What keeps you up at night? Pondering deep questions? Excitement about a big trip? Or is it stress about unfinished work, an upcoming test, or a dreaded family gathering? For many people, this stress is temporary, as its cause is quickly resolved. But what if the very thing keeping you awake was stress about losing sleep? This seemingly unsolvable loop is at the heart of insomnia, the world’s most common sleep disorder.
Zaradi česa ponoči ne spite? Razmišljate o globokih temah? Vznemirjeni zaradi pomembne poti? Ali pa ste v stresu zaradi nedokončanega dela, bližajočega se testa ali družinskega srečanja, ki se ga bojite? Za mnogo ljudi je stres začasen, saj se vzrok zanj hitro razreši. Kaj pa če vas ohranja budne prav stres, ker ne morete zaspati? Ta navidezno nerešljiva zanka je srčika nespečnosti, najbolj pogosta motnja spanja na svetu.
Almost anything can cause the occasional restless night - a snoring partner, physical pain, or emotional distress. And extreme sleep deprivation like jetlag can throw off your biological clock, wreaking havoc on your sleep schedule. But in most cases, sleep deprivation is short-term. Eventually, exhaustion catches up with all of us.
Kar koli lahko povzroči občasno neprespano noč - partner, ki smrči, fizična bolečina ali čustveni stres. Ekstremno pomanjkanje spanja, na primer zaradi poleta, vam lahko zmeša biološko uro in razdeja vaš urnik spanja. V večini primerov je pomanjkanje spanja kratkoročno. Nazadnje nas dohiti izčrpanost.
However, some long-term conditions like respiratory disorders, gastrointestinal problems, and many others can overpower fatigue. And as sleepless nights pile up, the bedroom can start to carry associations of restless nights wracked with anxiety. Come bedtime, insomniacs are stressed. So stressed their brains hijack the stress response system, flooding the body with fight-flight-or-freeze chemicals. Cortisol and adrenocorticotropic hormones course through the bloodstream, increasing heart rate and blood pressure, and jolting the body into hyperarousal. In this condition, the brain is hunting for potential threats, making it impossible to ignore any slight discomfort or nighttime noise.
Vendar pa lahko nekatere bolezni, na primer dihalne težave, gastrointestinalni problemi in mnoge druge, premagajo utrujenost. In ko se neprespane noči kopičijo, spalnica počasi postane asociacija za nemirne, razrvane noči. Ko se bliža čas za spanje, so nespečniki pod pritiskom. Možgani se pod takim stresom polastijo sistema za odziv na stres in preplavijo telo s kemikalijami za beg ali boj. Kortizol in adrenokortikotropni hormoni se pretakajo po krvnem obtoku, zvišajo srčni utrip in krvni pritisk ter poženejo telo v stanje izjemnega razburjenja. V tem stanju možgani lovijo potencialne nevarnosti, zaradi česar je nemogoče ignorirati kakršno koli rahlo neudobje ali nočni zvok.
And when insomniacs finally do fall asleep, the quality of their rest is compromised. Our brain’s primary source of energy is cerebral glucose, and in healthy sleep, our metabolism slows to conserve this glucose for waking hours. But PET studies show the adrenaline that prevents sleep for insomniacs also speeds up their metabolisms. While they sleep, their bodies are working overtime, burning through the brain’s supply of energy-giving glucose. This symptom of poor sleep leaves insomniacs waking in a state of exhaustion, confusion, and stress, which starts the process all over again.
In ko nespečnež končno le zaspi, je kvaliteta spanja kompromitirana. Primarni vir energije naših možganov je cerebralna glukoza in med zdravim spanjem se naš metabolizem upočasni, da ohrani glukozo za budne ure. A PET študije kažejo, da adrenalin, ki nespečnim preprečuje spati, prav tako pospešuje njihov metabolizem. Medtem ko spijo, njihova telesa delajo nadure in kurijo možgansko zalogo energijske glukoze. Ta simptom slabega spanja povzroči, da se nespečneži zbudijo izčrpani, zmedeni in v stresu, kar proces ponovno začne od začetka.
When these cycles of stress and restlessness last several months, they’re diagnosed as chronic insomnia. And while insomnia rarely leads to death, its chemical mechanisms are similar to anxiety attacks found in those experiencing depression and anxiety. So suffering from any one of these conditions increases your risk of experiencing the other two.
