The American Academy of Sleep Medicine issued the following news release:

Bright light therapy improves sleep disturbances in soldiers with combat PTSD

Study suggests that bright light therapy may be an effective treatment
for combat-related post-traumatic stress disorder

Bright light therapy has significant effects on sleep disturbances
associated with combat-related post-traumatic stress disorder, according
to a research abstract that will be presented Monday, June 7, 2010, in
San Antonio, Texas, at SLEEP 2010, the 24th annual meeting of the
Associated Professional Sleep Societies LLC.

Results indicate that bright light therapy produced a significantly
greater improvement than placebo in sleep disturbances specific to PTSD.

Bright light therapy also produced a moderate improvement in PTSD
symptoms and depression.

“Results of this ongoing study show significant effects of bright light
on disruptive nocturnal behaviors associated with combat PTSD, as well
as positive effects of bright light therapy on PTSD symptom severity,”
said study coordinator Shannon Cornelius, PhD, graduate research
assistant for Dr. Shawn D. Youngstedt in the department of exercise
science at the University of South Carolina in Columbia, S.C.

“Because bright light therapy is a relatively simple, self-administered,
inexpensive treatment with few side effects, these results are an
important step to further establish the efficacy of bright light therapy
as an alternative or adjunct treatment for combat-related PTSD.”

The study involved 16 soldiers who returned to the U.S. with combat-
related PTSD after serving in Operation Enduring Freedom or Operation
Iraqi Freedom. Following a one-week baseline, participants were
randomized to one of two four-week treatments.

Eight soldiers received 10,000 lux of bright light therapy for 30
minutes each day. The other eight participants were assigned to the
placebo group and received sham treatment with an inactivated negative
ion generator.

The Clinician-Administered PTSD Scale (CAPS-2) was completed at
baseline and immediately following completion of the study.

At weekly intervals, depression was assessed with the Beck Depression
Inventory (BDI-II), and sleep quality was assessed with the Pittsburgh
Sleep Quality Index (PSQI) with addendum for PTSD (PSQI-PTSD).

Cornelius noted that sleep disturbance is a commonly reported problem
that can play both a precipitating and perpetuating role in PTSD, making
it an important target for therapy.

“Disturbed sleep is known to interact with depression and anxiety in a
vicious cycle,” said Cornelius.

“By reducing the severity and occurrence of sleep disturbances, it may
be possible to reduce the severity of symptoms such as anxiety and
depression in combat-related PTSD.”

The American Academy of Sleep Medicine reports that 70 to 90 percent of
people with PTSD describe subjective sleep disturbance. Recurrent
nightmares of the traumatic event represent one of the most problematic
and enduring symptoms of PTSD.

These nightmares may take the form of a realistic reliving of the
traumatic event or depict only some of its elements.

Bright light therapy exposes your eyes to intense but safe amounts of
light for a specific and regular length of time.

Typically it involves exposure to up to 10,000 lux of light for
scheduled periods of 20 minutes or more using a small light box.

In a 2007 study published in the journal BMC Psychiatry, Youngstedt
reported that bright light exposure may have an anxiolytic effect.

Three hours of exposure to 3,000 lux of bright light for three
consecutive days reduced anxiety in a group of low-anxiety adults.

The new issue of *Canadian Psychology* includes an article: “Chronic
Insomnia: Recent Advances and Innovations in Treatment Developments and
Dissemination.”

The author is Charles M. Morin.

Here’s how the article begins:

[begin excerpt]

Sleep is a vital function, essential to psychological and physical well-
being.

Not surprisingly, sleep disturbances, particularly insomnia, are very
common amongst individuals with psychological or medical problems.

Insomnia is amongst the most prevalent health complaints and the most
common of all sleep disorders in the general population.

Epidemiological estimates indicate that 30% of the adult population
reports insomnia symptoms at least occasionally, while 10% presents an
insomnia disorder (Morin, LeBlanc, Daley, Gregoire, & Merette, 2006;
Ohayon, 2002).
(more…)

The University of Rochester Medical Center issued the following news release:

Cognitive behavioral therapy for insomnia significantly improved sleep
for patients with chronic neck or back pain and also reduced the extent
to which pain interfered with their daily functioning, according to a
study by University of Rochester Medical Center researchers.

