Here is another article I ran onto today in the New York Times historical records. It was published on Saturday, December 30, 1876:

Short Article in the New York Times on Saturday December 30, 1876

What intrigues me about this article is the suggestion by the American physician, Dr. Cooke, that, “…in numerous cases of sleeplessness it is only necessary to breathe very slowly and quietly for a few minutes to secure a refreshing sleep.” In In Pursuit of Sleep, I call this method “sleep breathing.” See pages 31/2. Of course, this is only one of several components of the Transition Trek method. But I suggest initiating sleep breathing at the very beginning of the Transition Trek, which then triggers the start of several physical processes that lead toward sleep.

I ran onto this today by accident. From the New York Times, Saturday, August 11, 1888:

Short Article in the New York Times on Saturday August 11, 1888

This brief little article suggests that someone having difficulty sleeping might think of a previous dream and go “over and over the scene it presented” to induce sleep. This is the subject of Chapter 6 Chasing Hypnos, pages 67-80. In that chapter, I recommend documenting five dreams and reading over them before bed. Then if you have difficulty getting to sleep initially or back to sleep after waking during the night, that you can use those five dreams to assist you getting to sleep. Of course, I also appropriate Hypnos, Greek God of Sleep, and Hermes, Guide of Souls in the Underworld, as aids with this.

The article also confirms my experience that, “counting numbers or repeating easy-flowing verses” frequently fails. Of course, In Pursuit of Sleep does suggest (Chapter 5 Controlling Your Psychic Voice) that poems can be used to augment the Transition Trek, but that is completely different from requiring the poem go it alone.

Anyway, interesting voice from the past with a couple of interesting thoughts on insomnia.

(Note that the article originally appeared in the London Figaro, a periodical founded by James Mortimer in 1870. It ended publication in 1897 due to a significant decrease in readership.)

Here is an extraordinarily interesting article in The American Journal of Health from August 2011 titled, “The Medicalization of Sleeplessness: A Public Health Concern.” What I find most interesting is the way the article draws a distinction between insomnia and sleeplessness. Here is the article abstract:

Sleeplessness, a universal condition with diverse causes, may be increasingly diagnosed and treated (or medicalized) as insomnia. We examined the trend in sleeplessness complaints, diagnoses, and prescriptions of sedative hypnotics in physician office visits from 1993 to 2007. Consistent with the medicalization hypothesis, sleeplessness complaints and insomnia diagnoses increased over time and were far outpaced by prescriptions for sedative hypnotics. Insomnia may be a public health concern, but potential overtreatment with marginally effective, expensive medications with nontrivial side effects raises definite population health concerns.

Further down, the article address the issue of possible over treatment more specifically:

It is unclear … if the United States is facing a true insomnia epidemic or a surplus of diagnoses and drug prescriptions. … Awareness raised by public health and pharmaceutical agencies may facilitate new diagnoses. Medicalization may also contribute to the increased perception, diagnosis, and treatment of sleeplessness as the medical condition insomnia.

This situation within the medical community is precisely what In Pursuit of Sleep is intended to address. If insomnia is a medical condition and sleeplessness is a behavioral issue, insomnia should be treated with medication and sleeplessness should not. If sleeplessness is diagnosed as insomnia, the wrong treatment can be prescribed and actually harm the patient.

The big problem, of course, is that we don’t have an effective treatment for sleeplessness. The reason for this is that the medical profession and scientific research community are not addressing what is going on within the mind during the transition from being awake to being asleep that is causing sleeplessness. Here is a quote from In Pursuit of Sleep (pages 16-17), which includes a reference that fully explains the situation:

The strange thing is that, although hypnagogia [sleep onset] has been studied, it is rarely, if ever, addressed when discussing insomnia. Yes, you read that right. When professionals deal with the problems of getting to sleep, they rarely if ever discuss the nature of the transition state and how to deal with it.

