Sleep expert Jade Wu, PhD, discusses the causes of insomnia and what to do—or not do—about it. Dr. Jade Wu is a clinical psychologist at Duke University School of Medicine and her current research focuses on treating sleep disorders in those with chronic illness.
Welcome to Headscratchers, a mini-cast from the Duke University School of Medicine. We ask Duke experts to help us understand the questions in science that have us scratching our heads. Today we’re speaking with Dr. Jade Wu, a clinical psychologist and sleep expert.
Dr. Wu, I’ve been sleeping well my whole life. Then, five years ago I developed insomnia. What’s keeping me up at night? And how can I get out of this rut?
I would say it almost doesn't matter why you got insomnia in the first place. Many people have different reasons for why they get insomnia. Maybe you moved, got a new job, had a baby, went through menopause. But what keeps you in the insomnia rut? What gives you chronic insomnia, is probably the same reason as everybody else. It's like insomnia lit a spark five years ago, but, over time, you've been putting on logs and keeping the fire going. So let's talk about how you can take those logs off.
If you have chronic insomnia, you're probably spending too much time in bed. So I know there's this magic number eight floating around in the ether, where we feel like we need to get eight hours of sleep, and you're just doomed if you don't, but that's actually not true. Not everyone needs eight hours. However, what happens when insomnia becomes chronic is that people are trying really hard to get those eight hours. So they spend a lot of time in bed, they cancel their evening activities to really “protect” their sleep (air quotes); they try to sleep in.
So if you spend too much time being sleepless, and awake, and frustrated, and angsty in bed, then your brain starts to learn that bed and being angsty go together. So every time you go to bed, it's almost as if a light switch flips on, because your brain is like, “Oh, I know what this place is; this is the place where we get angsty and, you know, very frustrated!” So then, of course, you’re not gonna fall asleep if you’re feeling that way.
The first thing I would do is set a really consistent wake-up time. So, instead of trying really hard to establish a regular sleep pattern by trying to calculate in your head how many hours you need, and when should you go to bed, I would just say get up at the same time every day, and be really strict about it -- like, boots on the ground when your alarm clock goes off. And what will happen is, even if you didn't get a good night's sleep last night, if you only got a few hours, that's okay because then you'll just be sleepier the next day, and, you know, eventually your body will regulate itself. Just remember that sleep is really resilient. Your body really, really knows how to do it, just like a knows how to breathe without you trying really hard. So, I wouldn't try really hard. I would just let your body figure itself out -- and go to bed only when you're sleepy, and not before that.
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