Good night, sleep tight

The implications and possible solutions of insomnia

2 a.m. She stares at the ceiling, her body splayed across her bed. The room is pitch black, and the house is filled with an almost suffocating silence. Yet her mind is anything but relaxed.

3 a.m. The house is still quiet. After an hour of laying down, her eyes remain wide awake. Maybe I should just get more work done. She gets up and turns on the light, flooding her vision with brightness. The other rooms remain dark and unmoving.

4 a.m. Numbness. She can feel it crawling up her limbs, weighing her down. She lays back down, but her mind won’t stop running. She closes her eyes and remains still.

5 a.m. The numbness takes over her body, seeping into her veins. Finally, it reaches her mind, and sleep washes over her.

For senior Kristin Lee, nights like these aren’t uncommon. Kristin suffers from insomnia, a sleep disorder characterized by the inability to fall asleep. However, she wasn’t affected by the disorder her entire life; rather, it began after she fell ill from a particularly severe cold in seventh grade.

“At that time, when I was sick, I wouldn’t stop sleeping,” Kristin said. “I would sleep 24/7 and I would only get up to eat, and after that I’d fall back asleep. It was really weird. And then after that, when I got better, I started not being able to sleep at all.”

Kristin’s insomnia was ultimately a side effect of a larger problem, one that went undiagnosed for months. After enduring several rounds of sleep testing and going to many different doctors, her condition was officially deemed to be an autoimmune disorder (a disorder in which the immune system attacks itself), most likely fibromyalgia.

According to Medical News Today, fibromyalgia is a condition involving widespread musculoskeletal pain. In Kristin’s case, it came with a slew of other side effects, including chronic migraines, general body pain and insomnia. Her insomnia affects her circadian rhythm, the body’s natural internal clock that regulates the sleep-wake cycle.

“I think my circadian rhythm is just shifted,” Kristin said. “So it’s not that I need less sleep, it’s just that, say, the normal sleeping time is 10 p.m. and you wake up at 6 a.m. Mine would be shifted six hours, so I would still need that amount of time, but that’s just when I feel I should go to sleep and wake up.”

Junior Anushka Keskar is also affected by insomnia, but rather than stemming from an autoimmune disorder, her lack of sleep originated from anxiety and depression.

“I can’t stop thinking at night,” Keskar said. “So my thoughts are just turning all the time in my mind, so it’s really hard to disassociate from all the thoughts that you don’t want to think about at 3 a.m. It’s really hard to fall asleep because of that.”

On average, Keskar sleeps three to four hours a night. Her difficulty sleeping only became a big problem in her most recent school year, due to increased stress and pressure from her peers and family.

“It’s just the stress from school,” Keskar said. “And you know, there’s always a lot of expectations from other people that are like, ‘Oh, you need to get into a good college. You need to have a good education to succeed in life.’ And I feel like there’s other paths that are available for me, but I can’t take those mainly due to like parental pressure to go to a good school.”

Mental health therapist Sherian Lee agrees that stress is the main cause of insomnia, particularly in teenagers. Having worked mostly with clients diagnosed with ADHD, anxiety and depression, Sherian is aware of the constant battle many individuals go through when faced with an overactive imagination, and she focuses on encouraging sleep hygiene in her clients.

“I offer a holistic approach, where I really look at how people eat, how people exercise and also how people relax and use meditation to help them relax,” Sherian said. “I’m looking at all four wheels of the car being in balance, so that they can be at their best performance.”

Sherian often works with teenagers and is thus constantly helping them confront the stress and pressures in their lives. According to her, although internal and external pressures from peers can be extremely influential, it’s important to maintain a logical mindset to systematically approach any issues.

“Raising the bar is good as long as you can reduce your stress,” Sherian said. “And I think part of that is being happy with it and practicing mindfulness, practicing positive self talk. [Telling yourself,] ‘I can do this, all I need to do is study. It’s not the end of the world, all I need to do is focus on learning this piece a little bit more.’”

Currently, around a quarter of Sherian’s clients suffer from insomnia, and for those specific clients, she takes aspects of their lifestyles and holds them accountable for changing them. For example, she strongly encourages meditating and going for a walk outside every morning to regulate circadian rhythms.

