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.
Šta vas drži budne po noći? Razmišljanja o velikim pitanjima? Uzbuđenje zbog važnog putovanja? Ili je to stres zbog nedovršenog posla, nadolazećeg testa ili bojazan zbog porodičnog okupljanja? Kod mnogih ljudi je ovaj stres privremen jer se njegov uzrok brzo reši. Međutim, šta ako vas održava budnim upravo stres od gubitka sna? Ova naoko nerešiva petlja je u srži nesanice, najuobičajenijeg poremećaja sna 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.
Gotovo bilo šta može uzrokovati povremenu nemirnu noć - partner koji hrče, fizički bol ili emotivni nespokoj. A ekstremni nedostatak sna poput džetlega može da poremeti vaš biološki sat, razarajući vaš raspored spavanja. Međutim, u većini slučajeva, nedostatak sna je privremen. Vremenom će sve nas da sustigne zamor.
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.
Međutim, neka dugoročna stanja poput respiratornih poremećaja, problemi s organima za varenje i mnogi drugi mogu da nadjačaju umor. A kako se besane noći gomilaju, spavaća soba može da poprimi asocijacije na nemirne noći morene anksioznošću. Čim stigne vreme za spavanje, insomničari su pod stresom. Pod tolikim stresom njihovi mozgovi preuzimaju sisteme protiv stresa, preplavljujući telo hemikalijama za borbu, beg ili zamrzavanje. Kortizol i adrenokortikotropski hormoni teku kroz krvotok, ubrzavajući rad srca i krvni pritisak i teraju telo u hiperaktivno stanje. U ovom stanju, mozak lovi potencijalne pretnje, zbog čega je nemoguće ignorisati i najmanju nelagodnost i noćnu buku.
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.
A kada insomničari konačno zaspe, kvalitet njihovog počinka je ugrožen. Glavni izvor energije našeg mozga je cerebralna glukoza, a tokom zdravog sna, naš metabolizam usporava da bi sačuvao glukozu za budne sate. No, istraživanja PET skenerom pokazuju da adrenalin sprečava san kod insomničara, ujedno im ubrzavajući metabolizam. Dok spavaju, njihova tela prekovremeno rade, sagorevajući energetske zalihe glukoze u mozgu. Ovaj simptom rđavog sna ostavlja insomničare da se bude u stanju iscrpljenosti, zbunjenosti i stresa,
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.
zbog čega proces kreće ispočetka. Kada ovi ciklusi stresa i nespokoja potraju nekoliko meseci, dijagnostikuju se kao hronična nesanica. Iako nesanica retko dovodi do smrti, njeni hemijski mehanizmi su slični napadima panike koje zatičemo kod onih u stanju depresije i anksioznosti. Dakle, bolovanje od bilo kog od ovih stanja
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.
vam uvećava rizik od proživljavanja ostala dva. Srećom, postoje načini da se razbije ciklus nespokoja. Kontrolisanje stresa, koji dovodi do hiperaktivnog stanja, jedan je od najbolje shvaćenih tretmana za nesanicu, a praksa dobrog sna može da pomogne u novoj izgradnji vašeg odnosa sa vremenom za počinak. Postarajte se da vam je spavaća soba mračna i ugodno sveža kako biste umanjili „pretnje” tokom hiperaktivnog stanja. Za spavanje jedino koristite krevet, a ako ste nespokojni, napustite sobu i izmorite se opuštajućim aktivnostima, poput čitanja, meditacije ili pisanja dnevnika. Regulišite metabolizam podešavanjem doslednih perioda sna i budnosti kako biste pomogli vašem biološkom satu da se orijentiše. Ovaj sat, to jest cirkadijalni ritam, takođe je osetljiv na svetlost, stoga izbegavajte jaku svetlost po noći
In addition to these practices,
kako biste pomogli telu da zna da je vreme za spavanje.
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.
Uz ove prakse, neki doktori preporučuju lekove koji pospešuju san, ali ne postoje pouzdani lekovi koji pomažu u svim slučajevima. A pilule za spavanje u slobodnoj prodaji mogu da izazovu značajnu zavisnost, koja vodi u apstinenciju koja pogoršava 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.
Ali, pre nego što potražite bilo kakav tretman, postarajte se da je vaša nesanica zaista uzrokovana insomnijom. Otprilike 8% dijagnostikovanih pacijenata sa hroničnom nesanicom zapravo pati od manje zastupljenog genetskog problema koji se naziva poremećajem odgođene faze spavanja ili DSPD-em. Ljudi sa ovim poremećajem imaju cirkadijalni ritam mnogo duži od 24 sata, zbog čega su njihove navike spavanja u raskoraku sa tradicionalnim vremenom za spavanje. Pa, dok imaju poteškoće da zaspe u tipično vreme za spavanje, ne radi se o povećanom stresu. A kad im se pruži prilika,
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.
mogu ugodno da spavaju po sopstvenom odloženom rasporedu. Naš ciklus spavanja i budnosti je u delikatnoj ravnoteži i od životnog je značaja za održavanje naše fizičke i mentalne dobrobiti. Zbog svih ovih razloga, vredi uložiti nešto vremena i truda u održavanje postojane rutine spavanja,