Dr. Maude Bouchard, a neuropsychologist and director of research and development at the HALEO virtual sleep clinic, sheds light on the difference between the concepts of insomnia and chronic insomnia.
Chronic insomnia refers to a condition where a person consistently experiences difficulty falling asleep and staying asleep at night. This must occur at least three times a week and persist for at least three months. While insomnia symptoms may be intermittent, they are not a fleeting problem.
Although seven to nine hours of sleep per night is generally recommended for adults, Dr. Bouchard emphasizes that each individual has unique sleep requirements and some may fall outside this range.
She also highlights that occasional nighttime awakenings are normal. “Waking up three or four times is acceptable if you fall back asleep quickly. However, if it takes you half an hour or an hour to fall back asleep and you toss and turn, it becomes more problematic,” explains the neuropsychologist.
Dr. Bouchard explains that our brain houses a biological clock that regulates various bodily rhythms, including hormone fluctuations and body temperature. “For individuals with consistent schedules, this clock sends signals to sleep at night and be awake during the day. These signals synchronize with external cues like light,” she clarifies.
“During the day, exposure to natural light triggers a wake-up signal in our brain. In the evening, when light diminishes, the opposite occurs, signaling the brain to release sleep hormones, enabling us to fall asleep and sleep soundly through the night,” Dr. Bouchard elaborates.
A worker who starts their day at 3 a.m., for example, disrupts these natural rhythms. While a regular but atypical schedule might have a less significant impact on sleep, “it will still pose a challenge for the biological clock because at that time, the brain is sending a sleep signal, and we must do the opposite,” adds Dr. Bouchard.
Occupations with atypical schedules can disrupt circadian rhythms, leading to sleep problems. Police officers, firefighters, nurses, doctors, airplane pilots, flight attendants, truck drivers, and media professionals are professions where the prevalence of insomnia symptoms is higher than in the general population.
The Hypervigilance Factor
Police officers and hospital staff are particularly susceptible due to their heightened vigilance levels.
According to scientific data from the HALEO Virtual Sleep Clinic, police officers exhibit a five-fold higher prevalence rate of insomnia compared to the general population. Moreover, officers with poor sleep quality are three to seven times more likely to be diagnosed with anxiety, depression, chronic pain, substance abuse, or other mental health issues.
On the hospital front, studies indicate that 52% of nurses are diagnosed with sleep disorders. Dr. Bouchard clarifies that variations exist between studies, particularly depending on the questionnaires used.
Another contributing factor is hypervigilance. As part of their job, police officers are trained to be hyper-aware of their surroundings. “Unfortunately, this hypervigilance often carries over to their home life,” notes Dr. Bouchard.
“It’s more difficult for individuals who are trained to work around the clock and remain hyper-alert to their environment,” she says.
On-call doctors, who are always on standby, also experience hypervigilance, which can hinder their ability to fall asleep or stay asleep at night.
Police officers and hospital staff are also more prone to experiencing work-related post-traumatic stress, which is often accompanied by sleep disorders or insomnia.
Solutions
Over-the-counter melatonin capsules are increasingly popular, but Dr. Bouchard believes many people lack a full understanding of how they work. “The intention is to synchronize the biological clock,” explains the neuropsychologist, emphasizing that melatonin is not a sleep aid. She recommends taking melatonin supplements two hours before bedtime and starting with the smallest dose, typically 3 mg.
For individuals struggling with insomnia, cognitive behavioral therapy for insomnia (CBT-I) is another option. After assessing sleep quality, a program is tailored by trained professionals, such as psychologists and social workers specializing in sleep, and the patient receives support over several weeks to address their sleep disorder.
Even simple adjustments at home can make a significant difference. Dr. Bouchard recommends removing clocks from your bedroom, although not necessarily the time on the dial. For individuals who experience difficulty falling asleep or frequent awakenings, seeing the time in the middle of the night or the progression of time can create stress or frustration, impeding sleep.
Furthermore, caffeine and alcohol are two substances that should be consumed sparingly by those struggling with sleep problems. Coffee drinkers can develop a tolerance to caffeine and consume amounts that disrupt their sleep. Alcohol, especially as we age, disrupts sleep patterns and reduces the time spent in deep sleep.
