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Myths about Insomnia Treatment

March 12, 2014

Although the mythology of the ancient Greeks can be easily dismissed today as belonging “to the region of poetry and fable, and not to that of history and real fact”  (Saint Augustine, City of God, Book 18, 8), people unwittingly accept certain contemporary myths surrounding aspects of daily life, even though those tales are also the products “of a picturesque imagination” (Saint Gregory the Theologian, Oration 2). With respect to the problem of insomnia, there are a number of myths that need to be articulated and exposed, so that they will not disorient the sufferer searching for some solution and solace. What is needed in approaching the time for dreams is not the imaginative world of mythos, but the ordered universe of logos, not the weaving of fables, but the setting down of facts about how to best proceed.

In his dissertation to which I have referred before, Alfonso Marino discusses the two most prevalent myths about insomnia that many accept without a second thought. On the one hand, many believe that insomnia is not really a medical problem, but just an irregularity that will go away on its own. On the other hand, others think it is exclusively a medical problem for which medication in the form of sleeping pills is the only answer. Both myths distort the truth that many discover after years of suffering. In fact, insomnia often does not inevitably go away on its own, but the irregularity becomes an unfailing reoccurrence. Even more troubling, pills are not only far from being the ideal, easy answer people suppose, but rather are a Pandora’s box of other serious difficulties such as dependence, tolerance, hangover, memory deterioration, potentially toxic drug interactions, serious falls during over-sedation, and even mortality! In the ancient world, sleeping potions were used as an anesthetic for surgical procedures, since “the soul can be lulled to sleep by drugs, which overcome the pain and produce in the mind a death-like forgetfulness of its power of sense” (Hilary of Poitiers, On the Trinity, Book 10, 14), but those drugs were never meant to be a daily remedy.

In addition to these misconceptions about insomnia that affect laypeople, there are other insomnia myths that even influence the medical community.  In their article entitled, “Insomnia Treatments:  Moving from Efficacy to Effectiveness,” authors Patricia L. Haynes and Richard R. Bootzin begin by addressing four myths related to insomnia.  The first myth concerns the medical community’s belief that in order to treat insomnia, one must be an expert in the field of sleep disorders, which in turn makes medical professionals hesitant about treating sleep disorder for fear of exacerbating the problem. The second myth is that if there is a co-existing mental disorder, then that disorder should be treated first, which will then result in the manifestations of insomnia dissipating on their own. The third myth is that insomnia is an inevitable part of a chronic problem such as aging or chronic pain.  In practical terms, this has a similar effect as outlined in the second myth.  Insomnia is not treated per se but viewed as something that will go away once the primary issue is addressed and treated.  Finally, the fourth myth relates to blanket, general statements that equate sleep hygiene and therapy as though therapy for insomnia was just a matter of education and not about specific changes in behavior.

All of these myths and misconceptions need to be put to rest before we can proceed on firm footing. Sleeping medication is not a good option, although in some cases it may be called for on a temporary basis. Insomnia is a medical problem, but not solely a problem for sleep specialists alone. Insomnia is not just the byproduct of another chronic condition, but is a long-standing condition to be addressed in its own right. Falling asleep is a behavior and changes in behavior may be necessary to bring about changes in sleep habits. In all aspects of life, theoria and praxis, ideas and actions, need to be united for a new state of affairs to be established.

The good news that remains, when these myths are put aside, is that a medicated stupor is not the only solution, nor does one need to bide one’s time until other emotional difficulties or chronic conditions are resolved. It’s not always necessary to turn to a sleep clinic. There are changes that can take place through monitoring thoughts and behavior that can be quite efficacious. Authors Haynes and Bootzin make their point effectively that cognitive therapy may prove helpful in treating insomnia.  They write, “Although sleep may be more difficult to initiate or sustain with some medical conditions, the development of an insomnia disorder is often the result of unhelpful compensatory behaviors associated with the chronic condition. This assertion is supported by studies showing how CBT-I is effective for sleep in older adults and in individuals with comorbid medical conditions, including fibromyalgia and osteoarthritis. As discussed above, insomnia operates independently via behavioral mechanisms and is responsive to change, even when other conditions are not. In fact, insomnia treatments are highly effective for most insomnia disturbances, regardless of attributed source of the disturbance or whether the original source of the disturbance is still occurring.”

Myths and preconceptions are part of our worldview. In Ancient Christian Wisdom, I note that “Worldviews, as they relate to psychology, provide background theories about human nature and the universe, a diagnosis of the human condition, and a prescription for its healing. In other words, they respond to four basic questions: Who am I? Where am I? What is the problem? and What is the cure?” The myths about insomnia can make it difficult to perceive the true problem and cure, because they present other problems and other cures. Deception is a problem in all aspects of life, physical, social, and spiritual. Some clear thinking about thought and behavior, however, can help individuals form a new inner and outer world. When this new state of affairs is infused with faith and trust in God, desired for rest is indeed nearer at hand. And that is in itself hopeful and refreshing.

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