In matters of survival, the rule of three serves to orient oneself in situations of maximum risk. It is said that the human being can spend, at most, three minutes without breathing, three days without drinking water and three weeks without food. Regarding sleep, some experts claim that the maximum is also three days without sleep. After 72 hours of total rest deprivation, you can be at risk of death. “I went for eight days where I barely managed to sleep an hour or two at most. I took up to six benzodiazepines in a row, but they did nothing for me. It was like drinking water.”
Raimon S. suffered an episode of severe insomnia for months. When he got into bed, he cried helplessly, because it had never happened to him. “Just thinking about going to bed gave me terrible anxiety. The closer the night got, the worse it got.” Of course, he has managed to recover. “I was prescribed a very strong sedative. I started to sleep a few more hours continuously, until I left it to incorporate the melatonin. Thanks to this, and following strict routines, I now usually get several days of sleep a week.”
“We must understand that not being able to sleep must be classified as a symptom. That is to say, that most of the time it has a cause”, says Eduard Estivill, specialist in sleep medicine. The reason, he adds, can be anything from a pathology or disease to a lifestyle. “People who drink too much stimulants, who use drugs or who work at night tend to have more trouble sleeping. Diseases such as Alzheimer’s, psychiatric problems, thyroid disorders and chronic pain also lead to sleep problems.” Most cases “have their origin in the strenuous pace of life we ??lead”.
According to the Spanish Society of Neurology (SEN), between 20% and 48% of the Spanish adult population has difficulty initiating or maintaining sleep. As for children, the percentage is 25%. In total, close to 12 million Spaniards lack a good quality of sleep. Of the latter, 4 million have chronic or serious disorders. Less than a third seek professional help. According to Estivill, to maintain good sleep hygiene and start a treatment to overcome a period of insomnia, it is essential to have good habits during the day.
The treatment to be given depends on the diagnosis. There is a common denominator among the people who go to your consultation: they want to solve it immediately. “Many tell me: ‘Yes, following these routines is very good. But today, what do I do? How do I sleep?'”. It is, he points out, a disorder that does not have an immediate resolution.
One of the most important rules is to follow, as strictly as possible, a series of routines during the day. Eat healthily, follow meal times – 8 am for breakfast, 1 pm for lunch and 8 pm for dinner are the most appropriate, according to Estivill – do sports, expose yourself to sunlight during day and reduce activity before going to sleep is essential. “Sport, moreover, is preferable to do it in the morning, since the sunlight contributes to melatonin being generated naturally during the night”, he adds.
Albert C. has overcome insomnia. “I had been sleeping badly since I turned 18, but from the age of 45 a horrible stage began”. He explains that he had to resort to taking up to five benzodiazepines to sleep two or three hours a day. When he got up, he had to drive to work. From Barcelona to Vilafranca del Penedès: almost an hour. “There were days when it seemed like a miracle to have arrived. Once there, the stress he suffered increased as the hours passed.”
In his case, the solution was based on making several decisions. The first, solving the most urgent problem: getting a divorce and leaving home. Then follow a doctor-controlled regimen of anxiolytics with antidepressants. The latter, as a side effect, also induced drowsiness. Finally, and what stands out as the most effective, follow a strict routine. “Although I overcame the severe insomnia, I continued to have problems sleeping. In the end, it’s about trying methods, trial and error. Always following the same routine before going to bed has helped me a lot.” For example, reading articles on the electronic tablet. “I lower the brightness and try to make it nice and quiet subjects. Nothing that talks about facts that could leave me with discomfort”. Podcasts and audiobooks also help you fall asleep.
Ignasi E. had episodes of somnambulism until the age of 30. “It affected the whole family. There was a time when the situation was unsustainable: I opened my eyebrow late at night against the door frame. In his case, the therapy consisted of taking very low doses of paroxetine – used to treat depression and anxiety – for a few months, combined with a complete change of routine. One of the aggravating factors, he confesses, was the stress at work.
“I started to have a lighter dinner. Do sport in broad daylight, try to sleep a minimum of seven hours a day and avoid films, series or stimulating situations in the hours before going to sleep”. Thanks to this, for more than 20 years Ignasi has not suffered episodes of somnambulism that affect his rest. “Now, as the years go by, I have become stricter with my habits. It changed my life completely.”
We spend, on average, almost a third of our lives sleeping. A person who is 90 years old, for example, will have spent nearly 30 of them sleeping. “Although for some people it may seem like a waste of time, without these 30 years of rest the remaining 60 years of vital activity could not exist”, concludes Estivill.
