“Here we go again,” you think. Another night, another wake-filled night. Each tick of the clock, louder than the last. Each thought heavy, important, cycling. “How long until I get to sleep this time?” you wonder. Your chest tightens. “Is there something wrong with my heart?” you think. You worry about worrying. Your body, chest and breath are tight, you are rigid like a board. “Will this ever end?” you ask, the void echoing through the chambers in your ears. Another tick. It’s only been a minute. Your eyelids are heavy. You are exhausted. And yet you are wide awake.
To meet criteria according to the DSM, the following criteria need to be met: Unhappiness with the quality or quantity of sleep. Examples include, trouble falling asleep, staying asleep or waking up early and being unable to get back to sleep. The sleep disturbance causes significant distress or impairment in functioning. Difficulty sleeping occurs at least three times a week and is present for at least three months. The problem occurs despite ample opportunity to sleep. The difficulty cannot be better explained by other physical, mental, or sleep-wake disorders.
The art suggests someone who is restless, that is consumed by the clock during the night. The body adjusts itself, and the eyes tell a story of sad weariness.
Insomnia is a 24-hour brain condition, like a light switch that is always on. Individuals with insomnia cannot turn on brain regions critical to working memory tasks, as well cannot not turn off “mind-wandering” brain regions irrelevant to the task. Unable to recruit resources from the dorsolateral prefrontal cortex, and to dial down the “default mode” regions insomniacs have measurable abnormalities of brain activity.
Treatment options include biofeedback including heart rate variability, breath training, progressive muscle regulation, Cranial Electrostimulation (CES), cognitive behavioral therapy, and activities/supplements to lower neuroinflammation.