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Contents Acknowledgments iv Introduction: Why America Can't Sleep 1 1. The Insomnia Solution 28 2. How To Use This Book 89 3. Relax Your Body 121 4. Calm Your Mind 213 5. Lull Yourself to Sleep 311 Introduction: Why America Can't Sleep "Enjoy the honey-heavy dew of slumber: Thou hast no figures nor no fantasies, Which busy care draws in the brains of men; Therefore thou sleep'st so sound. -Shakespeare, Julius Caesar Do you have trouble sleeping? You are not alone. In a recent poll conducted by the National Sleep Foundation, more than one-half of the respondents had symptoms of insomnia at least a few nights a week. Thirty-five percent said that they experienced symptoms every night or almost every night in the past year. Since September 11, 2001, sale of sleeping pills have soared by 25%, and anti- anxiety drugs are up nearly 10% according to the chief of integrative medicine at Memorial Sloan-Kettering Cancer Center in New York. And Dr. Carl E. Hunt, director of the National Center on Sleep Disorders Research, estimates that there are as many as 70 million problem sleepers in the US. By all accounts, the US is suffering from an epidemic of sleeplessness. We may chuckle when we see someone nodding in front of the TV, in a movie, or during a political speech. "Poor fella needs a vacation!" we think, without much compassion. But sleep problems and sleep deprivation are no laughing matter. Sleep-challenged people are irritable, inattentive, and accident-prone. They are more likely to suffer depression, heart disease, or stroke than their well-rested peers. A 1999 study reported in the journal Sleep notes that insomniacs suffer impaired concentration, impaired memory, decreased ability to accomplish daily tasks, and decreased ability to enjoy interpersonal relationships, and increased use of health care services. The Archives of Internal Medicine notes that insomnia sufferers are more likely to develop affective disorders, heart disease, and other adverse health outcomes. Another study puts it more bluntly: "Insomnia is predictive of cardio-vascular and non-cardiovascular disease." An study of the hormonal consequences of sleep deprivation was conducted by the University of Chicago's Eve Van Cauter and associates at a Belgian University. They found that restricting sleep to four hours per night brings disturbance in the activity and timing of several important hormones including cortisol, melatonin, leptin, thyroid hormones, and prolactin. "Since these alterations are qualitatively and quantitatively similar to those observed during aging and sometimes during depression, a state of sleep debt, as is experienced by a substantial fragment of the population in modern societies, is likely to increase the severity of depression and widespread age-related chronic conditions such as obesity, diabetes, and hypertension." Numerous studies associate insomnia with reduction in immune function. One, conducted at a German university, investigated measures of immune defense as well as subjective well being and psychosocial performance in ten healthy males before and after sleep deprivation and again after recovery sleep. Sleep deprivation evoked not only decreased function of the immune system, most clearly visible on the morning following the sleepless night, but also deterioration of both mood and ability to work, which were most prominent the following evening. The list of health consequences of insomnia goes on. It would take the rest of this book to detail all the negative health effects of sleep loss, though is not our purpose here. Perhaps a monetary estimate will best suggest the full scope of the problem. According to one estimate, sleeplessness costs $15.9 billion a year in health-care costs alone. Accidents are another serious consequence of the insomnia epidemic. The National Highway Traffic Safety Administration attributes over 100,000 automobile crashes per year are to drowsy drivers, with 1500 fatalities, 71,000 injuries, and a monetary cost of $12.5 billion. A British study revealed that drivers who report moderate to severe daytime sleepiness (about 20% of all drivers) are twice as likely to have been involved in a crash as other drivers. Yet 37% of respondents to an NHTSA poll said they have fallen asleep behind the wheel, 8% in the last six months. But accidents don't only occur on the road. Do the names Bhopal, Chernobyl, and Exxon Valdez ring a bell? Sleep deprived workers were implicated in each of these industrial disasters. Insomnia plays no favorites, either: our doctors, our police, our pilots, and our military personnel, all those charged with protecting our lives, are just as likely as the rest of us, perhaps more so, to suffer insomnia and sleep deprivation. Does it matter? Of course. Sleep deprivation wreaks havoc with our physical, cognitive, and intellectual abilities. One study of motor and sensory performance during and after experimentally induced sleep deprivation found a general reduction in overall response speed, a decrease in the speed of the fastest responses, and an increase in "lapsing"-delays in responding to stimuli-which in turn produced further decreases in response speed. Mark