The Insomnia Answer A Personalized Program

The first book to provide a personalized prescription for each of the three main types of insomnia, The Insomnia Answer teaches you how to prepare both your mind and body for sleep, and gives you real answers to finally get the rest you need. With a program that helps you self-diagnose your particular type of insomnia and treat it accordingly, you'll learn how to stop trying to get to sleep and, instead, let sleep find you. The revolutionary drug-free sleep therapy program has been designed by two leading experts in the evaluation and treatment of insomnia who help you discover: How to identify the three main types of insomnia (and their causes), Why your sleep is so unreliable, Why your insomnia may continue after the event that triggered it, Why you can be both sleepy and unable to sleep at the same time, Why you get a "second wind" without sleeping first, How to use a sleep log to track your insomnia...and resolve it. Book jacket.

Dr. Paul Glovinsky is the clinical director of the Capital Region Sleep/Wake Disorders Center and a Diplomat of the American Board of Sleep Medicine.

Dr. Arthur Spielman is the Associate Director at the Sleep Disorder Centers at New York Methodist and Presbyterian Hospitals.

Introduction: How Can I Mend My Broken Sleep?

1

(14)

PART 1 Catching the Wave of Sleep

1. Why Is Sleep So Unreliable? Discovering Why Sleep Doesn't Come Naturally

15

(16)

Sleep Hygiene Instructions

17

(2)

Sleep Is Complicated

19

(1)

Thinking Can Cause Insomnia

20

(2)

Insomnia Can Be Learned or Innate

22

(3)

Socialization Can Cause Insomnia

25

(2)

Sleep Is a Risk

27

(2)

Sleep Is Out of Your Control

29

(2)

2. How Is Sleep Supposed to Happen? Building a Wave of Sleep

31

(20)

Sleep and Wakefulness Come in Waves

32

(1)

Simple Models of Sleep

33

(2)

Sleepiness and Alertness Are Generated Independently

35

(2)

The Wave of Sleep

37

(1)

The Sleep Drive

38

(2)

The Alerting Force

40

(3)

Circadian Rhythms

43

(1)

Building a Wave of Sleep

44

(4)

The Sleep Drive and Alerting Force in Everyday Life

48

(3)

3. How Did I Get Insomnia? Learning About the Three Types of Sleeplessness and How They Arise

51

(32)

Do You Have Insomnia?

52

(3)

The 3P Model of Insomnia

55

(28)

Predisposing Characteristics

57

(10)

Physiological Hyperarousal

58

(1)

Cognitive Hyperarousal

59

(1)

"Night Owls" and "Morning Larks"

60

(4)

Anxiety and Depression

64

(3)

Precipitating Events

67

(1)

Perpetuating Attitudes and Practices

68

(40)

Extending Bedtime to Gain More Sleep

69

(1)

Using Naps and Stimulants to Counter Sleep Loss

70

(4)

Sleep Aids

74

(5)

Counterproductive Beliefs and Attitudes About Sleep

79

(4)

4. What Does Sleep Mean to Me? Challenging Your Beliefs About Sleep

83

(25)

Sleep Is Meaningful

87

(2)

Sleep as a Pleasure

89

(2)

Sleep as an Escape

91

(2)

Sleep as a Waste of Time

93

(2)

Sleep as Letting Go

95

(1)

Clearing Your Mind for Sleep

96

(12)

PART 2 The ABCDEs of Sleep

5. Preliminary Treatment: Identifying Which Type of Insomnia You Have and Preparing Yourself for Better Sleep

108

(38)

Address Your Insomnia Factors

108

(20)

Improve Your Sleep Hygiene

114

(4)

Seek Treatment for Your Depression

118

(2)

Counter Hyperarousal with Exercise, Behavior Therapy, or Pharmacologic Treatments

120

(6)

Question Your Beliefs About Sleep

126

(2)

Boost Your Sleep Drive

128

(11)

Start Your Sleep Log

128

(2)

How to Complete Your Log

130

(2)

Did You Log a Typical Week?