The study, published online by the journal Sleep Medicine, demonstrates
that a behavioral intervention can help patients who already are taking
medications for pain and might be reluctant or unable to take additional
drugs to treat sleep disturbance.

“This therapy made a major difference to these patients,” said Carla R.
Jungquist, F.N.P., Ph.D., of the Medical Center’s Sleep and
Neurophysiology Research Laboratory, who is the lead author of the Sleep
Medicine article.

(more…)

A nice summary on this, with links to articles for further reading

———————————————————————

Like hunger and thirst, sleep is a basic biological drive we can’t ignore. In fact, when we don’t get enough of it, our bodies eventually force us to make up for the sleep lost. However, why we sleep remains a mystery-and one of the biggest unanswered questions in psychology.

But recently, results from sleep studies in humans and animals have begun to lead some promising explanations. Researchers are finding that sleep may help babies learn the placement of their own limbs (“To sleep, perchance to twitch”), it may help adults fix new memories in their brains (“Let’s sleep on it”), it may give the brain time to replenish energy stores (“Brain, heal thyself”) or it may allow it to recuperate from the learning it does during the day (“Wild findings on animal sleep”). Or-perhaps most likely-sleep may do some combination of all those things.

Indeed, although there’s no consensus yet, researchers are beginning to figure out what’s really going on during this deceptively passive third of our lives.

APA Monitor Volume 37, No. 1 January 2006  http://www.apa.org/monitor/jan06/why.html

The journal *Archives of Internal Medicine* issued the following news release:

Insomnia often appears to be a persistent condition

About three-fourths of individuals with insomnia report experiencing the
condition for at least one year and almost half experience it for three
years, according to a report in the March 9 issue of Archives of
Internal Medicine, one of the JAMA/Archives journals.

Insomnia is the inability to fall asleep or stay asleep. “Approximately
30 percent of adults report symptoms of insomnia and 6 percent to 10
percent meet diagnostic criteria for an insomnia disorder,” the authors
write as background information in the article. Several factors such as
being female, increasing age, having anxiety or depression and
experiencing pain from medical conditions have been associated with
insomnia. The condition has been linked to higher health care costs,
work absenteeism, disability and higher risk of hypertension and depression.

Charles M. Morin, Ph.D., of Universite Laval and Centre de recherche
Universite Laval–Robert Giffard, Quebec, Canada, and colleagues
evaluated insomnia persistence, remission and relapse in 388 adults
(average age 44.8) over a course of three years. Individuals with an
insomnia syndrome (insomnia symptoms at least three nights per week for
at least one month causing substantial distress or daytime impairment)
at the beginning of the study (n=119) were compared to those with
insomnia symptoms (n=269) to examine the course of initial severe sleep
difficulties.

“Of the study sample, 74 percent reported insomnia for at least one year
and 46 percent reported insomnia persisting over the entire three-year
study,” the authors write. The group with initial insomnia syndrome had
a higher persistence rate than the group with symptoms of insomnia (66.1
percent vs. 37.2 percent), respectively. About fifty-four percent of
participants went into insomnia remission; however, 26.7 percent of them
eventually experienced relapse. “Individuals with subsyndromal insomnia
[insomnia symptoms] at baseline were three times more likely to remit
than worsen to syndrome status, although persistence was the most
frequent course in that group as well,” the authors note.

Of the 269 individuals with baseline symptoms of insomnia, after one
year 38.4 percent were classified as good sleepers, 48.7 percent still
had insomnia symptoms and 12.9 percent had insomnia syndrome. Results
were similar after the second and third year of follow-up. Of the 119
participants with insomnia syndrome at the beginning of the study, 17
percent were good sleepers after one year, while 37 percent had symptoms
of insomnia and 46 percent remained in the insomnia syndrome group.

“This study provides preliminary evidence to better understand the
natural course of insomnia. Additional studies are needed, however, to
identify moderating and mediating factors of persistence, remission and
relapse,” the authors conclude. “Improved understanding of the long-term
course of persistent insomnia would be helpful to guide the development
of effective public health prevention and intervention programs to avert
long-term negative outcomes.”

