A Summary Look at CES Studies of Insomnia

Primary insomnia as a complaint lasting for a least one month, of difficulty initiating and/or maintaining sleep or of the presence of non restorative sleep, as defined by the Diagnostic and Statistical Manual of Mental Disorders.1 The International Classification of Sleep Disorders Revised (ICSD-R) uses the term “psychophysiologic insomnia” for a complaint of insomnia, and for the associated decreased functioning during wakefulness, and regards insomnia of 6 months duration as chronic.

Estimates of the number of people in the U.S. who suffer from insomnia range from 18 million to 24 million in adulthood, and up to 20% in later life, or 7 million in persons 65 years of age and older, with women being about two times as likely to develop insomnia as men.

The primary function of sleep is to ensure adequate cortical function when awake.5 According to one theory, two processes interact in normal sleep production. The sleep homeostat drives the sleep-wake schedule toward a balanced requirement (prolonged wakefulness incurs a “sleep debt”), and an internal circadian timer regulates the 24 hour biological clock’s sleep wake cycle.6 Together, the two processes regulate not only the amount of sleep but the type of sleep an individual will experience. The two processes also differ across the life span, with young children experiencing longer sleep periods, with more rapid eye movement (REM) sleep than do adults, and the homeostatic drive declines with age.

Good sleepers do not have a recipe for falling asleep and staying asleep. Instead the good sleeper is regarded as passive in the sleep process in which internal and external cues act as automated setting conditions for sleep. According to the inhibition model, there is both a physiological de-arousal, and a cognitive de-arousal, allowing sleep to occur.

Under conditions of cognitive arousal, sleep will usually not occur. Students are taught that according to Freud, the first step in becoming an insomniac is to worry that one will not sleep when one goes to bed. Recent research has borne out the fact that mental worries of any kind, but certainly a fear of not falling asleep and worrying about the resulting consequences of this for one’s life the next day, clearly deactivates the cognitive de-arousal required for sleeping.

When asked what kinds of thoughts they have when they attempt to sleep, insomniacs provide a long list, typically including planning, thinking things out, especially things with a negative emotional content, fear of not sleeping, plus concentrating on worrisome changes that are operative in their lives. Persons who have no sleep problems, when asked what they think about when they go to bed at night, are more likely to answer, “nothing especially.”

While medications are often used to treat insomnia, those that are of the benzodiazepine and related families have limited usefulness over the long range, since they suffer tachyphylaxis and produce tolerance. The use of cognitive behavior therapy is often suggested since it can often quickly identify the things that the insomniac is doing that is defeating the brain’s attempt to de-arouse.

Other things that can keep people awake are illnesses, especially pain, depression, medications of various types, sleep apnea, anxiety and other stress related disorders. These would all need to be addressed and evaluated in any therapy that is provided to the insomniac.

Of additional interest to practitioners of electromedicine is the fact that the head in the awake person has a negative ionic charge anteriorly and a positive ionic charge posteriorly. Those charges reverse, both when the person is asleep, and when under general anesthesia. The person whose head remains ionically negative in front will not sleep until it reverses.

Leave a Reply

Your email address will not be published. Required fields are marked *