132

(1)

Find Your Average Bedtime and Average Rising Time

133

(2)

Find Your Average Sleep Time and Average Wake Time

135

(1)

Calculate Your Target Time in Bed

136

(1)

Raise Your Body Temperature

137

(2)

Choose the Right Time for Bed

139

(3)

You Have Difficulty Falling Asleep

140

(1)

You Have Difficulty Staying Asleep

140

(1)

Your Sleep is Broken Throughout the Night

141

(1)

Differentiate Your Therapy

142

(1)

Ease Your Mind

143

(3)

Relaxation Training

144

(1)

Guided Imagery

144

(2)

6. Answers for Difficulty Falling Asleep

146

(29)

Problem: Sunday Night Insomnia

147

(2)

Answer: Limit Weekend Oversleeping

148

(1)

Problem: It Usually Takes an Hour to Fall Asleep

149

(8)

Answer: Maintain a "Buffer Period"

149

(2)

Answer: Gauge Your Readiness for Sleep

151

(1)

Answer: Set Aside "Worry Time"

152

(2)

Answer: Follow Stimulus Control Instructions

154

(1)

Answer: Use Melatonin to Induce Sleep

155

(2)

Problem: It Usually Takes Several Hours to Fall Asleep

157

(4)

Answer: Chronotherapy

158

(3)

Answer: Bright Light Treatment

161

(9)

Setting Up Your Bright Light Device

166

(1)

Scheduling Your Bright Light Treatment

167

(3)

Answer: Use Dark or Blue-Blocking Sunglasses to Filter Evening Light

170

(5)

7. Answers for Difficulty Staying Asleep

175

(12)

Problem: You Awaken After a Few Hours of Sleep

176

(11)

Answer: Stimulus Control Instructions

176

(2)

Answer: Seek Evaluation and Treatment for Depression

178

(1)

Answer: Set Aside "Worry Time" and Maintain a "Buffer Period"

178

(2)

Answer: Use Bright Light to Delay Your Sleep Phase

180

(1)

Answer: Use Dark or Blue-Blocking Sunglasses to Filter Morning Light

181

(1)

Answer: Use Hypnotic Medication to Prolong Sleep

182

(6)

Anxiety or Depression

183

(1)

Excessive Daytime Sleepiness

183

(1)

Altered Timing of Sleep

184

(1)

Choosing a Medication

184

(3)

8. Answers for Broken or Irregular Sleep

187

(25)

Problem: Your Sleep is Broken

188

(7)

Answer: Sleep Restriction Therapy

189

(6)

Problem: Your Sleep Is Scattered Around the Clock

195

(5)

Answer: Reserve Time for Wakefulness Instead of Sleep

196

(4)

Problem: You Awaken About Every Ninety Minutes

200

(3)

Answer: Screen for REM Sleep Disordered Breathing

201

(1)

Answer: Review Your Use of Alcohol and Medications

201

(1)

Answer: Calm Your Dreams

202

(1)

Problem: You Work a Variable Shift No Set Work or Sleep Schedule

203

(4)

Answer: Anchor Sleep

205

(2)

Problem: You Work a Night Shift

207

(5)

Answer: Wear Dark or Blue-Blocking Sunglasses in the Morning

207

(2)

Answer: Nap Before Your Shift

209

(1)

Answer: Obtain Bright Light Exposure At Work

209

(1)

Answer: Protect Your Sleep from Daytime Intrusions

210

(2)

9. Easing Into Sleep: Freeing Yourself to Catch the Wave

212

(19)

The Threshold of Sleep

214

(2)

Learn to Enjoy Your Rest

216

(3)

Breathe Easy

219

(1)

Relax Your Muscles

220

(3)

Ease Your Mind Inward When the World Outside is Chaotic

223

(3)

Focus Outward When the Turmoil Lies Within

226

(5)

Afterword

231

(8)

Endnotes

239

(8)

Index

247

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The Insomnia Answer A Personalized Program for Identifying and Overcoming the Three Types ofInsomnia

Summary

Author Biography

Table of Contents

Supplemental Materials