After seeing school therapist Richard Prinz, using his suggestions, Keskar has been meditating more often in her daily life, but she still finds it difficult to channel her stress into a productive manner. As she sleeps less and less, focusing in school only becomes more difficult.

“It’s really hard staying awake in classes sometimes,” Keskar said. “It’s also really hard [to focus] too, because you’re tired, but you know you have to stay awake to be present in the classroom and to learn. So it’s actually [an internal struggle], like, ‘No, you have to stay awake,’ versus your body’s natural instinct to just shut down when you’re exhausted.”

Kristin experiences a similar issue, as mental exhaustion worsens other symptoms, making her headaches more noticeable and her body feel heavy.

“When it’s worse, it just makes studying harder,” Kristin said. “Especially during tests, because sometimes it’s worsened by stress, so during tests, the effects of a headache or other body pain is amplified.”

Sherian has observed this negative feedback loop in many of her personal clients as well. When consulting with a client, she generally targets sleeping issues first because of the negative effects that lack of sleep has on cognitive function.

“Usually, if people don’t sleep well for a longer period of time, you end up with symptoms such as anxiety, depression and an inability to cope with things,” Sherian said. “It’s kind of like a vicious cycle. Because the harder it is for you to fall asleep, the less sleep you get, and it turns out with you being more prone to stress and anxiety the next day and then [it’s] harder for you to sleep at night.”

Freshman Anant Chaudhary experiences this cycle as well, especially because his form of insomnia was acquired through unhealthy habits — mainly his excessive screen time and late-night homework sessions.

“I was just doing my homework, and I don’t know why it took so long,” Chaudhary said. “All the other people [in] my grade said it was so easy and stuff, but [it] wasn’t that easy for me. So I stayed up really late, and I did it. And after that, because I thought I deserved a reward I thought it would be nice to start watching TV.”

He first began noticing a problem in seventh and eighth grade, when he would be sleeping much less than the recommended hours for his age.

“We had a survey in seventh grade [and it asked,] ‘How much do you sleep?’” Chaudhary said. “And I’m the only guy who wrote three hours, and they were like, ‘What?’ The teacher was concerned.”

Sherian has noticed that most of her clients with insomnia are affected due to lifestyle habits, particularly the connectivity of social media and the internet. Because they are preoccupied during the day, they wait until the night to be productive and sacrifice their sleep time.

“During the day, [people are] at school, they’re at work, they can’t do the thing that they really love,” Sherian said. “And then when they get to it, they’re just nonstop on it. So it’s kind of like a combination of not having the things they love during the day and then using that as a distraction.

Although Chaudhary does feel tired in his day-to-day interactions due to a lack of sleep, he has found certain strategies that allow him to fall asleep more quickly. He makes sure that he is exercising, particularly running in the mornings, as well as strictly regulating his screen time.

“If I get mentally tired, then overall my body starts getting tired too, and I feel like falling asleep,” Chaudhary said. “At least now I’m averaging like three or four hours, so it’s getting better. In sixth grade its used to be… just one or two. So it’s definitely improved, but it still has a ways to go.”

Sherian is a passionate advocate in terms of the positive effects that exercising can have on those with sleeping problems. According to her, just being outside can help regulate body functions and maintain a normal circadian rhythm. However, she acknowledges that it is important to follow a case-by-case basis in terms of what each individual’s needs are regarding exercise.

“From my standpoint, any kind of physical exercise is good,” Sherian said. “You get it whenever you can, but you pay attention. Like, if I go all out, and I can’t sleep, maybe I put one and two together and say, ‘Maybe I shouldn’t [exercise] all out right before I go to bed.’ Maybe I could do a workout because that clears my mind, but I just don’t go all out.”

While Chaudhary has found solutions to help improve his condition, Kristin endured a much more extensive and exhausting trial to improve both her insomnia and her fibromyalgia. From being monitored while sleeping to trying all kinds of sleep medication, she wasn’t able to find a concrete solution to her worries.

At first, she tried contacting American doctors, but was often ignored or disregarded when she explained her symptoms.

“At first, they were just trying to figure out what it was, and a lot of them were like, ‘oh, you’re just getting over a sickness’ or ‘it’s just a really long flu,’” Kristin said. “So that part was really frustrating because they dismissed it as a regular thing that would go away soon.”