Understanding Insomnia: A Deep Dive with Dr. Maude Bouchard
Insomnia, the unwelcome guest that disrupts our sleep, can take many forms. Dr. Maude Bouchard, a neuropsychologist and director of research and development at the HALEO virtual sleep clinic, sheds light on the nuances between chronic insomnia and the sleep disturbances commonly experienced by those in professions with atypical schedules.
Chronic Insomnia: Beyond a Temporary Sleepless Night
While we all experience the occasional restless night, chronic insomnia is a different beast altogether. It’s characterized by persistent difficulty falling or staying asleep, occurring at least three times a week and lasting for at least three months.
While a typical adult requires around seven to nine hours of sleep per night, Dr. Bouchard emphasizes that individual needs vary. She clarifies that waking up a few times during the night isn’t necessarily a cause for concern, “Waking up three or four times and falling back asleep within minutes isn’t problematic. But if it takes half an hour or an hour to fall back asleep each time, then it becomes more of a concern.”
The Body’s Internal Clock: A Delicate Dance
Dr. Bouchard explains the vital role of our biological clock, a meticulous conductor orchestrating our body’s rhythms, including hormone fluctuations and body temperature. This internal clock, also known as the circadian rhythm, is synchronized with external cues, primarily light.
“Natural light during the day signals our brain to wake up, while the decrease in light in the evening triggers the release of sleep hormones, preparing us for restful slumber,” she clarifies.
Shift Work: A Challenge for the Body’s Rhythms
Individuals working atypical schedules, such as those who start their day at 3 a.m., disrupt these natural rhythms. While regular, atypical schedules have a less significant impact than irregular schedules, they still pose a challenge for the internal clock. “When our biological clock is programmed to signal sleep at a particular time, and we need to be awake, this creates a conflict,” adds Dr. Bouchard.
Professions requiring irregular hours, such as policing, firefighting, nursing, medicine, piloting, flight attendanting, trucking, and media, are prime examples of where insomnia symptoms are more prevalent.
The Hypervigilance Factor: A Unique Challenge for Certain Professions
Police officers and hospital staff face a unique challenge: heightened vigilance, often spilling over into their off-duty hours. Research conducted by HALEO Virtual Sleep Clinic underscores this, revealing a five times higher prevalence of insomnia among police officers compared to the general population. Furthermore, officers with poor sleep quality demonstrate a three to seven times higher likelihood of being diagnosed with anxiety, depression, chronic pain, substance abuse, or other mental health issues.
The nursing profession mirrors this trend. Studies indicate that 52% of nurses experience sleep disorders, although Dr. Bouchard notes variations in statistics can arise due to differences in the questionnaires used in different studies.
Hypervigilance, the constant need to be alert, further complicates the situation. “Police officers are trained to be hypervigilant, unfortunately, taking this tendency home with them,” explains Dr. Bouchard. “It’s even more challenging for professions requiring both nighttime work and heightened awareness of their surroundings.” This is also true for on-call doctors who are constantly on alert.
Adding to these challenges, police officers and hospital staff are more prone to developing post-traumatic stress, which is closely linked to sleep disorders and insomnia.
Solutions for a Restful Night: Exploring Options
Melatonin supplements, readily available over the counter, have gained popularity as a sleep aid. However, Dr. Bouchard stresses the importance of understanding their mechanism of action. “The goal is to synchronize the biological clock, not to induce sleep,” she emphasizes. She recommends taking melatonin two hours before bedtime and starting with the smallest dose, typically 3 mg.
Cognitive behavioral therapy for insomnia (CBT-I) is a powerful tool for those struggling with chronic insomnia. Patients are assessed for sleep quality and then guided through a personalized program by trained psychologists and social workers specializing in sleep issues. The program aims to address underlying maladaptive thoughts and behaviors contributing to insomnia.
Simple Strategies for Better Sleep
Beyond professional interventions, simple lifestyle adjustments can significantly impact sleep quality. Dr. Bouchard suggests removing the clock from your bedroom, or at least covering up the time display. “Constantly seeing the time while trying to sleep can increase stress and frustration, making it harder to fall asleep or stay asleep,” Dr. Bouchard explains.
Moderation is key when it comes to caffeine and alcohol. Caffeine intake can lead to tolerance, resulting in consumed amounts that disrupt sleep. Alcohol, particularly as we age, can fragment sleep and reduce the duration of deep sleep.