Ko ti ciklusi stresa in nespečnosti trajajo nekaj mesecev, se jih diagnosticira kot kronično nespečnost. Medtem ko nespečnost redko vodi v smrt, so njeni kemični mehanizmi podobni napadom panike, ki jih občutijo tisti, ki se borijo z depresijo in anksioznostjo. Če trpimo za enim od teh problemov, imamo večjo možnost, da bomo občutili še druga dva.
Fortunately, there are ways to break the cycle of sleeplessness. Managing the stress that leads to hyperarousal is one of our best-understood treatments for insomnia, and good sleep practices can help rebuild your relationship with bedtime. Make sure your bedroom is dark and comfortably cool to minimize “threats” during hyperarousal. Only use your bed for sleeping, and if you’re restless, leave the room and tire yourself out with relaxing activities like reading, meditating, or journaling. Regulate your metabolism by setting consistent resting and waking times to help orient your body’s biological clock. This clock, or circadian rhythm, is also sensitive to light, so avoid bright lights at night to help tell your body that it’s time for sleep.
Na srečo obstajajo načini, kako presekati začarani krog nespečnosti. Nadzorovanje stresa, ki vodi v močno razburjenje, je eden od naših najbolj razumljivih pristopov k zdravljenju nespečnosti in trening dobrega spanja lahko pomaga popraviti naš odnos do spanja. Zagotovite, da bo vaša spalnica temna in prijetno hladna, da zminimalizirate 'nevarnosti' med izjemnim razburjenjem. Posteljo uporabljajte le za spanje in če ste nemirni, zapustite sobo in se utrudite s sproščujočimi aktivnostmi, kot so branje, meditacija ali pisanje dnevnika. Regulirajte svoj metabolizem tako, da si nastavite stalen čas počitka in bedenja, s čimer pomagate svoji biološki uri, da se orientira. Ta ura ali cirkadiani ritem je občutljiv tudi na svetlobo, zato se ponoči izogibajte močnim lučem, da boste pomagali povedati telesu, da je čas za spanje.
In addition to these practices, some doctors prescribe medication to aid sleep, but there aren’t reliable medications that help in all cases. And over-the-counter sleeping pills can be highly addictive, leading to withdrawal that worsens symptoms.
Poleg tega nekateri zdravniki predpisujejo zdravila, ki pomagajo zaspati, a nobeno zanesljivo zdravilo ne pomaga v vseh primerih. Tablete za spanje v prosti prodaji lahko povzročajo močno odvisnost, ki vodi v odtegnitev, ki še poslabša simptome
But before seeking any treatment, make sure your sleeplessness is actually due to insomnia. Approximately 8% of patients diagnosed with chronic insomnia are actually suffering from a less common genetic problem called delayed sleep phase disorder, or DSPD. People with DSPD have a circadian rhythm significantly longer than 24 hours, putting their sleeping habits out of sync with traditional sleeping hours. So while they have difficulty falling asleep at a typical bedtime, it’s not due to increased stress. And given the opportunity, they can sleep comfortably on their own delayed schedule.
Preden se odločite za zdravljenje, se prepričajte, da je vaša nespečnost dejansko insomnija. Približno 8 % pacientov z diagnozo kronične nespečnosti dejansko trpi za manj pogostim genetskim problemom, ki se imenuje motnja faze spanja ali (z angleško kratico) DSPD. Ljudje s to motnjo imajo cirkadiani ritem znatno daljši kot 24 ur, zato njihove spalne navade niso usklajene s tradicionalnimi urami za spanje. Ko tako težko zaspijo v tipičnem času za spanje, za to ni kriv stres. Če imajo možnost, lahko mirno spijo po svojem lastnem zamaknjenem urniku.
Our sleeping and waking cycle is a delicate balance, and one that’s vital to maintain for our physical and mental wellbeing. For all these reasons, it’s worth putting in some time and effort to sustain a stable bedtime routine, but try not to lose any sleep over it.
Naš ciklus spanja in bedenja je delikatno ravnovesje, ki je nujno za ohranjanje našega fizičnega in mentalnega zdravja. Zaradi tega se je vredno potruditi za vzpostavitev stabilnega spalnega ritma, a zaradi tega ne izgubljajte spanca.