Every night, while most people are sound asleep, millions of Americans are lying awake, wishing they could get the sleep their body demands.
They experience insomnia, a sleep disorder affecting 60 million Americans each year, according to the U.S. Department of Health and Human Services.
But many students who are unable to fall asleep may not realize that lifestyle changes can ease the symptoms.
Insomnia is defined as a difficulty falling asleep or the inability to maintain sleep for a reasonable amount of time. Sufferers experience fatigue, lack of productivity or trouble concentrating, said Alon Avidan, the associate director of the UCLA Sleep Disorders Center.
Several factors can lead to insomnia, with high levels of stress a particularly common one among college students.
“Many students have acute, or short-term, insomnia at some point that may manifest due to the stress of studying for a test, the death of a loved one or difficulty adjusting to college, but it generally goes away,” Avidan said.
While stress is a major trigger of insomnia, perpetuating factors are what sustain the symptoms and allow it to progress into the more serious chronic, or long-term, insomnia, said Michael Irwin, a professor of psychiatry at the UCLA Semel Institute.
“Perpetuating factors relate to disadvantageous methods of falling asleep, such as using alcohol, sedatives or watching television in bed,” Avidan said. “This worsens the insomnia because the patient is in a pattern of relying on substances or television to go to bed.”
Another major cause of insomnia in college students is poor sleep hygiene, which involves making choices that reduce the ability to fall asleep, such as exercising late at night or taking naps after 3 p.m., said Joel Becker, the director of the Cognitive Behavior Associates and an associate clinical professor in the psychology department.
One common component of poor sleep hygiene is high caffeine intake.
“Students drink way too much caffeine. … Even if they have caffeine early in the afternoon, much of the caffeine is still in their system when they go to bed,” Avidan said.
Another factor leading to insomnia is anxiety, as students lay in bed thinking about the next day and have trouble getting their brain to relax, Avidan said.
“Sometimes my body is physically exhausted, but my mind is really active,” said Tina de Giso, a fourth-year neuroscience student. “I just think too much and can’t go to sleep.”
Treating insomnia involves breaking out of the negative cycle of behaviors that perpetuate the disorder.
One possible option is cognitive behavior therapy, an approach that involves education about sleep, addresses dysfunctional thoughts about sleep and uses sleep restriction to establish a regular sleep pattern, Becker said.
The treatment improves sleep efficiency by making patients only lie in bed when they feel tired. The patients may get little sleep one night, but the next night they will feel tired earlier and have less trouble falling asleep. Unlike medication, the therapy does not cause side effects that may impact thinking ability, Irwin said.
The therapy has allowed 75 percent of insomnia patients to become normal sleepers and 91 percent to reduce their use of sleeping pills, Becker said.
One recommendation in the therapy is to make the bedroom just for sleeping, which is difficult for college students living in the residence halls, Becker said.
“To the extent that students can do things outside their room, they should. … They will sleep better if their bed is not overstimulated as an environment and is used only for sleep,” he said.
Some students cope with the difficulty of having their room be a living space and bedroom by trying to keep their room only for sleeping.
“I associate my room with relaxing and not doing any work, which helps me fall asleep better,” de Giso said.
With so many Americans suffering from insomnia, students may feel like their symptoms are a normal part of college life, but there can be negative effects beyond the daytime consequences.
“Insomnia does have health risks, and data shows that people who have a problem sleeping have a twofold risk of dying, mostly due to cardiovascular disease,” Irwin said. “Insomnia leads to an elevation in the chemicals that control blood pressure, leading to hypertension. It is important for people to develop a regular sleep behavior.”