An Ongoing 'Quest for Sleep'
by Randi Mazzella
From time to time, almost everyone has trouble sleeping. While frustrating, occasional bouts of insomnia are expected and manageable. But for people that have chronic insomnia, the problem goes beyond just feeling exhausted for a few days or needing an afternoon double espresso to make it to the end of the workday.
Rachel Mills, the producer behind a new film, "The Quest for Sleep," says, "Before making the film, I thought of insomnia as a nighttime issue. I was surprised at its impact on people throughout their daytime hours. Chronic insomnia interferes with a person's ability to function in their daily life and affects their relationship with friends, family and co-workers."
Chronic insomnia goes way beyond just being tired.
In the film, narrated by Octavia Spencer, Mills follows several people impacted by chronic insomnia, including "Big Steve," a psychotherapist named Margaret and Kelly, a nurse.
"We wanted to show the diversity of insomnia. Each story we tell shows the struggle when you can't turn your brain off and get the sleep your body needs," says Mills. "A common theme for everyone with chronic insomnia is that the problem goes way beyond just being tired."
Defining Chronic Insomnia
The American Academy of Sleep Medicine (AASM) defines insomnia as difficulty either falling or staying asleep that is accompanied by daytime impairments related to those sleep troubles. Chronic insomnia is when a person has sleep issues at least three days a week for more than three months or repeated bouts over the years. It is believed that 10 - 15% of people suffer from chronic insomnia disorder. Insomnia is more common in women than men.
There are different causes of insomnia, including stress, mental health issues (anxiety or depression), physical pain, medical issues and sleep disorders (sleep apnea or restless leg syndrome). With chronic insomnia, sleep itself becomes a source of anxiety.
Mills says, "Once people start having trouble sleeping, they can develop anxiety about sleeping, which exacerbates the problem."
Dr. Michael Grandner, a behavioral sleep medicine specialist and a sleep expert who appears in the film, explains, "Sleep is a universal need. Over our lifetime, we develop a relationship with sleep. When this relationship is healthy, we see our bed at night and our sleep response kicks in. We associate our bed with rest. But when a person has insomnia, the bed can become a trigger. The person starts to anticipate that they will have trouble sleeping and they get anxious that they won't sleep and then they can't sleep."
How Sleep Changes with Age
Insomnia becomes more common over the age of 60. "As you get older, you tend to wake up more throughout the night with aches, pains, or due to hormonal changes," explains Grandner. "With age, sleep tends to become shallower and people get less REM sleep. The number of hours slept doesn't change much with age, but the quality does."
Bad habits related to sleep can accumulate throughout a person's life. One example in the film is Margaret's story. Her insomnia began when her daughter was born.
Mills explains, "Margaret constantly worried about the baby, listening for her throughout the night. She began sleeping lighter, not falling into a deep sleep and this problem has continued even though her daughter is now an adult."
Not getting enough sleep can impact a person's mental and physical health. "For people sixty-five years of age and younger, sleeping six hours a night or less correlates to weight gain and increased risk of heart disease, stroke and diabetes," says Grandner. "It can also impact cognitive function, decision making and mood."
One silver lining is that the older you get, the less sleep you need.
"In your seventies and eighties, you sleep less but it isn't as correlated to health concerns or impairment," says Grandner. "Older adults are more resilient and satisfied with the amount of sleep they get even if it's less than when they were younger."
The Perception of Insomnia
"Before filming, it felt like everything I read online about sleep was geared toward fixing the problem. Articles like 'Five Tips for Better Sleep' or 'Why Screens at Night Interfere with Sleep,'" says Mills. "It made it seem like there was an easy solution and if you are having trouble sleeping, it is your fault. "
Adds Grandner, "When a person sleeps well, they are perceived as relaxed and together. Conversely, a person that has trouble sleeping is judged as 'on edge.'"
One of the stories in the film focuses on Big Steve. He is shown wandering the street late at night, trying desperately to tire himself so he will be able to fall asleep. "We wanted to illustrate the loneliness and isolation that accompanies insomnia," says Mills.
Another story depicted in the film is Lois's struggle. She approaches her bed at night in slow motion with ominous music.
"Lois knows that going to sleep will be a battle, that she will struggle, and we wanted to show the audience the anxiety that accompanies her on a nightly basis," explains Mills.
Treating Chronic Insomnia
Grandner points out that there is a big difference in handling occasional sleep issues versus chronic insomnia.
"If you Google 'insomnia', you will get a lot of advice on sleep hygiene," he says. "Yes, it's helpful to go to bed at the same time each night, keep the room dark and limit screen time before bed. But it's like brushing and flossing your teeth. It's essential, it helps keep your teeth healthy, but those habits will not solve the issue of crooked teeth. That requires something more like braces. The same is true for chronic insomnia: it requires more treatment than just better sleep hygiene."
If a person has chronic insomnia, they should make an appointment with their physician. They can run tests and come up with a treatment plan.
Grandner says, "People may think, 'No one sleeps well at my age' or 'I just have to suffer' or 'Prescription sleep medication is the only option,' but that is not true. There are treatments available such as CBT therapy (cognitive behavioral therapy) that are effective in treating insomnia."
While tempting, avoid self-medicating for insomnia. Grandner says, "Alcohol, the most commonly used sleep aid, will cause you to fall asleep but wake you up as it goes through your system. Other options like CBD, THC and OTC sleep medications are also not ideal for combating chronic insomnia."
Our Relationship with Sleep
Throughout the film, Mills talks about our "relationship with sleep."
"Just like people have relationships with each other, everyone has their own relationship with sleep. Like any relationship, it evolves and changes with time and circumstances. Relationships by nature are not stagnant," she says. Mills hopes the film will shed light on this silent epidemic and let people know they are not alone. They didn't do anything wrong, and it's not their fault.
"By viewing sleep as a relationship, it gives people power. You don't need to label yourself a 'bad sleeper' and feel there is no hope," she says. "The same way people can improve their relationship with their spouse, they can improve their relationship with sleep."
Randi Mazzella is a freelance writer specializing in a wide range of topics from parenting to pop culture to life after 50. She is a mother of three and lives in New Jersey with her husband and teenage son. Read more of her work on randimazzella.com.