From psychologytoday.com
KEY POINTS
- Quick fixes such as taking a nap or guzzling coffee are often used to help us cope with daytime sleepiness after a poor night's sleep.
- Naps and caffeine can make it harder to fall asleep at bedtime, which may increase the use of sleep aids. This can create a vicious cycle.
- Maladaptive strategies (naps, caffeine, sleeping pills) used to cope with insomnia can disrupt REM cycles and reduce sleep quality.
Most of us have struggled with bouts of insomnia or had sleepless nights. How do you cope with sleep deprivation the next day? Many people with insomnia overuse caffeine. Others might take a daily nap.
Unfortunately, coping strategies that involve caffeine or napping can make it harder to fall asleep at bedtime. Over-the-counter (OTC) sleep aids or prescription sleeping pills are often used to counteract night-time wakefulness caused by drinking too much caffeine during the day or dozing off for too long during a "cat nap."
The yo-yo effect caused by coping with insomnia using caffeine, long daytime naps, or sleep aids can feel like a roller coaster ride vacillating between extreme exhaustion and hyperarousal.
3 Maladaptive Coping Mechanisms of Sleep
- Caffeine
- Napping
- Sleep Aids
According to new research by Rhonda Winegar of Aspen University, so-called "maladaptive coping mechanisms of sleep" don't make insomnia better; they can make it worse over time. This exploratory pilot study (Winegar, 2022) appears in the March issue of the peer-reviewed journal Nurse Practitioner.
The cohort for this polysomnography-based pilot study included 137 patients who visited a sleep clinic between 2017-2019 seeking treatment for insomnia or obstructive sleep apnoea.
What Makes Maladaptive Coping Mechanisms of Sleep Counterproductive?
Maladaptive coping strategies can disrupt sleep quality in numerous ways. About two-thirds (66%) of patients with insomnia reported using caffeine to boost energy if they felt sleepy during the day. However, overusing caffeine led to increased problems with night-time sleep and created a vicious cycle.
About 25% of the people in this study reported taking daily naps, which can cause problems falling asleep at night. People who took regular daytime naps tended to use less caffeine and reported less sleepiness during the day. But at night, they experienced longer sleep onset latency (i.e., the time it takes to go from being awake to asleep) than those who didn't take naps.
Caffeine and Sleep Aids Disrupt REM Cycles
People taking prescription sleeping pills such as Lunesta, Restoril, or Sonata enter rapid eye movement (REM) slower than those who don't. On average, sedative-hypnotic drugs can delay REM onset by almost an hour (131 vs. 167 minutes). Notably, those who drank more than two cups of coffee per day also took longer to enter REM sleep.
Of the 137 people in this study, almost half (47%) took prescription sleep medications, and about 1 in 5 (19%) used OTC sleep aids.
The polysomnography data identified some short-term benefits of sleep medications prescribed by a health professional. Although prescription sleeping pills delayed REM onset, they also reduced sleep onset latency and increased sleep duration, meaning that people fell asleep faster and slept longer. Patients in this study who didn't take OTC sleep aids or prescription drugs slept for a shorter time and had more frequent night-time arousals (i.e., waking up in the middle of the night).
Long-Term Use of Sleeping Pills Can Lead to Dependency
Many sedative-hypnotic sleeping pills can lead to addiction or dependency and shouldn't be used for longer than two weeks; these drugs are not intended for long-term use. "Making small modifications to daily routines can help much more than prescribing hypnotics that have side effects and run the risk of dependency," Winegar said in a news release.
Overall, most people in this study used counterproductive strategies for coping with insomnia. Winegar says that "prioritizing sleep" is the most effective way to break the cycle of maladaptive coping mechanisms that can perpetuate chronic insomnia and poor sleep quality.
Take-Home Message: Prioritize Sleep and Avoid Quick Fixes
"Learning about good sleep hygiene and making some slight changes to their routines—going to bed at the same time, turning off the television and lights when in bed—can help [people] sleep better without the use of sleep aids," Winegar concludes. "Do not nap. Keep the same sleep hygiene routine and sleep schedule on all days."
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