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Insomnia and the Elements of Healthy Sleeping

Insomnia and the Elements of Healthy Sleeping

Sleep eludes many these days. Insomnia affects approximately 30 – 35% of the adult population. The different aspects of insomnia involve difficulty falling asleep, difficulty staying asleep, not feeling as though you’ve actually slept, and at worst, being unable to sleep at all.1,2 Ongoing insomnia creates an increased risk for many medical conditions (including stroke, diabetes, and heart disease), mental health issues, accidents, and shortened life expectancy.3

Why Are So Many People Unable to Sleep?

Disrupted Circadian Rhythms

Disrupted Circadian Rhythms

We have natural biological rhythms called “circadian rhythms” which follow a daily cycle governed by the light in the environment.4 Obviously, in our most natural state, the light is the sunlight. When the sun is up, our circadian rhythms tell us to be awake, and when the sun goes down, these same rhythms tell us it’s time to wind down and go to sleep by signaling the pineal gland to produce the sleep-including hormone, melatonin.5 Our digital, switched-on world with devices and flashing screens is the antithesis of “natural,” and continually confuses our circadian rhythms.6

Digital Sensory Overload

In addition to the unnatural light given off by device screens, many of us unknowingly suffer from digital sensory overload7 which causes stress and anxiety. Our brains are constantly trying to process the huge amount of digital information thrown at us on a daily basis. Some of the information is actually important, but much of it is certainly not. Those of us old enough to remember not having instant information, games, and entertainment at our fingertips, or social media, understand the gravity of this massive change on the psyche. Unfortunately, people born post-internet revolution or post-“screen invasion”8,9 don’t know any differently and, in many instances, must work harder at learning to “switch off.” Graphic designer, Kim Taylor, shows how “there is no rest for people who are permanently online” in her short video, Dopamine: Digital sensory overload,10 which captures perfectly how the brain on gadgets is continually digitally inundated.

Internet Addiction

Internet Addiction Disorder (yes, that’s a thing!) is a growing problem. Internet addiction co-exists with and can exacerbate insomnia, anxiety, and depression.11 A study in Current Psychiatry Reviews goes so far as to state that, “Internet Addiction Disorder (IAD) ruins lives by causing neurological complications, psychological disturbances, and social problems.”12 A recent study conducted with female college students found that internet “surfing” was one of the biggest problems. The results of the study showed a “significant negative association between the degree of internet addiction and sleep quality.”13 Most people end up “surfing the net” or scrolling through social media threads and clicking on “clickbait” when they’re tired. I heard a friend say just the other day that she was exhausted because she’d been “down the black hole of YouTube” the night before after which she was unable to fall asleep when she finally went to bed.

Online Gaming Addiction

What begins as a recreational activity, can become an obsession. Playing video games for hours on end can lead not only to blood clots from lack of movement, but also addiction and insomnia. Online gaming activates the same region in the brain as cue-induced urge/cravings in substance addiction.14 People can become so addicted to gaming that they forego sleep in order to play for longer periods of time.15

COVID-19

Any kind of unusual event can cause sleep disturbances. However, a global pandemic is an extremely unusual and stressful situation with a multitude of ongoing unknowns. Besides health and financial worries, COVID-19 has caused significant depression, anxiety, and insomnia in many people.16

Steps You Can Take for Restful Restorative Sleeping

1. Unplug. Switch off the electronic gadgets 30 minutes prior to bedtime.

2. Create a bedroom that is calming, comfortable, and able to be completely darkened.

3. Remove TVs and devices from the bedroom. An environmental sound (rain, ocean, and brook sounds) machine is okay and can be helpful for some people.

4. If you have a clock with large, bright numbers, consider getting a different one or turn the clock around and cover it.

5. Consider helping to restore a healthy circadian rhythm with the natural hormone, melatonin. Extended Release Melatonin helps your body wind down, encourages the onset of sleep, and increases total sleep time and restorative sleep. Unlike over-the-counter sleep medications, Extended Release Melatonin does not cause grogginess upon waking or memory impairment.

Melatonin and COVID-19

The Eastern Virginia Medical School Critical Care COVID-19 Management Protocol uses Melatonin, Vitamin C, Zinc, and Vitamin D prophylactically (as a protective measure) and for symptomatic people.17 In the elderly, and in people with chronic metabolic diseases, there is a decrease in pineal melatonin production18 which is associated with increased susceptibility to severe viral infections.19 “Melatonin reduces infection-associated oxidative stress” and “can reduce immunosuppression induced by chronic stress and sleep deprivation.”20

Please discuss Extended Release Melatonin, or any dietary supplement you take or wish to take, with your healthcare professional, as dietary supplements can react with prescription medications as well as with one another.

