Insomnia Support Group
Insomnia is a symptom, rather than a disease, and is characterized by inadequate quantity or quality of sleep. People with insomnia complain of difficulty falling or staying asleep, which results in significant impairment of daytime functioning. Insomnia is categorized as transient (shorter than one week), short-term (one to three weeks) or chronic (longer than three...
Having gone through nearly 1 year of insomnia and it's impact on my sleep/other physical symptoms, I have done a good bit of research on the matter. I find it interesting how our mind/body can get thrown off and cause us to "lose sleep".
First of all....what is the HPA Axis? It's easy to "google" and get the particulars. Basically it is the interaction and communication between the hypothalamus, pituitary gland & adrenal glands. The HPA axis is largely responsible for the hormones that contribute/cause primary insomnia (mainly cortisol). Primary insomnia is insomnia that is not related to other medical or specific-identified psychiatric issues.
Prolonged and/or severe stress/anxiety can cause the HPA axis to become hyper-active and therefore create more cortisol. Each person is different based on genetics. One person can under-go tons of anxiety before the HPA axis becomes dysfunctional whereas the next person needs less. A hyper-active HPA axis makes it more difficult to fall/maintain sleep. Sleep fragmentation also contributes to HPA axis activation....so basically it is a vicious cycle.
So we have 2 problems (at minimum) don't we? We have our anxiety about not sleeping (whether conditioned or active) and we have the actual biological problem in our brain with the HPA axis. Many of us have not had problems sleeping before and then BAM!! All of a sudden something happens and we feel like our body is "broken" as it relates to getting to sleep.
How do we fix this? 1st....I'm not aware of any quick fix. The HPA axis takes time to become regulated again (I don't know how long). Anti-depressants and/or supplements can be taken to help with this (google it if interested) but we also have to stop the "fuel" of anxiety that caused/perpetuates HPA axis dysfunction.
The "fuel" is the general anxiety we had before our sleeping problem (whatever that is) + our anxiety about our new-found sleeping problem. This is where cognitive behavioral therapy can help. We cannot control the time it takes for our HPA axis to "heal" but we can work on controlling the "fuel" that perpetuates the problem. Sleep restriction, stimulus control, sleep hygiene & correct/positive thinking about our sleep are all components of CBT-I that can help STOP/REDUCE anxiety related to not sleeping. If you have interested in CBT-I just google it (cognitive behavioral therapy for insomnia).
There are studies that show that untreated sleep apnea causes HPA axis activation. Some of those same studies showed that CPAP treatment of individuals that had sleep apnea + insomnia cleared up both issues. This doesn't mean that you have sleep apnea if you have chronic insomnia!
I have been recovering from chronic insomnia since August 2011. I got diagnosed with sleep apnea in April 2012 and started CPAP (I don't snore and my BMI is normal...so go figure that one out!). I implemented CBT-I upon seeing a sleep doctor in Nov 2011. My sleep and head aches/fogginess are improving with CBT-I and CPAP therapy. I almost feel normal but it is a slow recovery.
Hang in there everyone! Don't take all this info as fact....I'm just a lay person who has been interested in this. Some of the info provided may be wrong. Some of you will find it helpful.
Best wishes!
First of all....what is the HPA Axis? It's easy to "google" and get the particulars. Basically it is the interaction and communication between the hypothalamus, pituitary gland & adrenal glands. The HPA axis is largely responsible for the hormones that contribute/cause primary insomnia (mainly cortisol). Primary insomnia is insomnia that is not related to other medical or specific-identified psychiatric issues.
Prolonged and/or severe stress/anxiety can cause the HPA axis to become hyper-active and therefore create more cortisol. Each person is different based on genetics. One person can under-go tons of anxiety before the HPA axis becomes dysfunctional whereas the next person needs less. A hyper-active HPA axis makes it more difficult to fall/maintain sleep. Sleep fragmentation also contributes to HPA axis activation....so basically it is a vicious cycle.
So we have 2 problems (at minimum) don't we? We have our anxiety about not sleeping (whether conditioned or active) and we have the actual biological problem in our brain with the HPA axis. Many of us have not had problems sleeping before and then BAM!! All of a sudden something happens and we feel like our body is "broken" as it relates to getting to sleep.
How do we fix this? 1st....I'm not aware of any quick fix. The HPA axis takes time to become regulated again (I don't know how long). Anti-depressants and/or supplements can be taken to help with this (google it if interested) but we also have to stop the "fuel" of anxiety that caused/perpetuates HPA axis dysfunction.
The "fuel" is the general anxiety we had before our sleeping problem (whatever that is) + our anxiety about our new-found sleeping problem. This is where cognitive behavioral therapy can help. We cannot control the time it takes for our HPA axis to "heal" but we can work on controlling the "fuel" that perpetuates the problem. Sleep restriction, stimulus control, sleep hygiene & correct/positive thinking about our sleep are all components of CBT-I that can help STOP/REDUCE anxiety related to not sleeping. If you have interested in CBT-I just google it (cognitive behavioral therapy for insomnia).
There are studies that show that untreated sleep apnea causes HPA axis activation. Some of those same studies showed that CPAP treatment of individuals that had sleep apnea + insomnia cleared up both issues. This doesn't mean that you have sleep apnea if you have chronic insomnia!
I have been recovering from chronic insomnia since August 2011. I got diagnosed with sleep apnea in April 2012 and started CPAP (I don't snore and my BMI is normal...so go figure that one out!). I implemented CBT-I upon seeing a sleep doctor in Nov 2011. My sleep and head aches/fogginess are improving with CBT-I and CPAP therapy. I almost feel normal but it is a slow recovery.
Hang in there everyone! Don't take all this info as fact....I'm just a lay person who has been interested in this. Some of the info provided may be wrong. Some of you will find it helpful.
Best wishes!
P.S. I've not gone to the Nashville sleep clinic yet, so many things going on right now but I will as soon as things settle down. Thanks.
In fact, if you have insomnia there's a very good chance you are experiencing chronic stress and/or anxiety. So learning how to deal with this constructively will be of great value in improving sleep.
In addition to the CBT components you mentioned, another method specifically designed to counteract the build-up of cortisol resulting from excessive stress and anxiety is learning how to deliberately elicit the relaxation response.
The relaxation response is powerful and fast-acting, and it easily can be done throughout the day, whenever stressful thoughts occur. By learning how to do this, the result can be surprisingly effective to help improve sleep.
Thank you for a helpful post.