
Second, you must learn the art of relaxation.
When body muscles relax, the activity of the brain lessens, preparatory to sleep. Relaxation may be achieved by the Tenlax method:
- Get into bed, switch off the light, and lie on your back. Close your eyes.
- Deliberately tense your muscles.
- Stretch your legs fully with the toes of both feet strained to stiffness and pointing away from you.
- Deliberately tense the muscles of both legs as tightly as you can without bending the knees, and hold this position as long as possible.
- Press the backs of your knees down into the mattress.
- Let the muscles slacken suddenly and go limp. Tense and relax the muscles of the legs six times.
- With your arms lying by your sides, make their muscles tense. Clench your hands as tightly as you can without bending your elbows.
- Suddenly relax and release your fists. Repeat this process six times.
- If by now you do not feel sleepy, close your eyes and roll your eyeballs downward and inward as though trying to look at the tip of your nose.
- With your eyes still closed, roll them upwards. Repeat these movements a few times, when sleep will overpower you.
The muscle-relaxing method should be used at night. It may not be necessary to complete all ten steps before sleep overpowers you.
Pre-sleep insomnia due to morbid anxiety: When a person is frightened, his thoughts and ideas of association run riot. Fear manifests itself in an easily recognized mental state, and in bodily symptoms. Since the brain controls the body, the muscles become tense as part of a defense mechanism.
Other changes also occur, depending on the intensity of the fear: the heart beats faster, the pulse rate increases, breathing becomes rapid and shallower; there may be a sensation often described as “butterflies” in the stomach, which seems to turn over; the arms may tremble, and there may be a fine tremor in the hands and profuse sweating of palms and armpits.
In extreme cases there may be an urge to pass water frequently, and sometimes diarrhea may occur. These are the symptoms of fear, which is extreme anxiety. It is hardly surprising, therefore, that if you are beset by morbid anxiety you should find it hard to sleep.
If your insomnia does not respond to the Tenlax method, or if it is more distressing than a simple failure to relax would suggest, it should be regarded as a major, and perhaps the only, manifestation of a morbid anxiety.
But insomnia from this cause can be conquered. If, like a tortoise which draws in its limbs when threatened with danger from outside, you can succeed in divorcing your sense organs from external stimuli, your mind can attain that equanimity which leads to sleep.
Pranayama Method (Deep Breathing)
This is not so difficult a process as is generally believed. It can be achieved by the Pranayama or deep breathing method:
- Sit in a comfortable posture, and loosen your clothing.
- Hold the end of your nose lightly with the tips of three fingers of your right hand, so that the thumb rests on the right nostril, the index finger on the bridge of the nose, and the tip of the middle finger on the left nostril.
- Pinch the right nostril by a gentle pressure of the thumb, and breathe deeply in through the left nostril. Pinch the left nostril with the tip of the middle finger.
- Concentrate on looking at the tip of your nose.
- With both nostrils closed, hold your breath as long as you can.
- Then exhale slowly through the right nostril, pinching the left.
- Repeat this process a few times, slowly and gently, all the while gazing at the end of your nose. As soon as your eyes feel tired, close them, and you are ready for sleep.
During the phases of Pranayama, or deep breathing – inhaling through the left nostril, holding your breath, exhaling through the right nostril – it is essential that the eyes be kept firmly focused on the tip of the nose.
When this procedure has been repeated a few times, your thoughts concentrate at first on the breathing and then on the focusing of the eyes, to the exclusion of other thoughts. The mind is thus gradually cleared of anxiety and fear.
Depending upon your co-operation, suspicions, jealousy, greed, anger, and whatever you have been worrying about, recede into the background; obsessional ruminations temporarily cease, to be replaced with tranquility.
The contraction of the external and internal muscles of the eyes causes them to turn downward and inward and the pupils to dilate. As these muscles become tired, breathing slows down and drowsiness creeps in.
If you then lie down and close your eyes, the eye muscles relax fully, causing the eyes to turn upward and outward, a condition that precedes sleep.
Pre-sleep insomnia due to over-reliance on sleeping pills: Persons suffering from this form of insomnia have evidently lost their self-confidence and have forgotten how to sleep without pills.
They seem to have lost their joie de vivre and to have become diffident and utterly dependent on drugs and doctors. They form the hard-core of insomniacs who pester doctors for bigger and bigger doses after each trivial disappointment and minor frustration.
Many of them have no apparent reasons for their symptom, but the psychiatric investigation may reveal deep causes such as feelings of guilt, or disguised phobias.
This extreme form of insomnia can be conquered like the others. Those suffering from it need:
First, to be weaned off the drug addiction and helped to regain their confidence and faith. During this trying stage of the withdrawal of the drug they need sympathy, encouragement, and friendship, to comfort and reassure them.
Those looking after them should possess an understanding of human weakness, infinite patience, and the power to exert kindly discipline.
