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Mindful : December 2015
I felt so weak and drained of energy that, without consciously deciding to, I began to keep myself awake at night, terrified that if I allowed myself to descend into sleep, I’d never wake up. That became an increasingly vicious cycle: sleep deprivation, exhaustion, insomnia, followed by even greater exhaustion—and mounting terror. I felt on the verge of collapse. But instead of grasping the whole picture, my internist prescribed sleeping pills. It wasn’t until I was rushed to the coronary care unit of my local hospital with a dangerously low heart rate that the problem got sorted out and I was taken off Inderal. But by then my story about not being able to sleep without pharmaceuticals had crystallized. Still, I worried constantly about the long-term effects of the drugs on my mind and body, and took frequent stabs at rewriting my story. I’d try the latest, supposedly less harmful, wonder drug. When that didn’t work, the natural supplement and herbal sleep aid industry made a pile off of me. I meditated, aerobicized, did tai chi, qigong, and yoga, consulted acu- puncturists, shrinks, energy healers, and Reiki masters. There were even periods—weeks or even months at a time—when, miraculously, I slept unaided. But then I’d have a pressing deadline, an overseas trip, a big meet- ing and the story would return full- blown. Within a night or two, I was again the victim of my own dark and doom-filled narrative, abetted by my doctors. The prevailing wisdom was that it was better to take a pill and get some sleep than to spend the night tossing and turning. One physician even told me not to worry, I could take a little Xanax every night for the rest of my life, no harm in it. I wanted to believe him. According to the American Acad- emy of Sleep Medicine, as many as 30-35% of adults complain of insom- nia. The percentages spike to 40-60% in people over 60. Women are twice as likely as men to have trouble falling or staying asleep—the two sides of the insomnia coin. The disorder is diag- nosed when: patients get less than 6.5 hours of sleep; it takes 30 minutes or more to fall asleep, and symptoms persist for at least one month; after six months the diagnosis is classified as chronic insomnia. The Centers for Disease Control has labeled insufficient sleep a “public health epidemic,” and estimates that 50-70 million adults in the US suffer from a sleep or wakefulness disorder. Only a third of Americans (and almost no one I know personally) get the standard recommended eight hours of sleep a night. In a report issued in 2014, the CDC warned that people who get too little sleep are at risk for increased mortality, as well as chronic diseases such as cancer, diabetes, hypertension, heart disease, obesity, and depression. Sleep deprivation is also strongly linked to impaired immune function. It’s no wonder. In 2013, research- ers at UC Berkeley found that sleep deprivation fires up the brain’s amygdala and insular cortex, regions associated with emotional process- ing. The resulting pattern mimics the abnormal neural activity seen in anxiety disorders. “These findings help us realize that those people who are anxious by nature [hello!] are the same people who will suffer the great- est harm from sleep deprivation,” said Matthew Walker, a professor of psychology and neuroscience at UC Berkeley and senior author of the paper, which was published in the Journal of Neuroscience. Another 2013 study, published by the CDC’s National Center for Health Statistics, revealed that nearly nine million US adults take prescription sleep aids, called hypnotics—a num- ber that is on the rise—with women leading the pack. And emergency room visits due to bad reactions to the drugs—especially zolpidem, the active ingredient in Ambien—are also on a steep uptick, having nearly doubled between 2005 and 2010. The news just gets worse. The day I returned home in the fall of 2014 after a trip to Italy, I found this email message from a close friend in my inbox: “You have to STOP tak- ing Xanax NOW!!!” My friend’s concern was prompted by a new study reported by French and Canadian researchers showing that benzodiazepine use is linked to higher rates of Alzheimer’s disease, and that the correlation increases with greater exposure to the drugs. “The more the cumulative days of use, the higher the risk of later being diagnosed with dementia,” Antoine Pariente, a pharmacoepidemiologist at the University of Bordeaux and a coauthor of the study, told The New York Times. The researchers found that older adults who took daily doses for 91-180 days had an increased risk of 32%; those who popped benzos daily for more than 180 days had an increased risk of 84%. It didn’t seem to matter whether the number of days patients consumed the drugs took place over six months or five years. → 40-60% of people over 60 are affected by insomnia As many as 30-35% of adults complain of insomnia. That spikes to 40-60% in people over 60, and women are twice as likely as men to have trouble falling asleep or staying asleep. 44 mindful December 2015 health