Rosekind, a consultant on industrial sleep hygiene, says that many pilots, policemen, and doctors admit to making errors in sleep-deprived states. According to his findings, cited in Business Week, 19% of health care workers report worsening a patient's condition because of fatigue; 44% of law enforcement officers report taking unnecessary risks while tired; and 80% of US regional pilots say they've fallen asleep in the cockpit. William C. Dement, in his book The Promise of Sleep, describes tests Rosekind conducted on commercial pilots during long haul flights between the West Coast and Japan. He found that pilots' reaction times during these prolonged flights often dropped 25%, and they frequently lapsed into "microsleeps" lasting 5 to 10 seconds or more. These lapses of consciousness occurred not only in mid-flight but, even more alarmingly, during takeoffs and landings. A recent US Army study suggests that combat stress and sleep deprivation may affect soldiers so badly that they perform as if they were drunk or sedated. Ill effects include slower reaction times, reduced vigilance, and problems remembering key details. The bottom line? Estimates of the total monetary cost of insomnia and other sleep disorders, including medical, property damage, industrial accidents, absenteeism, and lost productivity, approach $45 billion per year. This is a huge cost for society to bear. But the human cost is far higher. Sleeplessness threatens our jobs, our relationships, and our health. It is a major public health issue that affects the quality of life of millions of people. On the brighter side God bless the inventor of sleep, the cloak that covers all men's thoughts, the food that cures all hunger...the balancing weight that levels the shepherd with the king and the simple with the wise. -Miguel de Cervantes , Don Quixote Now you know the dark side of sleep. Fortunately, there is a brighter side, too: sleep, when we get the right quantity and quality of it, is nature's best medicine- a universal tonic that boosts our energy and vitality, elevates our mood, quells anxiety, and enhances our ability to learn and remember. When we are well rested, we're more at peace with the world around us, and with our fellow human beings. We're more patient and compassionate. Recent research even indicates that sleep makes us smarter and more creative! But here no scientific data is really required, because anyone who has ever endured a string of sleepless nights and dragged through the days that follow them knows what a relief it is to awaken from that first, full night of blissful, restorative slumber. Suddenly the world seems to a brighter, kinder, gentler place. We feel happier, stronger, and smarter. We feel more balanced and relaxed, more alert and alive. Scientific research does confirm these subjective feelings about sleep. After centuries during which sleep was believed to be merely a quiescent state of brain and body, contemporary science is beginning to identify numerous, positive benefits conveyed by natural, restful sleep. In the brain, lower metabolic rates and brain temperatures during quiet sleep provide an opportunity for brain cells to recover from oxidative damage done by free radicals during waking. Most regions of the brain cannot regenerate cells as other organs do, so this sleep-dependent repair work is essential for keeping the brain in good working order. The active, or REM, phase of sleep, which is when we do most of our dreaming, brings a temporary cessation of release of the essential neurotransmitters norepinephrine, serotonin, and histamine. This brief respite, which comprises about 20% of total sleep time, allows the receptors for these neurotransmitters to rest, restoring them their appropriate levels of sensitivity. The restored sensitivity is thought to play an important role in regulating mood during waking hours. As we have seen, sleep deprivation depresses the functioning of the immune system, but the converse is also true. A good night's sleep has a wonderful restorative effect on our body's defense system. In one experiment, a group of 19 healthy people were given a hepatitis vaccination followed by either a full night of sleep or a night of sleep deprivation. Four weeks later, the sleep group exhibited nearly two-fold higher HAV antibody titer, indicating a considerably more robust immune response. Sleep is unquestionably the most effective stress reduction technique we will ever know. The demands of daily life can overcharge the sympathetic branch of the autonomic nervous system, triggering the so-called "fight or flight" mechanism that launches mind and body into overdrive in response to stress, and keeping it there for prolonged periods. Sleep, particularly deep sleep, effectively rebalances the system, giving the parasympathetic branch, which governs our ability to "rest and digest," a chance to assert itself. In this way sleep moderates the effects of stress and switches the body into self-healing mode. Watching your weight? Deep, restful sleep is something you can't do without, according to van Cauter. Human growth hormone (HGH), which drives the growth of living tissue during childhood, in adulthood takes on the job of regulating