The Doctor Emi Team

References

1. Suni E. What Causes Insomnia? SleepFoundation.org. Medically reviewed by Dr. Alex Dimitriu. Updated August 6, 2020. https://www.sleepfoundation.org/insomnia/what-causes-insomnia
2. Roth T. Insomnia: definition, prevalence, etiology, and consequences. J Clin Sleep Med. 2007;3(5 Suppl):S7-S10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1978319/
3. O’Connell K. Effects of Insomnia On the Body. Healthline. Medically reviewed by Sacy Sampson, D.O. Updated on August 22, 2018. https://www.healthline.com/health/insomnia-concerns
4. Circadian Rhythms. National Institute of General Medical Sciences. NIH. Last reviewed on 7/13/2020. https://www.nigms.nih.gov/education/fact-sheets/Pages/circadian-rhythms.aspx#
5. Martinez R, Ruiz D. Sleep and Circadian Rhythm. Hormone Health Network. Last updated June, 2019. https://www.hormone.org/your-health-and-hormones/sleep-and-circadian-rhythm#
6. Why Electronics May Stimulate You Before Bed. National Sleep Foundation. Updated July 28, 2020. https://www.sleepfoundation.org/articles/why-electronics-may-stimulate-you-bed
7. Can’t Sleep? You May Have Information Overload. Traditional Chinese Medicine World Foundation. https://www.tcmworld.org/using-tcm-and-dragons-way-qigong-meridian-therapy-for-better-sleep/
8. Digital Overload: Your Brain On Gadgets. Matt Richtel, Technology Reporter for the New York Times, interviewed by Terry Gross. NPR. August 24, 2010. https://www.npr.org/transcripts/129384107
9. Lee Rainie; Barry Wellman, “The Internet Revolution,” in Networked: The New Social Operating System , MITP, 2012, pp.59-80. https://ieeexplore.ieee.org/abstract/document/6278077
10. Kim Taylor, Graphic Designer. Dopamine: Digital sensory overload. Video. Deutsche Welle. December 27, 2017. https://www.dw.com/en/dopamine-digital-sensory-overload/av-41944001
11. Younes F, Halawi G, Jabbour H, et al. Internet Addiction and Relationships with Insomnia, Anxiety, Depression, Stress and Self-Esteem in University Students: A Cross-Sectional Designed Study. PLoS One. 2016;11(9):e0161126. Published 2016 Sep 12. doi:10.1371/journal.pone.0161126.
12. Cash H, Rae CD, Steel AH, Winkler A. Internet Addiction: A Brief Summary of Research and Practice. Curr Psychiatry Rev. 2012;8(4):292-298. doi:10.2174/157340012803520513
13. Lin PH, Lee YC, Chen KL, Hsieh PL, Yang SY, Lin YL. The Relationship Between Sleep Quality and Internet Addiction Among Female College Students. Front Neurosci. 2019;13:599. Published 2019 Jun 12. doi:10.3389/fnins.2019.00599
14. Ko CK, Liu GC, et al. Brain activities associated with gaming urge of online gaming addiction. Journal of Psychiatric Research
Volume 43, Issue 7, April 2009, Pages 739-747. Received 20 April 2008, Revised 28 September 2008, Accepted 29 September 2008, Available online 8 November 2008.  https://doi.org/10.1016/j.jpsychires.2008.09.012
15. Crystal. Insomnia, Sleeping Disorders and Gaming Addiction: What is the Connection? Addiction Hope. Reviewed By: Jacquelyn Ekern, MS, LPC on January 26, 2016. https://www.addictionhope.com/blog/insomnia-sleeping-disorders-and-gaming-addiction-what-is-the-connection/
16. Morin CM, Carrier J. The acute effects of the COVID-19 pandemic on insomnia and psychological symptoms [published online ahead of print, 2020 Jun 6]. Sleep Med. 2020;S1389-9457(20)30261-6. doi:10.1016/j.sleep.2020.06.005
17. Eastern Virginia Medical School. Critical Care COVID-19 Management Protocol. Updated September 2, 2020. https://www.evms.edu/media/evms_public/departments/internal_medicine/Marik-Covid-Protocol-Summary.pdf
18. El-Missiry MA, El-Missiry ZMA, Othman AI. Melatonin is a potential adjuvant to improve clinical outcomes in individuals with obesity and diabetes with coexistence of Covid-19. Eur J Pharmacol. 2020;882:173329. doi:10.1016/j.ejphar.2020.173329
19. Anderson G, Reiter R. Melatonin: Roles in influenza, Covid‐19, and other viral infections. Wiley Online Library. First published: 21 April 2020 https://doi.org/10.1002/rmv.2109
20. Alex Shneider, Aleksandr Kudriavtsev & Anna Vakhrusheva (2020) Can melatonin reduce the severity of COVID-19 pandemic?, International Reviews of Immunology, 39:4, 153-162, DOI: 10.1080/08830185.2020.1756284

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