What Chronic Insomnia Really Feels Like


Everyone has trouble sleeping from time to time. But what about every night for weeks on end? (Illustration: Connie Manna/Corbis)

It’s 4 a.m. and I’m awake. We’ve all been there from time to time. But this is the third night this week.

The worst thing about being awake at 4 a.m., for me at least, is that my thinking is crap. Should I go back to bed or stay up? I can’t decide. Should I do some work? I don’t know. Eventually I try, but can’t drum up the creative thinking I need to come up with anything remotely useful for the next day. I can’t clean the house because I don’t want to wake up my soundly sleeping family. I putz around for a while, thinking of how much I wish I could sleep.

I opt for “Doctor Who” reruns … again. By the time my anxious thoughts (“How am I going to be productive tomorrow? Will I sound like an idiot during interviews? I hate my brain so much…”) finally subside, it’s 5:30 a.m. I let myself sleep in an extra hour than I had planned, logging about three or four hours for the night. Again.

I’ve suffered from insomnia most of my adult life. It’s always periodic, flaring up for anywhere between a few days to six months in times of high stress or drastic change. And in that way, I’m lucky. I know that it will eventually end. There are plenty of people who struggle much more than I do. But in its throes, insomnia feels like a prison. I am a prisoner of sleep. Or lack thereof, rather.

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The prevalence of insomnia depends on how you define it and whom you ask. In surveys, about 30 percent of people report at least one insomnia symptom — trouble falling asleep, difficulty staying asleep, waking up too early, or unrefreshing sleep. But when you narrow it down to people who have experienced symptoms for at least one month, and whose symptoms can’t be attributed to something else (like another medical condition that disrupts sleep), the rate drops to 6 percent. Which is still a lot, when you consider the misery involved.

For me, the worst part of sleep deprivation is its impact on my ability to think well. My IQ drops to that of a terrier after a few days without much sleep. By day five, I’m a squirrel. A dumb squirrel. I lose my keys constantly. I have trouble thinking ahead, end up blowing off plans, or get lost for silly reasons like zoning out on the train or forgetting to charge my phone. I have penned many a regrettable email in the squirrel-brained stupor following a week of sleepless nights.

I’ve learned to push through by breaking up tasks into small, bite-sized pieces. Transcribe an interview. Outline a story. Put appointments into my calendar. But thinking on my feet becomes impossible. And you can’t will yourself to be spontaneously creative. By the end of the day, sometimes I can barely form complete or coherent sentences. “What do you want for dinner, honey?” “Uhh nah nah nah … something? … food … brain dead … sotiredsorry …” becomes an acceptable answer.

If I’m so tired, then why can’t I sleep? Simply asking that question becomes part of the problem. It’s called “sleep anxiety,” and it refers to negative and worrisome thoughts about sleep that can (and often do) keep insomniacs awake. Sleep expert Gregg D. Jacobs, PhD, in his book Say Good Night To Insomnia, describes these beliefs as “negative sleep thoughts,” or NSTs. “I won’t be able to function tomorrow unless I get to sleep by [X time],” for example, is one of my recurring NSTs.

Jacobs spends much of his book dispelling these beliefs. He cites research on yacht racers, college students, and doctors — all whom are able to function at very high levels on very little sleep. Although plenty of studies have linked poor sleep to health problems, “there is no consistent scientific evidence that insomnia causes significant health problems, and no one has ever died from insomnia,” he writes. (For what it’s worth, Say Goodnight To Insomnia was recommended to me by a cognitive-behavioral therapist. The program it outlines was developed for Harvard Medical School, I highly recommend it to anyone with insomnia and/or sleep anxiety.)

Jacobs instructs readers to replace incorrect, unhelpful thoughts about sleep — “I’m going to be a wreck tomorrow” — with more accurate and productive thoughts — “I’ll feel sleepy, but I’ll be able to do what I need to get done.” For example, take the idea that “I need to get eight hours of sleep or I’ll feel awful.” Jacobs points out research showing that humans have a “core sleep” requirement of about five-and-a-half hours (which is what most insomniacs get, according to sleep studies). If you get your core sleep, you can function well enough — you just may feel extra sleepy or a little irritable. So instead of thinking, “I need eight hours — or else,” you can think to yourself, “I’ll be fine because I’ll probably get my core sleep.”

Knowing these facts helps minimize the anxiety you feel about sleep that keep you awake. They haven’t completely cured my insomnia, but these strategies have made a significant difference for me on nights when I would otherwise not sleep because I’m worrying about sleep.

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One question that almost always comes up when I mention I have insomnia to friends is, “Do you take anything for it?” Yes and no. I have in the past, during times of desperation when my sleep is so completely wrecked, and my mind so completely lost, that I feel as if I’ve exhausted all other options. In those times, a 30-day prescription of sleep medication with zero refills has helped to reset my schedule. It takes about a week of consistent sleep to feel like myself again, and the medication feels like a godsend. Which is exactly why I refuse to take it regularly.

Sleep medications are extremely controversial, and I can see why. On one hand, sleep is a vital part of our physical, mental, and emotional well-being. On the other, it’s easy to need the medication to fall asleep (and/or feel like you do), which can make it very hard to get off it.

I’m not here to debate the use of sleep medication, but I will share my experience for those who might be considering meds. After one particularly stubborn and frustrating five-month-long stretch of insomnia, I visited a new primary care doctor. I had just moved across the country and changed jobs, and was recently engaged and planning a wedding — just the type of stress superstorm that keeps a worrywart like myself awake.

I explained my situation to my new doctor, expecting a scrip for something … and she suggested Benadryl and relaxing before bedtime. When I saw her the next month and explained that no amount of Benadryl helped, she still didn’t prescribe me sleep medication. And for that, I am eternally grateful. Because once the life stressors were under control (the new home arranged, the wedding budget set, the new job going well) my sleep returned to normal on its own. Who’s to say for sure, but had she prescribed me medication, I would have likely experienced another round of sleep anxiety centered around getting off the pills.

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Nowadays, my sleep still isn’t great, but it usually isn’t terrible, either. Fortunately, I have found a few things that help immensely. My bedroom has Alaska-during-the-summertime-level blackout curtains over the windows, which are even clothes-pinned to the window frame to prevent light from seeping in. I splurged on high-quality organic cotton sheets from Gaiam, which dry super-quickly — important since my husband and I tend to sweat a lot at night and both easily overheat.

A lot of insomniacs dread going to bed, which starts the sleep anxiety spiral. So beyond the logistics of a dry, cool, and comfy bedroom, I’ve also made it a place I want to be at night. A cute lamp that I picked up from Salvation Army fit with a soft white bulb gives the room a warm, homey feel. I’ve trained my love-bud cat to come in at night for petting when I call, “Kitty! Bedtime snuggles!” I’m currently reading The Hitchhiker’s Guide to the Galaxy, a humorous sci-fi classic, before bed, a few pages at a time. And for bad nights, my favorite stuffed animals sit within arm’s reach, just as they did when I was a child.

I may never be free of sleepless nights. but I’m not as afraid of them anymore. And that’s made a world of difference.

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