Eventually, she was prescribed different sleeping pills, as well as a more natural alternative, melatonin. While these did help her sleep, ultimately she woke up feeling even more groggy and disoriented, so she decided to stop taking them.

Keskar, on the other hand, takes melatonin regularly, as it has proven to help her fall asleep. After she told her parents about her condition, she was encouraged to seek more professional help and medications.

“Since 11th grade started, my sleep schedule has been really crazy,” Keskar said. “I take melatonin, and that’s why I’ve been sleeping a lot recently. Because I told my parents just a while back, so they’re like, ‘Try taking melatonin and see.’”

As for the effects of melatonin, Sherian doesn’t work with any particular type of medication, but she is always aiming to change sleep hygiene first with more natural alternatives.

“One of the things that I tend to go towards is Epsom salt baths, because the magnesium from the Epsom salt baths gets absorbed into your system,” Sherian said. “And there’s a strong correlation with Epsom salt and melatonin, and helping people get really nice, relaxed sleep.”

Beside the prescribed medication, Kristin tried changes to her sleep hygiene as well, including what Sherian recommended. Along with this, she saw many different East-Asian doctors, who helped her through acupressure and acupuncture. Eventually, she was seeing a chiropractor regularly as well.

Because of her constant pain and insomnia, Kristin was forced to miss school for two to three months in her freshman year. She describes it as an extremely difficult time in her life, particularly because of her loss of connections and social activity.

“When I tried to go back into school, it was really hard because I hadn’t talked to my friends or anyone else for a while,” Kristin said. “It was hard to reconnect with past friends, also because during the time I was gone, a group of friends, they would have a bunch of experiences together that I wasn’t a part of.”

Eventually, Kristin was able to return full-time to MVHS, making new connections and joining school teams. Even today, she is still working on maintaining lifestyle changes to improve her sleeping conditions, though she does acknowledge that the alternative medicine she tried could be beneficial to any other individual.

“I think even regardless of whether I had insomnia, those are still beneficial, so there’s not really any harm done there,” Kristin said. “The things they prescribed didn’t really help me, and the biggest thing that would help me right now… would just be fixing bad habits and trying to go to bed earlier.”

Sherian shares a similar opinion: she acknowledges that while there are cases of insomnia that can be alleviated with medication, in most affected individuals, a lifestyle change is often the most helpful solution.

“It’s sometimes easier to think, ‘I can’t sleep, I’ll just take a sleep medication,’” Sherian said. “But when it comes to changing your lifestyle and your habits and your sleep hygiene, [I think] that’s where it’s at. Because that’s where you’re going to get more benefits for life.”

After enduring health complications for so long, Kristin is able to find light in her situation, discovering what she wanted to pursue in university and her future career: medicine.

“I want to help people like me,” Kristin said. “Not only people that are sick, but people with what I have, since it took so long to diagnose. [I had] a lot of doctors dismissing me, and saying it was just a random thing. If I became a doctor, I want to be the type of doctor who would actually be able to help people in the same situation as me.”

Growing up with learning disabilities including ADHD, Sherian is extremely passionate in sleep-related health. In the previous year, she set a rigid number of minutes that she had to sleep in a year, dividing into around seven and a half hours of sleep per night. Overall, the difference in her body and focus was “like night and day.”

“After going through that first year, everything was better,” Sherian said. “I was able to think better, my mood was better, my thoughts were better, I wasn’t stressed. It was like one of the most valuable goals I’ve ever done. And I was a total overachiever, and all I had to do is sleep.”

Chaudhary, who isn’t particularly affected by insomnia, still actively works on his health by exercising to improve his mood and interactions with others.

“I don’t know why, I’m always really energetic no matter what time of day it is because I just am,” Chaudhary said. “And so it always improves my confidence when I know I can get enough sleep, because I wake up even happier the next day.”

Despite the stress and pressure that every individual may experience throughout their life, Sherian emphasizes how important it is to focus on sleep hygiene.

“Sleep is one of the most precious commodities that we could ever have,” Sherian said. “Sleep, our interpersonal relationships and our ability to have downtime in self care. I just think that people really underrate that, that if you want peak performance, that’s where it is. Whether you’re an athlete or you’re a student, that’s when your body repairs itself. It’s so important.”

Good night, sleep tight
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