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Mindful : December 2015
Therapy for Insomnia—or MBTI. Although both mindfulness medita- tion and Mindfulness-Based Stress Reduction (MBSR) have been shown to improve sleep quality in adults, MBTI integrates specific behavioral strategies from CBTI with mindful- ness meditation practice. “Insomnia is a disorder of cogni- tive and physiological hyperarousal, which mindfulness addresses but CBTI doesn’t deal with directly,” said Jason Ong, a psychologist at Rush University Medical Center. This inspired him to combine the strengths of each approach into one program. What’s more, he told me over the phone, MBSR lacks tar- geted cog nitive and sleep hygiene techniques that are key to CBTI. Ergo, Ong recently conducted a randomized controlled trial com- paring MBTI to MBSR in patients struggling with chronic insomnia, and found that MBTI showed signifi- cantly greater—and longer lasting— benefits in reducing insomnia. A lot of acronyms, I know. But in a funny way, by practicing mindfulness meditation daily (well, almost) in tan- dem with CBTI, I have (loosely) been practicing my own version of MBTI. And, yes, I sleep. Drug-free now for months, I sleep. Not always as many hours as I’d like, sometimes fitfully, yet I sleep. On nights when I’m having trouble, my little herbal cocktail—melatonin and the L’s, tryptophan and glycine—help. On other nights I need to talk myself down, like a parent to an anxious child, placing my hand over my heart and reminding myself that my body does indeed know how to sleep. And when I have a really lousy night, I don’t panic the way I used to. For the most part, sleep has become what it’s designed to be—rest and recuperation for body and brain—and I would add, spirit. Letting go into sleep is no lon- ger (in my most fearful imaginings) the dark herald of death, imprinted in me so many years ago. The expectation that I will sleep has made all the difference. So has realizing that, like many people who struggle with insomnia, I had swallowed some pretty basic myths. For starters, the notion that we need eight hours of shuteye every night: Recent studies involving over a million people found that those who sleep seven hours live longer than people who sleep eight or more. Even more surprising, sleeping five hours a night is associated with longer life expectancy than sleeping nine hours. And seven (some studies suggest that the range is between 6.5 and 7.5) hours per night appears to be the sweet spot. The same number holds true for preserving memory. A land- mark study of 15,000 female nurses conducted at Brigham and Women’s Hospital in Massachussetts found that women who slept an average of seven hours each night had signifi- cantly stronger cognitive skills later in life than those who slept less than five hours or more than nine. Perhaps the most liberating of the debunked myths is the discovery that the belief we hold so dear—namely, that we should sleep undisturbed in eight-hour chunks—is a rela- tively recent development in human evolution. In 2001 Roger Ekirch, a history professor at Virginia Tech, published a paper revealing a wealth of historical evidence showing that for millenia—until there was artificial light—humans slept in two segments, usually referred to as the first and second sleep. The time between the two chunks was often devoted to prayer, meditation, quiet reflec- tion—and it was also notably the hour when many babies were conceived. Ekirch’s hypothesis, based on 16 years of research, was backed by an experiment conducted by psychiatrist Thomas Wehr, a prominent scientist at the National Institute of Mental Health. In Wehr’s study, subjects were plunged into darkness 14 hours a day for one month. After adapting to the new schedule, they typically slept for four hours, then awoke for one or two hours before falling into a second fourish-hour snooze. In his new book on the subject, Waking Up to the Dark, author Clark Strand writes: “Recently, as a result of Wehr’s study and others like it, some sleep specialists have reported that the best treatment for the Hour of the Wolf [Strand’s term for middle-of- the-night agita] is to tell patients that nightly waking is natural and, conse- quently, that they shouldn’t struggle against it. A doctor told me that once he explained this to them, many of his patients simply went to bed earlier each night and never asked him for sleep medications again.” A glowing new spin on a damaging old story. Just like the bright new spin on my own story, which continues to unfold. ● 7 hours of sleep = stronger cognitive skills A landmark study of 15,000 female nurses found that women who got an average of 7 hours of sleep each night had significantly stronger cognitive skills later in life than those who slept less than 5 hours or more than 9. 48 mindful December 2015 health