Free Sleep Soundly Every Night, Feel Fantastic Every Day by Robert S. Rosenberg

trouble dealing with chronic daily stressors such as occupational or family conflicts, as well as major life events such as divorce, death in the family, or illness. For example, insomnia is a risk factor for depression. Recent research on a small sample of people with chronic primary insomnia provided the MRI evidence of the neurobiology “underlying the dysfunctional emotion regulation in people with insomnia” and linked the risk between insomnia and depression.
    Obviously, the symptoms of the brain and body coexist and one can exacerbate the other. That is why one treatment does not fit all persons with insomnia. Sleep experts sometimes need to combine pharmacologic treatment with CBT, even if for a short period, to achieve the goal of getting good quality sleep such as in the example of my patient Maria.
Do You Have a Vulnerability to Insomnia?
    No matter what your age or gender, insomnia can happen to you. The following is a list of inherent traits and life stressors that could increase your vulnerability to insomnia:
    1.   Hyperarousal—chronic state of alert.
    2.   Family history of light or disrupted sleep.
    3.   Tendency to worry.
    4.   Anxiety-prone personality.
    5.   Preoccupation with well-being.
    6.   Dramatic responses to impactful life events such as surgery, death, birth, loss of job or financial security, illness onset or chronic illness.
    7.   Environmental factors such as living near traffic noise.
    8.   How you deal with sleep and insomnia most often perpetuates the insomnia.
Insomnia and Women
    Women are two times more likely to report insomnia than are men. Why?
    Sleep experts understand that women may have greater awareness of insomnia symptoms. They are more likely to talk about insomnia or mention incidents in social situations and in their roles as mother, caretaker, or wife. While biological differences in a woman’s life cycle contribute to insomnia, a family history of a mother’s insomnia alsolikely increases the incidence. Insomnia increases with age, but women’s research confirms a steep rise of insomnia in midlife.
    The rise is easily understood considering the three phases of menses a woman passes through in the twenty years from age 40 to 60: perimenopause hot flashes, menopause with psychological sensitivity and distress, and post-menopausal possibility of sleep-disordered breathing. Any further factors contributing to persistent insomnia are similar to those in men.
    In summary, women are at higher risk of developing insomnia than are men, and treatment considerations must include the stage of the life cycle, predisposition to mood disorders, and hormonal considerations such as nocturnal hot flashes.
Treatment Options
    The greatest news is that there are treatments for insomnia that can improve your health, function, and quality of life. The American Academy of Sleep Medicine suggests both pharmaceuticals and behavioral approaches in order to improve sleep.
GOOD SLEEP HYGIENE
    Sleep hygiene simply refers to the habits you put in place for better sleep. People can develop counterproductive behaviors referred to as poor sleep hygiene. Constantly looking at the alarm clock, going to bed and staying in bed when not sleepy, attempting to sleep later on weekends or nonwork days, and consuming alcohol to help get to sleep are but a few of these counterproductive behaviors. If you haven’t already instituted the suggestions outlined in chapter 3 , do so now.
    Set a specific schedule of going to bed and waking up. The insomniac’s internal circadian clock is out of sync with the sun cycle. To reset your internal clock requires a consistent time for sleep and waking. Your body thrives with a consistent routine. Chapter 6 on circadian sleep disorders explains in detail why the brain and body function best on a set schedule.
STIMULUS CONTROL
    With chronic insomnia, you tend to develop negative sleep-preventing behaviors, like severe anxiety