weight, among other functions. And HGH is only secreted during deep sleep. Without sleep, even the most ardent weight watcher will experience plenty of frustration, but not much weight loss. Can sleep really make you smarter or more skillful? It may well be. A large number of studies offer extensive evidence supporting this role of sleep in what is becoming known as sleep-dependent memory processing. These studies indicate that what we learn during waking hours requires distinct periods of consolidation before it is finally retained in our memories and reflected in our abilities. The simple passage of time does part of the job, but sleep has the unique capacity to enhance the process. In one study done at Harvard, subjects trained in a finger-tapping task at either ten in the morning or ten in the evening were tested immediately following training, and again twelve hours later without further training. The morning group, who had remained awake for the twelve hours following training, displayed modest gains in speed and accuracy of performance. But the evening group, who received a full night of sleep before the retest, scored startling performance gains averaging twenty percent for speed and thirty-nine percent for accuracy as compared to the no-sleep group. Additional gains were seen over the following two nights. Similar results have been obtained in auditory and language learning tasks, visual texture discrimination tasks, and others. Another study conducted at the University of Lubeck in Germany, published in Nature, suggests that sleep brings insight, helping us to find creative solutions to difficult problems. In the study, 106 volunteers aged 18 to 32 were asked were asked to solve a "number reduction task" in which they could gradually improve their score by increasing their response speed with each round. However, they could also improve abruptly by gaining insight into a secret abstract rule underlying all the sequences. After initial exposure to the task, a third of the participants slept eight hours, another third were kept awake, while a third group was retested after eight hours of waking activities. Upon subsequent retesting, participants in the sleep group were twice as likely to discover the hidden rule as members of the other two groups. This research has great significance for both children's school performance as well as workplace productivity and creativity. Want to excel in school or industry? Be sure to get plenty of sleep. Want a strong immune system? Sleep. Want vibrant good health, happiness, and a trim figure? Sleep, sleep, sleep. Chronic insomnia and sleep disorders are medical problems, and therefore beyond the scope of this book. If you experience sleeplessness or other sleep-related symptoms for a week or more, please see your doctor or other medical provider and work with him or her to discover and alleviate the causes of your problem. Of course, once you've addressed all of the medical issues, you are welcome to return to these pages for help in restoring your natural, human ability to fall asleep and sleep through the night. What is presented here is applicable to anyone who wishes to learn how to encourage and amplify those natural, God-given processes that enable us to get the rest we need. However, many people experience transitory insomnia with no apparent medical cause. They exhibit no diagnosable medical condition, other than an inability to sleep for one or several nights. The condition may come and go, it may disappear for a time, it may recur. That doesn't make it any less troubling! If that sort of transitory insomnia is what ails you, this book is for you! Dive right in, and you will learn what you need to know to fall asleep effortlessly at bedtime, and to return to sleep quickly should you awaken during the night or early morning. Stress: the principal cause of insomnia What causes the transitory insomnia that plagues so many millions of us? And more importantly, why is it happening to you? The short answer is, stress. Stress is the principal cause of insomnia. But what is stress? Everyone talks about stress, and everyone suffers from it at one time or another, but when we come right down to it, we're not really sure what stress is. So let's try to clarify it a bit. Any healthy animal, whether it's a jellyfish, your family dog, or you, exists for the most of its life in a state of homeostatic balance. That means that certain essential measures of vitality-fluid balance, caloric intake, temperature, and so on-are kept close to the ideal "set-point." This allows the organism to function at its peak potential. A stressor is anything that throws that fundamental balance out of whack, and stress is the variety of physical responses that the organism uses in attempting to restore it. In humans, the stress response begins with the release of two hormones from the adrenal glands: epinephrine and cortisol. The two hormones channel extra energy to the muscles and boost blood supply to allow quick action in response to the stressor. At the same time, they withdraw energy from processes that aren't needed for short-term survival, like growth and digestion. The stress response is often triggered by an acute physical threat or