Women experience significantly more nightmares than men and have more emotional dreams, research suggests.  In a study of 170 volunteers asked to record their most recent dream, 19% of men reported a nightmare compared with 30% of women. Researcher Dr Jennifer Parker of the University of the West of England said there was no difference in the overall number of dreams reported.  Other research has shown women tend to have more disturbed sleep than men.

One factor which has been linked to this is changes in a woman’s body temperature during her monthly cycle. Dr Parker, a lecturer in psychology, said it has been known for a long time that pre-menstrual women report more vivid and disturbing dreams. “The consistent finding in this research was that women report more unpleasant dreams than men.”

Women taking part in the study were much more likely to report dreaming about very emotionally traumatic events such as the loss of a loved one. She added: “In terms of processing emotional information, women may be more prone to taking unresolved concerns into their sleep life.”

Dr Chris Idzikowski, director of the Edinburgh Sleep Centre said he was not surprised the research showed a gender difference but what is difficult to pick out is whether women are having more nightmares or remembering them better. “This fits in with what’s in the literature. “Women’s sleep tends to be more disrupted and they have more insomnia. “And more frequent wakening could cause them to pick up on the dream. “But it could be that disturbed sleep is contributing to the fears.” He added that nightmares in everyone were probably more common than people realised as they are quickly forgotten about

BBC 12 Sept 08

Cat’s Dream

How neatly a cat sleeps,
sleeps with its paws and its posture,
sleeps with its wicked claws,
and with its unfeeling blood,
sleeps with all the rings–
a series of burnt circles–
which have formed the odd geology
of its sand-colored tail.

I should like to sleep like a cat,
with all the fur of time,
with a tongue rough as flint,
with the dry sex of fire;
and after speaking to no one,
stretch myself over the world,
over roofs and landscapes,
with a passionate desire
to hunt the rats in my dreams.

I have seen how the cat asleep
would undulate, how the night
flowed through it like dark water;
and at times, it was going to fall
or possibly plunge into
the bare deserted snowdrifts.
Sometimes it grew so much in sleep
like a tiger’s great-grandfather,
and would leap in the darkness over
rooftops, clouds and volcanoes.

Sleep, sleep cat of the night,
with episcopal ceremony
and your stone-carved moustache.
Take care of all our dreams;
control the obscurity
of our slumbering prowess
with your relentless heart
and the great ruff of your tail.

Translated by Alastair Reid
Pablo Neruda

Oh sleep! It is a gentle thing,
Beloved from pole to pole.
Samuel Taylor Coleridge (1772 – 1834)

If you can’t sleep, then get up and do something instead of lying there and worrying. It’s the worry that gets you, not the loss of sleep.
Dale Carnegie

Laugh and the world laughs with you, snore and you sleep alone.
Anthony Burgess (1917 – 1993)

[Sleep is] the golden chain that ties health and our bodies together.
Thomas Dekker (1572 – 1632)

*Harvard Mental Health Letter* includes an
article: “Insomnia in later life: Overcoming obstacles to a good night’s
rest.”

Here’s the article:

The older you are, the more likely you are to have a sleep disorder.
According to a National Institute on Aging study, more than 50% of
people over age 65 report regular sleep problems that trouble them at
night or interfere with daytime activities. They can’t fall asleep when
they want to, they wake up repeatedly, they wake up too early, their
sleep is not refreshing, or they feel drowsy or groggy all day.
Fortunately, our understanding of sleep itself and the sleep disorders
of late life have improved greatly, and help is more easily available
than ever.

Sleep becomes shallower and briefer with age. Its deepest stages
practically disappear by age 50 in many people. As we grow older, we not
only sleep more lightly but wake up more often, have more brief periods
of wakefulness, and spend more time lying awake (experts use the term
“poor sleep efficiency”). We may fall asleep and wake up earlier than is
desirable, and make up for sleepless nights, if we can, by daytime napping.

One result is falling asleep at the wheel, in the metaphorical sense
(loss of alertness, concentration, and memory) and the literal sense
(drowsiness may account for 100,000 automobile accidents each year, many
of them involving older drivers). Insomnia may be a mortal danger in
other ways as well. According to a study, people who sleep less than
five hours a night have twice the average rate of heart attacks. Another
study found that older adults who lay awake in bed for a half-hour or
more on most nights had a high death rate even if their overall health
was good.