…we know neither why nor how we fall asleep. The study of sleep has for the most part focused on measures obtained during established sleep, and many of the events and phenomena of sleep onset have been ignored. [Sleep Onset, Normal and Abnormal Processes, edited by Robert D. Ogilvie, PHD and John R. Harsh, PhD, Washington DC: American Psychological Association, 1994, page xviii]

Again, researchers are focused on the physics and chemistry of brain function during sleep because they are developing medication to put you in that state, and they specifically exclude the subjective personal experience of sleep onset (hypnagogia). This is incompetence on a colossal scale. It is difficult to understand how this could be happening without conscious disregard for the origin of the sleeplessness problem because to do so would result in behavioral solutions that would cut into the profits of pharmaceutical companies, perhaps putting some of them out of business. This situation is intolerable and In Pursuit of Sleep is intended as a first step in remedying this situation.

Here is an article in the NY Times about sleeping pills and the elderly from a couple of years back. Seems a CDC study (online here) reported that it is not a good mix. Here is the most potent paragraph in the NY Times article:

The data also showed that Ambien, the use of which has soared in recent years, accounted for one in five E.R. visits among those older than 65, more than any other medication.

Concern over prescribing medication as a sleep aid for the elderly prompted this comment by a well known geriatrician:

“I’m not comfortable writing a prescription for these medications,” said Dr. Cara Tannenbaum, the geriatrician at the University of Montreal who led the weaning study. “I haven’t prescribed a sedative-hypnotic in 15 years.”

So what should an elderly person with insomnia do?

Well, I am elderly, 74 years old, and I use the Transition Trek method of getting to sleep as presented in In Pursuit of Sleep. I have found it practically foolproof. I use it every night, multiple times if necessary, and it works every time.

Getting to sleep and staying there is the cornerstone of health, both physical and psychological. Now we have a new study reported in the NY Times that insomnia can increase the risk of Type 2 Diabetes in women. Insomnia is rampant throughout the world, and it is healthy people who are developing it.

What has gone wrong?

It seems that research scientists (pharmaceutical companies, wouldn’t you know) are concentrating exclusively on drugs to put us into a sleep-like state instead of investigating the mental process that prevent us from sleeping. If it is not drugs they want us to take, they tell us about all the things we can do before we close our eyes to improve our chances of going to sleep. And they have a CBT course you can take online or in seminars that cost hundreds of dollars and take weeks if not months. All with marginal results.

Here’s the problem: They do not concentrate on the 5 to 10 minute period of time following when we close our eyes and go to sleep. And yet, that is where insomnia starts.

The time between being awake and being asleep is called “sleep onset” by scientists but also goes by the term “hypnagogia.” This short period of time under normal circumstances can expand into hours if we cannot get our thought processes under control. Sleep onset is complex and has creative, problem-solving and worry elements. These distracting elements of sleep onset can be controlled with a mental process that leads the mind safely through this hypnagogic quagmire and into sleep.

But you can’t just lie there waiting for sleep to come to you. You have to go get it. The method of doing this is presented in In Pursuit of Sleep. It is really easy and doesn’t take much time and costs very little money.

Older people tend to go to bed earlier and rise earlier. It seems that their circadian rhythms have shifted, and for no apparent reason. Older people also get less sleep than younger people even though they require just as much. At least that’s the way the story goes.

I think this shift and truncation of sleep may be caused by less demand on our time in the evening and getting poor sleep at night. One thing we do know, our sleep propensity curve (Figure 1-1 of In Pursuit of Sleep), which is only somewhat dependent on sunlight, is malleable and is easily changed. I also believe that older people sleep less because we are more thoughtful, and our thoughts have a tendency to bleed over into the nighttime hours after we wake. Our thoughts then prevent us from getting back to sleep.

This runaway brain activity can be controlled, so that we can get back to sleep. To do it requires some effort but also requires a game plan that we can depend on. Since we sleep in cycles (Figure 2-1) of vary sleep depth — as many as five cycles each night — when we surface, we may actually wake, and then our thoughts may waylay us and not allow us to get back to sleep. If we do this repeatedly over several nights, it changes our sleep propensity curve and contributes to reinforcing the sleep disturbance. We are then destined to repeat that scenario night after night.

This is a solvable problem. The problem originates in the period of time between being awake and being asleep, which is called “sleep onset” but also goes by the term “hypnagogia.” Hypnagogia generally lasts only five or ten minutes, but it has distracting influences that can lead you off the trail to sleep and onto a diversionary track of problem solving or worrying, as well as other mental activities that have nothing to do with sleep.

How do we solve this problem?