demand- fleeing from a predator is the most often cited example-but it can also result from less dramatic factors such as heat or cold, scarcity of food or water, exposure to pollutants or toxins, immobilization, crowding, noise, darkness and, yes, lack of sleep. Then there are the intangibles, like fear, anger, grief, uncertainty, even extreme joy. All of these things are stressors, all of them are capable of provoking a stress response. When the average animal encounters a stressor, its body produces a stress response for only as long as necessary and then returns quickly and efficiently to its previous homeostatic state. But humans and other primates are not your average animal. For them, the stress response can be triggered not only by real threats, but also by the mere anticipation of one. Sometimes, if stressful events persist for a long time or recur with great frequency, or even if we just anticipate that they will, the stress response becomes a more or less permanent state of affairs. When the stress response becomes the norm rather than a transitory state, then we are in for some real trouble. In the homeostatic state, our bodies conserve energy, using only what is necessary to maintain the balance of life. But with the stress response, there is a generalized increase in our metabolic rate: our pulse quickens, our blood pressure and oxygen consumption soar, our muscles tense, and our body temperature runs hotter than normal, as if to prepare us for immediate action. But this is far more energy than we can afford to spend on a regular basis. While the purpose of the stress response is restore the body to balance, prolonged or unremitting stress creates serious imbalances of its own. By keeping all our bodily systems in a constant state of alarm, it eventually wears us out. It's no wonder that stress plays a role in the development of so many diseases, from heart attacks and stroke to anxiety and depression, diabetes, ulcers, colitis, and cancer. So where does insomnia fit into this picture? How does stress cause insomnia? To understand that, we must first know a little bit about the physical processes that occur when we fall asleep. Falling asleep is a natural process that involves a distinct sequence of events in the body. As we approach sleep, there is a gradually lowering of metabolism. Our heart rate slows and our blood pressure declines. Our breathing becomes more regular, and we consume less oxygen. Our postural muscles, which have worked all day to keep us upright and moving about, now relax. At the same time, there are changes in the processing activity of the brain. The activity of neurons in the cerebral cortex becomes first slower, and then more synchronized, indicating a shift away from the complex, activated patterns of waking consciousness, toward a homogenous, deactivated state. As a result, we cease to process the sensory messages coming in from the outside world, and we slip into quiet sleep. If we compare this description of the sleep-onset process with the description of the stress response in the preceding paragraph, it becomes very obvious that these are two antagonistic processes. Falling asleep involves a decrease in metabolism, and a gradual cessation of readiness for action, while the stress response involves a rapid increase in metabolism, sending the organism into a state of preparedness for action. The sleep process decreases arousal, making us less alert, while the stress response, increases arousal, making us more so. You'll remember we mentioned that the adrenal hormone cortisol was a trigger of the stress response. That's not cortisol's only job, however. In addition to the sharp transitory peaks of cortisol secretion that characterize the stress response, there is also a daily, cyclical rise and fall of cortisol levels that governs our level of wakefulness throughout the day and night. Cortisol is excitatory; it arouses us and wakes us up. Blood levels of cortisol have been shown to increase between 50 and 160 percent within thirty minutes of waking; that produces the powerful jolt of arousal needed to wake us up and get us moving in the morning. Then, cortisol levels decline as the day wears on, and reach their lowest point in the evening, allowing us to rest, relax, and sleep. But, as we know, cortisol levels can also be affected by the conditions of our daily existence. Dangerous, demanding, or threatening events-stressors-cause us to temporarily secrete higher levels of cortisol. That's a good thing, because we need to be aroused in order to answer the challenges that arise in the course of our lives. But when, as a result of prolonged or unremitting stress, whether real or perceived, our cortisol levels get stuck at a chronically higher level, that's bad news for our bodies and minds, and especially bad news for our ability to sleep and rest. Chronic over-secretion of cortisol leaves us chronically hyper-aroused. Numerous studies indicate that insomnia is accompanied by excessive activation of the stress-response system not only during waking hours but during sleep as well. Furthermore, chronically elevated levels of cortisol and its precursor, ACTH, can make sleep shallow, fragmented, and unrestful, delay the