Risk factors (more…)

Six Natural Principles of Sleep Improvement

A good night’s sleep is important. Many things as well as pain can affect sleep. The sleep experts suggest most of us need 7-8 hours of sleep per night, but up to 30% of the general population complain of insomnia. These suggestions may help improve the quality of your sleep.

1) Cycles

  • The body has daily (“circadian”) and 90 minute (“ultradian”) cycles of wakefulness and sleepiness, and these can be cultivated and used.
  • The body’s daily cycles are sensitive to daylight and are reset by waking time
  • Ideally these are regular, and lead to regular sleep times
  • Altering them affects sleep (as in jet lag, shift work).
  • Irregular or prolonged napping, sleeping in, staying up late often disrupt sleep
  • Creating a rhythm in sleep / wake activity, night time routines, and ‘catching the tide’; that is, going to sleep when sleepy at night, help to use these cycles
  • If you nap, nap at the same time every day
  • Avoid sleeping in on weekends, or making up lost sleep by sleeping longer.
  • Wakefulness during the night usually happens at the end of 90 to 100 minute cycles in sleep.

2) Relaxation / stimulation

  • Relaxation aids sleep; stimulation is arousing and opposes sleep.
  • Stimulants such as caffeine, nicotine, exercise near bedtime, anger, anxiety and worry, and interesting activities will all tend to decrease sleep. Avoid these, especially near bedtime.
  • Relaxing practices such as gentle exercise in the evening, vigorous exercise earlier in the day, deep breathing and other relaxation techniques, warm baths, hot drinks (non-alcoholic), gentle routines at bedtime, reading, reducing stress reactions to events, and self-calming can help.
  • Alcohol sedates the body initially, but this wears off several hours later and then it is hard to sleep

3) Connections

  • Bed should be a peaceful sanctuary, not a place associated with wakefulness or discomfort.
  • If you consistently feel uncomfortable, worried, un-rested, awake, distressed, or aroused in your sleep place, it will eventually become harder to relax and sleep there.
  • The body learns to associate certain places with well-being and rest, and others with wakefulness and arousal.
  • Spend as little time in bed awake as you can. Get up if you can’t sleep: don’t lie in bed tossing and turning. Stay up: don’t go to bed until you can sleep.
  • Use your bed for mainly for sleep and sex (unless this disturbs your sleep). Other activities should be done outside the bedroom.

4) Comfort

  • We sleep better when we are comfortable
  • Comfort is affected by things like temperature, darkness, quiet, hardness / softness of bed, pillows, pain, hunger/fullness, thirst, and ease of breathing.
  • Make the bed as comfortable as possible by adjusting as many of these as possible.
  • An open window, fan, or a lighter cover can create the coolness many people need to sleep well. Earplugs, window shutters, or a different bedroom (or accommodation!) may help reduce noise. Dark curtains or an eye-mask can create needed darkness.
  • Avoid heavy meals or too many fluids in the evening.
  • Bedding can be adjusted so that there is comfortable support where needed. Preferences here are very individual. Many people find that using several pillows around the body or supporting an arm or leg help. The right mattress can make a difference.
  • Have a glass of water by the bed if you get thirsty.

5) Additive effects

  • Negative influences on sleep add up.
  • Sometimes we sleep well even though one or more of the factors above are present.
  • Sleep may suffer only when enough problems exist at one time.
  • Change in several negative influences may be necessary to improve sleep.
  • The factor which seems to be disrupting sleep may in fact only be one of several. Even if one or more ingredients for insomnia cannot be altered, sleep might be improved by making changes in the other ingredients.

6) Non-resistance

  • Sleep is not usually under voluntary control, so don’t fight it.
  • Trying to force yourself to sleep is counter-productive
  • “Losing sleep” (i.e., worrying) over insomnia is obviously going to make it worse.
  • Accept periods of wakefulness gracefully. Do not let yourself be preoccupied with the fact you are awake. Reassure yourself about your ability to function tomorrow.
  • Don’t watch the clock. Cover it or turn it around. You probably don’t have any appointments to keep in the night. It doesn’t matter what time it is. Set an alarm if you need to get up at a certain time in the morning.
  • by Brian Grady, PhD