The solution is to provide a mental activity that is conducive to sleep, one that keeps you on the straight-and-narrow path and won’t allow you to participate in the activities that prevent sleep. I call this corrective mental activity the Transition Trek. I provide detailed instructions on how to do this in In Pursuit of Sleep, Chapter 4 Charging the Gates of Slumberland.

Dry eyes can wake you in the middle of the night as quick as anything and thus lead to insomnia. (Discussed on pages 12-13 of In Pursuit of Sleep.) When we dream our eyes flash back and forth rapidly, which is called rapid eye movement (REM). REM can be painful if your eyes are dry. We go through REM five times every night, and if your eyes are dry, it will wake you. If you don’t do something about your dry eyes, you may not be able to get back to sleep. This condition can lead to insomnia. But dreaming itself is important and having it terminated early can contribute to depression.

So what do you do about it?

Even though your eyes may tear, the tears may not contain the necessary lubricating oils. I have this condition, and I keep an eye lubricant on the nightstand. I use it two or three times every night. My left eye is particularly bad. But I have it mostly during the night and rarely during the day. Solving this problem helped some with my insomnia, but it certainly wasn’t the whole cure. Your dry eyes may wake you, and even if you solve that problem immediately with eyedrops, you still may not be able to get back to sleep.

What do you do then? Well, that’s the subject of In Pursuit of Sleep, Chapter 4 Charging the Gates of Slumberland. Hint: It involves the use of something called the Transition Trek.

The last few nights I have been experiencing something I have not encountered in years, perhaps decades. When I wake and have to go to the bathroom, I can’t make myself get up because I am so sleepy. This is that really heavy sleepy feeling that we used to have when we were kids and our parents were trying to wake us so that we could go to school. It is that, “I can’t get awake,” feeling. This seems to be part of the natural progression of returning to a healthy sleep routine after practicing the Transition Trek for over a year. I suspect it has come about as a result of reestablishing the hardcore sleep propensity curve (Figure 1-1 of In Pursuit of Sleep). I am beginning to understand that it is possible to return to sleeping like a young person, with all the really good feelings, even after decades of insomnia, simply by using the Transition Trek consistently, night after night.

This may also indicate that solving the insomnia problem leads to much deeper sleep, which, if this article is correct, means that it reduces your chances of getting Alzheimer’s. Lots of good things happen when we sleep like we are supposed to.

This article in the New York Times is from a while back, but it is still an interesting read. It nails what happens to most of us as we get older: we have more trouble getting and staying asleep. That is even true of retired people. The author, Eric Nagourney, puts it this way:

As baby boomers age, many may find that a basic act they once took for granted (or intentionally neglected) has become a lot more complicated. They are finding it harder to get to sleep or stay asleep, and they may feel the consequences during the day.

In other words, our daily activities start to bleed more and more into the time we are supposed to spend sleeping. But the article also quotes Dr. Nathaniel F. Watson, a director of the University of Washington Medicine Sleep Center, as saying”

“Healthy aging is not necessarily associated with poor sleep. Some people have this sense that ‘Oh, I’m just going to sleep badly when I get older, because that’s what happens to everybody.’”

People don’t develop the inability to get to sleep and stay there because they have heard that that’s what happens as you age. Insomnia in older people isn’t a result of suggestion. It is hard to believe a sleep professional would say that, but he did. The problem results from the increased pressure of everyday life intruding on psychic space.

In Pursuit of Sleep addresses these issues and provides a method for overcoming these emotional pressures that intrude on our sleep time. Believe it or not, this is not a difficult problem to solve. You just have to take control of your mind and lead it through the minefield that is hypnagogia, the transition state between being awake and being asleep. Here’s a hint: It has to do with mental images and the Transition Trek.

So what happened after that amazing night’s sleep? As you might remember, I got 13 hrs of sleep that one night. And as you might guess if you have read In Pursuit of Sleep, it took a few nights to recover because it had altered my sleep propensity curve. The very next night, I got only 5 hrs of sleep before waking. The next few nights, I seem to sleep lighter than usual, but I stayed with the Transition Trek and made sure I did get a good measure of sleep. But then my propensity curve corrected, and I have been getting 7 to 9 hours every night.

The moral of this story is that too much sleep certainly can upset future nights’ sleep, but with proper discipline and use of the Transition Trek, all can once again be put back in order.