onset of sleep, and produce more frequent nocturnal awakenings. To summarize: Stress is the principal cause of insomnia. Stress hormones are excitatory. When stress becomes chronic, we become chronically excited, or hyper-aroused. When we're chronically hyper-aroused, we can't sleep, and the sleep we do get is not as restful. The big question: How much sleep do you need? This is the question I'm asked most frequently, and it's a tricky one. Each person's needs are different, not only for sleep but for all aspects of life. So there are probably as many ways to answer the question as there are people! To approximate any kind of an answer I would need to know: What is your age? What is the state of your health? What are your personal sleep rhythms? What is your profession? What is your work schedule? What is most important to you in life? What are your dreams, your aspirations? What is your life's purpose? When we know all of that and more, we can see how sleep fits into the total picture, and we can start to come up with an individual answer. In my private practice, I often spend quite a bit of time helping my clients discover how to balance their needs for sleep, rest, and repose with all the other aspects of their lives. Of course, I cannot give an individual answer for each reader. I have to say something general that will be helpful to each of you! So here goes. Before Thomas Edison's invention of the light bulb and the advent of artificial lighting, it is believed that Americans slept an average of 10 hours a night. Medical science currently recognizes 8.4 hours of sleep per night as the average sleep requirement for general good health, while recognizing that some people can get along fine on an hour or two less and some people need an hour or two more. While I don't disagree with that general rule of thumb, my perspective is a little different since I view sleep as not merely a medical matter, but a personal and spiritual one. My interest is not only in general health, but in personal growth, pleasure and self-healing as well. It is my belief that we need something like eight hours of sleep per night, give or take an hour or two, but we can use a whole lot more. You see, I believe that there are parts of each one of us that are in a state of profound un-rest, and that these parts of ourselves require more than ordinary nightly sleep to be fully rested, and fully healed. To make an analogy with nutrition, we all know that there is a Minimum Daily Requirement (MDR) set by the government for certain nutrients - Vitamins A, C, and E, calcium, magnesium, etc. The MDR for a given nutrient is the amount you need to maintain general health. But, as you may be aware, these same nutrients can be taken is larger doses to enhance our overall vigor and vitality and, in the case of illness or injury, to support healing. The same goes for sleep. That 8.4 hours, give or take two, is your MDR for "Vitamin S," sleep. That's a medical necessity! Still, you can take higher doses of sleep to dig down into those deeper recesses of yourself that need resting, nurturing and healing to help them to regain their full vitality, their full aliveness. These pleasurable, all-natural "sleep supplements" may include minutes or hours added to your usual bedtimes, as well as daytime naps, breaks, and periods of deep relaxation, introspection, meditation, daydreaming, and anything else that helps you to maintain a more peaceful existence. All of the mini-moves presented in this book are designed to help you do just that. The other big question: How many hours should you spend in bed? People so often wonder how many hours of sleep they need, but they rarely think about how many hours it might take to get them. The question is one of efficiency: how many hours does it take to get 8 hours sleep? If you really think about it, you'll see that it takes considerably more than eight hours! Or, to put it another way, eight hours in bed is not the same thing as eight hour's sleep. Here's why: Let's say you go to bed at 11 p.m. and you plan to wake up at 7 a.m. In other words, you're planning to spend eight hours in bed. How much sleep will you get during those eight hours? To answer that, first ask yourself, how long does it take you to fall asleep? Five minutes? Ten? Twenty? Or more? It is perfectly normal to experience some lag time between hitting the pillow and actually drifting off to sleep (scientists call this the sleep latency period). To be accurate, we really can't count that latency period as part of the sleep total. So, when you calculate how much sleep you've had, please do subtract that lag time from the eight hours you spend in bed. Ask yourself, too, do you tend to have periods of wakefulness during the night? Do you observe a nightwatch, awakening to muse or meditate some time during the late night or early morning? That's normal, too, and it can be richly rewarding, but how much does it detract from your actual snooze time? Finally, what about the morning? Do you wake up ten, twenty or thirty minutes before 7 a.m., just lying there, luxuriating in the waning moments of bedtime? That's an agreeable way to start the day! However, when you calculate your sleep time, that gets