Second, to be taught the art of sleeping naturally.
The art of sleeping without drugs is taught by the Nidra method, which is most successful if practiced with a background of soft, restful music in a darkened room:
- Lie on your back on a firm mattress. Loosen all clothing. Breathe deeply through one nostril only, hold your breath as long as possible, and then exhale through the other nostril. Repeat this process a few times.
- Stretch your legs fully with the toes pointing away from you. Hold them in this position as long as possible, then allow them to flop limp. Similarly, stretch your arms and clench your fists, then relax.
- With your eyes open, lift your head and shoulders but stop when you see your feet; hold for a few seconds, then flop back.
- Lie on your face. Clasp your hands behind your back and raise your head and shoulders. Hold the position for 20 seconds, then relax.
- Stretch your right leg with pointed toes and, without bending your knee, raise your leg from the hip. Hold it there for 15 seconds, then let it flop back.
- Repeat with your left leg. Continue with alternate legs four times each.
- Clench your fists, bend your elbows, hold them tightly as long as you can, then relax.
- Turn over, and again lie in the supine position. Close your eyes and breathe deeply, lying fully relaxed.
The whole sequence lasts about 20 minutes. Each individual movement lasts about 15 to 20 seconds, followed by 15 to 20 seconds of complete relaxation before the start of the next movement. It is quite possible that you may fall asleep after the first few movements.
These relaxation movements are designed to assist you to regain control over your body and limbs, while soft music helps to divert attention away from your mind.
Many insomniacs find they can learn this art of sleep after only a few lessons, and can then gain many benefits from either a short nap or by practicing the method at their proper bedtime. Several who had not known for years what it was like to sleep without the aid of drugs can now manage without them.
A final word against resorting to drugs as an aid to sleeping: Barbiturates are very effective hypnotics. They act by depressing the central nervous system.
Although they are of great service to patients suffering from certain diseases, unless there are strong indications for taking them, their consumption as a routine to help one sleep is bad for a variety of reasons.
Once people start taking drugs they may be tempted to take more than the prescribed dose when assailed by some extra worry. Addiction takes place easily, and the drug may fail to act effectively unless the dose is increased from time to time.
If a person who has taken sleeping pills does not drop off to sleep immediately, he may be tempted to take a further dose, and yet be too confused to be certain of the quantity taken.
So drugs for sleeping should be the last resort. There are a few types of insomnia that will not respond to drugless treatment. Remember, insomnia has never killed anyone yet, but sleeping pills have often been the direct cause of death.
People who suffer from mid-sleep insomnia have no difficulty in dropping off to sleep but suddenly wake up after two or three hours.
They are obviously in need of more sleep, and they will be able to get it provided they refrain from switching on the light or getting out of bed.
Such waking is usually due to intestinal carbohydrate dyspepsia caused by carbon dioxide and acetic and butyric acids produced by the fermentation of undigested starch taken with the last meal.
Attention to teeth, and the avoidance of starchy food at night, will overcome this type of insomnia. If the trouble persists, and if there is discomfort or definite pain in the stomach, a proper investigation should be made to exclude early gastric ulcers. Meanwhile, some relief may be obtained by drinking milk.
No particular exercises are needed to combat post-sleep insomnia: all that is required is a little understanding.
If you are one of those people who wake around 5 a.m. after five or six hours of sleep, and then find it difficult to get to sleep again, in all probability you have had enough rest for that night.
It is pointless to remain in bed tossing and turning, or simply staring at the ceiling, or wondering whether or not to take a pill; you will only set up nervous and muscular tensions which will create fatigue.
Get out of bed, bathe your eyes in warm water, and drink a cup of hot coffee or strong tea to give yourself the energy to remain awake.
Generally, people who suffer from insomnia need to be persuaded to go to bed each night at a given time, switch off the light, carry out some of the relaxation methods described, and stay in bed, whether asleep or not, until dawn.
If this advice is accepted, and acted upon, a natural adaptation soon takes place, and simply by leaving the body to take charge, almost every normal person will be able to get all the sleep he or she needs.
Disturbed sleep does not undermine physical health. No permanent physical or mental illness will result from missing, a few hours of sleep for a few nights, or for a number of successive nights.
If you learn to conform to a discipline of this nature, you will cease to panic simply because you are awake at 4 a.m. or 5 a.m. The body and mind can recuperate after exertion a lot more quickly than many people imagine.
Even in patients suffering from physical illness, the insomnia is not an invariable concomitant of the illness itself but results from the patient’s anxiety concerning its final outcome.
Will they recover fully, or will residual symptoms diminish their earning capacity? Such is the kind of question which keeps many intelligent persons awake.
Where there is ignorance there is fear and where there is fear there tends to be insomnia, because fear creates the need for vigilance, which prevents sleep.