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.
是什麼讓你夜裡仍然清醒? 思索很深的問題? 興奮期待一場大旅行? 或是壓力,擔心未完成的工作、 即將到來的考試, 或可怕的家庭聚會? 對許多人,這種壓力是暫時的, 成因很快就能被解決。 但如果讓你無法入睡的原因, 就是擔心睡不著的壓力呢? 這似乎無解的迴圈 就是失眠的核心, 失眠是世界上最常見的睡眠障礙。
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.
幾乎任何事物都能造成 夜間偶爾的焦躁—— 打呼的夥伴、 身體上的痛苦, 或情緒煩惱。 極端的睡眠剝奪,比如時差, 可能會打亂你的生理時鐘, 破壞你的睡眠時間表。 但在大部分的案例中, 睡眠剝奪是短期的。 最終,每個人都還是會精疲力竭。
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.
然而,有些長期的病症, 比如呼吸障礙、 胃腸問題, 以及許多其他狀況, 都可能壓過疲累。 隨著難以入眠的夜晚逐漸累積, 臥房開始會和因焦慮 而睡不著的夜晚 產生關聯性。 睡覺時間到了, 失眠患者就感到壓力了。 壓力大到他們的大腦 會劫持壓力反應系統, 讓身體充滿了「戰鬥—逃跑— 或靜止不動」的化學物質。 血液中會有皮質醇 和促腎上腺皮質激素, 造成心跳加速和血壓上升, 讓身體突然過度警覺。 在這個情況下, 大腦會獵尋可能的威脅, 以致於無法忽略任何些微的不舒服 或微小的夜間噪音。
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.
當失眠患者終於入睡了, 他們的休息品質也會被危及。 我們大腦的能量主要 來自於腦葡萄糖, 在健康的睡眠中, 我們的新陳代謝會減慢, 以保存這種葡萄糖, 供醒著時使用, 但正電子發射斷層掃描研究顯示, 讓失眠患者睡不著的腎上腺素 也會加速他們的新陳代謝。 雖然他們在睡眠, 他們的身體卻在加班工作, 將大腦所提供來給予能量的 葡萄糖給燃燒掉。 睡眠品質很糟的症狀,讓失眠患者 醒來時卻感到累壞了、 很困惑,且有壓力, 這個過程又再次重演。
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.
當這些壓力和睡不著的循環 持續了數個月之後, 他們就會被診斷為慢性失眠。 雖然失眠很少會造成死亡, 它的化學機制卻和飽受憂鬱症 與焦慮症之苦的人 所發生的焦慮發作類似。 所以,只要發生 這些狀況的任何一種, 都會增加你發生 另外兩種狀況的風險。
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.
幸運的是,有方法可以 打破無法入眠的循環。 就我們所知,治療失眠 最好的方式之一, 就是管理好會造成 過度警覺的壓力, 好的睡眠習慣能讓你 和上床時間重新建立關係。 要確保你的臥房是 黑暗且舒適涼爽的, 這樣能把過度警覺的 「威脅」減到最低。 你的床只能用來睡覺, 如果你睡不著, 離開房間,用放鬆的 活動讓你自己疲憊, 比如閱讀、 冥想, 或寫日記。 調節你的新陳代謝,做法是 維持一貫的睡眠和起床作息, 來協助調整你的生理時鐘。 這個時鐘,或說 24 小時的生理節奏, 也會對光很敏感, 所以在夜間要避免亮光, 來協助告訴你的身體, 現在是睡覺時間了。
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.
除了這些做法, 有些醫生也會開藥來幫助睡眠, 但並沒有對所有人 都有幫助的可靠藥物存在。 無處方的安眠藥很容易上癮, 會導致使症狀惡化的戒斷。
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.
但在尋求任何治療之前, 要確保你睡不著覺 真的是因為失眠造成。 被診斷出慢性失眠的 病人中,大約有 8% 其實是遇到了 一種少見的基因問題, 叫做睡眠相位後移症候群, 簡稱 DSPD。 有 DSPD 的人,生理節奏 會明顯比 24 小時還長, 讓他們的睡眠習慣 和傳統的睡眠時段無法同步。 所以,雖然在一般人的 上床時間他們很難入睡, 卻不是因為壓力增加而造成的。 如果有機會,
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.
他們也能夠依照他們的 延遲時間表舒適地睡一覺。 我們的睡眠和清醒的循環 是個很脆弱的平衡, 要維持我們的身心康樂, 這種平衡是很必要的。 基於所有這些理由, 是值得花些時間和心力 來維持穩定的按時上床習慣,