Chopra - Restful sleep: the complete mind/body program for overcoming insomnia

C ONTENTS

S leep, like good health in general, is something most people take for granted. As long as its coming easily, theres just no reason to give it much thought. But for millions of people, a good nights sleep isnt easily come byand as youll learn throughout this book, the reasons for that are more far-reaching and more complex than you might suspect.

Is insomnia more prevalent in our society today, as millions of us lie awake at night, worrying, mentally balancing our checkbooks, replaying arguments and misunderstandings until theres finally nothing left to do but get up and watch television?

At present this is certainly a nation of troubled sleepers. Based on the number of prescriptions written for sleeping pills and the volume of commercially produced sleep aids, insomnia may be our most widespread health problem. Virtually everyone has experienced insomnia occasionally, and currently one out of every three adults experience periodic trouble with sleeping. Each year, at least 10 million Americans consult physicians about their sleep, and about half of them receive prescriptions for sleeping pills. A survey by the National Institutes of Health conducted in the 1970s revealed that 17 percent of the total population was bothered greatly by insomnia, and among older people the percentage was even higher, with one out of every four people over the age of 60 reporting serious sleep difficulties. And when sleep difficulties arise, the basic human function that we may have once taken for granted is transformed into a labyrinth of anxiety.

Chances are good that right now youre surrounded by sleepy people. Theyre everywhere, many of them driving cars or operating sensitive equipment. They seem unable to get a good nights sleep; or, even if they do, theyre convinced that they dont, so the effect is the same, at least psychologically. Many of these people are elderly, but a significant percentage is young. Theres a perception that older people need less sleepthat insomnia among the elderly is to be taken for grantedbut thats only because older peoples sleeplessness is so widespread, not because its a natural condition. Similarly, college students might seem a relatively carefree group who simply choose to stay up late. But in fact the biological need for sleep is greater between the ages of 17 and 25 than at any time since infancy. So, if young people are sleep-deprived, its likely due to social or academic pressures.

Both young adults and the elderly consume significant amounts of alcohol. When a chronically sleepless person takes a drink, the effect is multiplied, so that a single beer can be as debilitating as a six-pack, according to sleep researchers.

I dont know anyone who hasnt experienced insomnia at one time or another, and Ive had a number of patients who were serious problem sleepers. Im glad to report that I also dont know anyone who hasnt experienced major benefits from the techniques presented in this book. Some of these ideas are derived from Ayurveda, the traditional medicine of India; others are the result of Western scientific research. Most significant, you can expect improvement right away, even if you havent had a good nights sleep in years.

Before we begin to learn these techniques, Id like to suggest an insight that was given to me by a woman who had been deeply troubled by chronic insomnia. I think it will be very useful, not only for its practical specifics but because it suggests one of the fundamental ideas that runs through this book: That is, what happens to you at night when you try to sleep cannot be understood except in terms of what you do during the day, when youre awake.

For years my patient had lain awake trying to sleep. Then, very late one night, she had an important realization about the source of her insomnia: There were things left undone in her waking life that made her, unconsciously, uncomfortable with going to sleep. There were active, positive things that she wanted to do, and until she did them she simply wasnt ready to sleep. These unsatisfied aspirationssuch as traveling, writing, or getting back in touch with old friendswerent things she could simply jump out of bed and take care of on the night she had this realization. Rather, they required a long-term reorienting of her life. Once she began that process, her sleep improved because her waking life had improved. The goal of this book is to help you do both those things in your life.

Sleep is a distinct state of mind and body in which the body is deeply at rest, the metabolism is lowered, and the mind becomes unconscious to the outside world. This last phrase must be examined carefully, for we all know that the sleeping mind does not become unconscious entirely; instead, it shifts the direction of consciousness from, say, a chair beside your bed to another chair inside your dream. In fact, in terms of its biological functions, the brain is really working harder during the dreaming period of sleep than it is during the day. Moreover, within that reoriented but not completely resting state, there are further gradations that vary from one individual to another and from one part of the sleep cycle to another. Just as some people seem more awake than others during the day, so some people are more asleep during the night.

However, with respect to good sleep, the elusive goal for which so many are striving, I think there are some general statements that can help us to recognize the phenomenon, if not exactly to define it:

• Good quality sleep seems to happen by itself. You dont have to fight for it against restlessness or anxiety, and you dont have to take drugs of any kind to experience it.

• You rarely wake up in the middle of the night from good sleep, but if you do, you get back to sleep quickly without worrying about it.

• You wake up naturally in the morning. Youre neither sluggish and groggy nor anxious and hyperalert.

• Finally, good sleep provides you with a sense of vitality that lasts throughout the day. You dont feel youve been deprived of rest during the preceding night, and you dont feel anxious about whats going to happen the next time you try to fall asleep.

These are some subjective characteristics of sleep from the sleepers point of view. Its also useful, here at the outset, to look at the more detached observations about sleep that have emerged from clinical studies.

When researchers study human physiological characteristics over a twenty-four-hour period, including measurements of the brain waves known as electroencephalography, or EEG, they find that four distinct states of consciousness, or psychophysiology, emerge. These are:

• Deep sleep, or delta sleep, during which most rest and restoration takes place

• The dream state, also known as REM sleep because of the rapid eye movements that accompany it

• Light sleep, which often takes up a majority of the time during the night, and which occurs after the above two periods have ended

• The waking state, in which you find yourself as you read this book

During each twenty-four-hour period, these four states tend to alternate within each individual according to certain regular progressions or rhythms.