subtracted that from the total. So let's say you spent twenty minutes drifting off, twenty for the nightwatch, and twenty minutes lying in the gold of dawn. There goes sixty minutes of sleep right there! You got into bed at 11 and you got out eight hours later, but you only slept for seven hours! The bottom line is, depending on your sleep style, it may take considerably longer than eight hours to get eight hours sleep. Of course, this is only an example, and your own sleep needs and your sleep schedule may vary considerably. For that reason, I strongly suggest that you perform a similar calculation for your own bedtime habits, and determine exactly how much sleep you actually get. You may be surprised! As a result, you may wish to adjust your sleep schedule, allowing more time in bed so you can get the rest you need. Sleep on it! Sleep medication: Cold comfort Sleeping pills are currently a $2 billion industry, and for the pharmaceutical industry that's just an appetizer. An article in Business Week cites industry estimates that the market will more than double, to $5 billion by 2010. "This is unquestionably one of the largest potential pharmaceutical markets in the world," opines pharmaceutical executive Gary A. Lyons, quoted in The New York Times. This rosy forecast is based on the finding that only 40% of insomnia sufferers have been diagnosed, and of those, only about half are receiving treatment and fueled by the expectation that new drugs entering the market will work more reliably than existing preparations, and find greater acceptance among consumers. Industry-sponsored public-opinion campaigns begun years ago engender the belief that drug treatment for insomnia is on the one hand medically necessary, and on the other as natural, safe, and unremarkable as taking an aspirin for a headache. But is it? It's telling to note that a recent study conducted at the Harvard Medical School found that half a dozen sessions of cognitive-behavioral therapy can do more to help a troubled sleeper than the top selling sleeping pill. CBT is a form of talk therapy previously proven to be highly effective for depression. The therapy addresses the root causes of insomnia-stress, worry, fear, anxiety-and teaches the patient to handle them more effectively. To me, that seems a much safer and more appealing solution than drugs. And by the way, the deeply relaxing movement and breathing techniques presented in this book are completely compatible with all psychotherapeutic approaches. The therapy addresses the emotional and behavioral roots of your problem, while the movement techniques restore your inborn ability for natural, restful sleep. Of course, swallowing a single pill at bedtime would be quicker and require less attention on your part. But I think you're worth a little extra time and attention, especially when the end result is likely to be safer, better, and longer lasting. I personally have no qualms about sleeping pills as a last resort. I'm glad they're available to folks who are enduring pain, illness, side effects of chemotherapy, or overwhelmingly stressful life events, and who would otherwise go sleepless for long periods. In those cases I consider sleep medication to be a blessing. Why should people suffer when we have medications that can help? However sleep medication has become the first, rather than the last resort, even for short-term, transitory insomnia. "Missed a couple nights, sleep?" say our doctors with increasing frequency, "Here's a sample. Take as needed." It's easy to start on sleeping pills, but it's not always easy to stop. Much of my private practice consists of people who are terribly eager to wean themselves off sleeping pills, most of them in the grip of a single best-selling brand. They welcomed sleeping pills as an easy ride to sounder sleep, and now they find they can't get off the merry-go-round. Although they may not be technically "habituated," they may struggle "rebound insomnia," sleeplessness that results when sleep drugs are withdrawn. After a period of time in which the sleep-wake rhythm was controlled by a drug rather than the body's natural time-keeping mechanisms, it can be hard for mind and body to resume their former duties. Even if you're suffering rebound insomnia, don't despair! If you're truly committed to your own self-healing, the insomnia solution presented in this book can help you. If you're considering trying sleeping pills, here are four questions I suggest you ask your doctor-and yourself. First, how will sleeping pills affect the quality of your sleep? Is the sleep you get with a pill equivalent to the natural, restful sleep we were born to enjoy? Or is it just an imitation of the real thing, like coffee creamer or a Dynel hairpiece? Bear in mind, sleep is more than just going unconscious for eight hours. Just as a balanced meal contains all the essential nutrients in precise proportion, natural sleep contains all the essential stages of sleep in precise proportion, too. Disturb that essential balance of sleep, as many medications are known to do, and you may get something quite different. What does modern science say on the subject? Is there any research to guide you? Sadly, not much. Research takes lots of