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The best Ways to Treat Long Term Insomnia

Say Goodnight to Insomnia, by Gregg D. Jacobs, Ph. D. (Copyright 2009) is a self-help book based on a 6 week program Dr. Jacobs has developed. Ninety percent of his patients report the program has helped them. The rate of success would probably be lower with insomniacs simply using the book. The sub-title states “Proven More Effective Than Sleeping Pills.”

The book is very repetitive, which is a good feature. Instructions do need to be given over and over again. Repetition is the heart of learning.

If you have insomnia, this book may help you. It attempts to counteract the many false myths about sleeping and insomnia. It reports that insomnia is a health problem suffered by up to half the US population. Research shows that substantial sleep deprivation for long periods of time has no ill effects on general health. Insomniacs have no more cancer, ulcers, lung problems, heart trouble, arthritis etc. than people who sleep well. A major myth Jacobs wants to correct is that everyone needs 8 hours of sleep a day.

That a health problem should have no ill effects on general health seems contradictory. Jacobs does work for a clinic at Massachusetts General Hospital offering treatment for insomnia. This may account for his calling it a health problem.

Jacobs cites research that shows sleeping less than 5.5 hours does impair the functioning of many people. Tests of mental functioning are lower the day after. Bosses and fellow workers notice when someone has had a bad night.

Part of his treatment is having his patients keep a daily sleep log. It is quite elaborate, filling 1-2 pages of his book for each of the 6 weeks. He suggests duplicating these pages. At the end of the course 42 or more pages would be filled. A log does seem a good idea. It helps patients learn their individual sleep pattern, which may vary greatly from averages or norms. It also helps correct failures in memory. Words on paper are more permanent and accurate than most memories.

He shows that sleep needs vary with age. Babies need the most, teenagers average 10 hours, young adults 8. Older adults 7, and many over 65 need no more than 6 hours. There is great variation in each age group.

Jacobs recommends going to bed at the same hour and rising at the same hour even on weekends. His treatment helps a patient train himself to sleep by the clock, to become regular as some insist their bowels should work. This ignores seasonal change. It also ignores the possibility that some individual’s natural or built in sleeping cycle doesn’t fit the 24 hour pattern. He does have some advice for night or swing shift workers.

He suggests your bedroom and bed should be used only for sleeping and possibly sexual activity. Stay in other rooms the rest of the time. He approves of afternoon naps, and cites research showing a slowdown in mental and physical function around 3.

If you do not fall asleep in 20 minutes after turning out the light, Jacobs urges getting out of bed and going to another room until you feel sleepy. He is willing to have you turn on the light, sit up in bed, and read until sleepy. Since he suggests not looking at the clock once lights are out, counting breaths could give a close estimate of 20 minutes.

The author of this article is a retired Ph. D. clinical psychologist. He agrees with Jacobs and the NIH that sleeping medications are dangerous and should be avoided. Even mild over the counter pills like Tylenol PM are a danger. What follows is not from Jacobs book, and is slightly slanted toward Asian practices.

He has tried a number of Jacob’s treatment ideas and has found they are workable. He could have easily trained himself into the pattern Jacobs recommends. Instead he simply trusts his body/mind to regulate his sleep patterns.

Words change the way you feel, perceive, and react. Wakefulness at night means the same as insomnia, but doesn’t sound like a medical diagnosis. Being wide awake is regarded as a very positive thing. It can be useful and enjoyable. Since your being awake at night causes no health problems, changing your words (thoughts) may be enough to cure your insomnia or to not regard it as a problem.

If you enjoy daydreaming, you might enjoy creating similar dreams at night while you are awake. The quiet of wee small hours is an excellent time to solve problems.

Your life situation plays a role in insomnia. A person’s responsibilities may require being certain places at certain times. Anyone who has few appointments to meet, no job to get to, is much freer to not treat insomnia as a problem. They are free to enjoy following what their mind and body dictates moment to moment. Older, retired people could forget about sleeping regular hours. They can enjoy being awake when awake, sleeping when sleepy. There should be a Zen saying of “When sleepy sleep, when wakeful, enjoy.”

Lying awake at night is an excellent time to meditate. Simply counting breaths and emphasizing the exhalation, one meditation practice, is likely to result in sleep. And it is possible you might become enlightened or reach satori in the middle of the night. (See Kapleau’s The Three Pillars of Zen).

It is possible through meditation to reach a point of inner silence, no thoughts at all. This usually takes practicing for a long time. Many people keep themselves awake with their thinking. Paying attention to non-verbal sensory input, breathing and other bodily sensations can disrupt the usual thought patterns and bring on sleep. The ‘60’s mottoes of “Be Here Now” rather than your mind wandering elsewhere might help getting to sleep. Baba Ram Dass (Richard Alpert) wrote a book with that title.

Try some of the above suggestions, or read the books mentioned. You are all individuals, and what works for you is likely not to work for the next reader. Sweet dreams!