money, and most studies on sleeping drugs are funded by the manufacturers themselves. They are interested in how long a drug takes to act, how long its effects last, and what the side effects are. That's about as far as it goes. Second, what are the long-term effects of sleeping pill use? Sleeping pills can't actually cure insomnia. They are at best a stopgap solution designed to tide you over until the causes of the problem abate. Bear in mind that no sleeping pill has ever been tested or approved for more than short term use-a month at best. Yet many troubled sleepers take them for months or even years. What are the health effects? What are the consequences? We can't be certain. Third, how long will the drug retain its effectiveness? Many sleeping pills work one way when you start, and quite differently a month or two later. Your body and mind may become desensitized to the drug's effect. You might need to add another drug, and then another, just to get the same effect you started with. Not a few people end up taking several drugs, every night at bedtime, without a cure in sight. I have clients who take three different sleep medications every night; Dement reports patients who take as many as eight. Fourth, what's the exit strategy? How long should you plan to use this drug, and what will it take for you to stop? Will you experience rebound insomnia? Please discuss these and any other questions you may have with your doctor or other health care provider before embarking on a course of sleep medication. With your doctor's consultation, and a bit of your own research, you can make the decision that's right for you. Even if you do decide to go the medication route, I hope you will choose to learn the gentle sleep-inducing exercises in this book as well. They will make your daily life more peaceful, thereby hastening the day when you won't need sleeping pills anymore. And when that day comes, the gentle, synchronized movements and breathing will put the healing power of natural, restful sleep will be quite literally right at your fingertips. The "Sleep Switch" and How to Flip It Over 70 years ago, a gifted neurologist named Constantin van Economo speculated that there were physical structures in the brain that were responsible for sleep and waking. He postulated a wakefulness center in the posterior hypothalamus and a sleep-promoting center in the preoptic area. Twenty years later a Dutch neurologist, Nauta, discovered that an incision in the front of a rat's hypothalamus interfered with its ability to sleep and one in the back of the hypothalamus sent it into a coma. But the exact location and character of the neurons responsible was unknown. Recently, building on these earlier discoveries, a team at Harvard Medical School has located two centers in the rat brain, which they believe comprise the "sleep switch" in the human brain. As predicted, the ventrolateral preoptic nucleus (VPLO), in the front of the hypothalamus, contains neurons that are active during sleep, while the posterior lateral hypothalamus contains neurons that are crucial for maintaining normal wakefulness. It seems that these two centers carry on an ongoing neurological tug-of-war in which each center attempts to inhibit, or suppress, the other's activity. Whether we're awake or asleep at any given moment depends on which of these centers is dominant at the time. Taken together, these interdependent structures are said to constitute a "sleep switch" that, when it's functioning properly, keeps us awake during the day and asleep through the night. By the same token, disruption of the communicating pathway between the two structures may be a cause of insomnia and other sleep disorders. Reports of these discoveries have caused a stir in the media, even making it to the cover of Newsweek. Much of the excitement centers on the search for new sleep drugs. Now that they think they know where the "sleep switch" is located, scientists plan to invent new drugs that will allow us to flip it "on" whenever we like. The hope is that the new drugs, rather than sedating the entire central nervous system, might act more specifically on the centers that actually control sleep, providing something closer to natural, restful slumber than existing sleep preparations, without the side effects, potential drug dependency, and unpredictable results. My response to the discovery of the alleged sleep switch is a bit different. I welcome the discovery as a scientific elucidation of something I already know in my own experience. For I have known for some time how to flip the sleep switch without drugs, without any artificial aids whatsoever. And I can teach it to you, too. Using the simple, immediately available tools of physical movement and breathing, you can learn to throw the sleep switch whenever you need to. In doing so, you needn't introduce any foreign substances into your body. Rather, you can switch on your body's innate faculty for healthy, restful sleep simply by acting in perfect accord with Nature's laws and your own deepest needs. And it won't cost a penny. That's what we're going to talk about in the next chapters.
Library of Congress Subject Headings for this publication:
Insomnia -- Popular works.
Sleep.