What causes insomnia? - Dan Kwartler

譯者: Lilian Chiu 審譯者: Regina Chu

What keeps you up at night?

是什麼讓你夜裡仍然清醒？

Pondering deep questions?

思索很深的問題？

Excitement about a big trip?

興奮期待一場大旅行？

Or is it stress about unfinished work,

或是壓力，擔心未完成的工作、

an upcoming test,

即將到來的考試，

or a dreaded family gathering?

或可怕的家庭聚會？

For many people, this stress is temporary, as its cause is quickly resolved.

對許多人，這種壓力是暫時的， 成因很快就能被解決。

But what if the very thing keeping you awake was stress about losing sleep?

但如果讓你無法入睡的原因， 就是擔心睡不著的壓力呢？

This seemingly unsolvable loop is at the heart of insomnia,

這似乎無解的迴圈 就是失眠的核心，

the world’s most common sleep disorder.

失眠是世界上最常見的睡眠障礙。

Almost anything can cause the occasional restless night -

幾乎任何事物都能造成 夜間偶爾的焦躁——

a snoring partner,

打呼的夥伴、

physical pain,

身體上的痛苦，

or emotional distress.

或情緒煩惱。

And extreme sleep deprivation like jetlag can throw off your biological clock,

極端的睡眠剝奪，比如時差， 可能會打亂你的生理時鐘，

wreaking havoc on your sleep schedule.

破壞你的睡眠時間表。

But in most cases, sleep deprivation is short-term.

但在大部分的案例中， 睡眠剝奪是短期的。

Eventually, exhaustion catches up with all of us.

最終，每個人都還是會精疲力竭。

However, some long-term conditions like respiratory disorders,

然而，有些長期的病症， 比如呼吸障礙、

gastrointestinal problems,

胃腸問題，

and many others can overpower fatigue.

以及許多其他狀況， 都可能壓過疲累。

And as sleepless nights pile up,

隨著難以入眠的夜晚逐漸累積，

the bedroom can start to carry associations of restless nights

臥房開始會和因焦慮 而睡不著的夜晚

wracked with anxiety.

產生關聯性。

Come bedtime, insomniacs are stressed.

睡覺時間到了， 失眠患者就感到壓力了。

So stressed their brains hijack the stress response system,

壓力大到他們的大腦 會劫持壓力反應系統，

flooding the body with fight-flight-or-freeze chemicals.

讓身體充滿了「戰鬥—逃跑— 或靜止不動」的化學物質。

Cortisol and adrenocorticotropic hormones course through the bloodstream,

血液中會有皮質醇 和促腎上腺皮質激素，

increasing heart rate and blood pressure,

造成心跳加速和血壓上升，

and jolting the body into hyperarousal.

讓身體突然過度警覺。

In this condition, the brain is hunting for potential threats,

在這個情況下， 大腦會獵尋可能的威脅，

making it impossible to ignore any slight discomfort or nighttime noise.

以致於無法忽略任何些微的不舒服 或微小的夜間噪音。

And when insomniacs finally do fall asleep,

當失眠患者終於入睡了，

the quality of their rest is compromised.

他們的休息品質也會被危及。

Our brain’s primary source of energy is cerebral glucose,

我們大腦的能量主要 來自於腦葡萄糖，

and in healthy sleep, our metabolism slows to conserve this glucose for waking hours.

在健康的睡眠中， 我們的新陳代謝會減慢，

以保存這種葡萄糖， 供醒著時使用，

But PET studies show the adrenaline that prevents sleep for insomniacs

但正電子發射斷層掃描研究顯示，

讓失眠患者睡不著的腎上腺素 也會加速他們的新陳代謝。

also speeds up their metabolisms.

While they sleep, their bodies are working overtime,

雖然他們在睡眠， 他們的身體卻在加班工作，

burning through the brain’s supply of energy-giving glucose.

將大腦所提供來給予能量的 葡萄糖給燃燒掉。

This symptom of poor sleep leaves insomniacs

睡眠品質很糟的症狀，讓失眠患者

waking in a state of exhaustion, confusion, and stress,

醒來時卻感到累壞了、 很困惑，且有壓力，

which starts the process all over again.

這個過程又再次重演。

When these cycles of stress and restlessness last several months,

當這些壓力和睡不著的循環 持續了數個月之後，

they’re diagnosed as chronic insomnia.

他們就會被診斷為慢性失眠。

And while insomnia rarely leads to death,

雖然失眠很少會造成死亡，

its chemical mechanisms are similar to anxiety attacks

它的化學機制卻和飽受憂鬱症 與焦慮症之苦的人

found in those experiencing depression and anxiety.

所發生的焦慮發作類似。

So suffering from any one of these conditions

所以，只要發生 這些狀況的任何一種，

increases your risk of experiencing the other two.

都會增加你發生 另外兩種狀況的風險。

Fortunately, there are ways to break the cycle of sleeplessness.

幸運的是，有方法可以 打破無法入眠的循環。

Managing the stress that leads to hyperarousal

就我們所知，治療失眠 最好的方式之一，

is one of our best-understood treatments for insomnia,

就是管理好會造成 過度警覺的壓力，

and good sleep practices can help rebuild your relationship with bedtime.

好的睡眠習慣能讓你 和上床時間重新建立關係。

Make sure your bedroom is dark and comfortably cool

要確保你的臥房是 黑暗且舒適涼爽的，

to minimize “threats” during hyperarousal.

這樣能把過度警覺的 「威脅」減到最低。

Only use your bed for sleeping,

你的床只能用來睡覺，

and if you’re restless,

如果你睡不著，

leave the room and tire yourself out with relaxing activities

離開房間，用放鬆的 活動讓你自己疲憊，

like reading,

比如閱讀、

meditating,

冥想，

or journaling.

或寫日記。

Regulate your metabolism by setting consistent resting and waking times

調節你的新陳代謝，做法是 維持一貫的睡眠和起床作息，

to help orient your body’s biological clock.

來協助調整你的生理時鐘。

This clock, or circadian rhythm,

這個時鐘，或說 24 小時的生理節奏，

is also sensitive to light,

也會對光很敏感，

so avoid bright lights at night

所以在夜間要避免亮光，

to help tell your body that it’s time for sleep.

來協助告訴你的身體， 現在是睡覺時間了。

In addition to these practices,

除了這些做法，

some doctors prescribe medication to aid sleep,

有些醫生也會開藥來幫助睡眠，

but there aren’t reliable medications that help in all cases.

但並沒有對所有人 都有幫助的可靠藥物存在。

And over-the-counter sleeping pills can be highly addictive,

無處方的安眠藥很容易上癮，

leading to withdrawal that worsens symptoms.

會導致使症狀惡化的戒斷。

But before seeking any treatment,

但在尋求任何治療之前，

make sure your sleeplessness is actually due to insomnia.

要確保你睡不著覺 真的是因為失眠造成。

Approximately 8% of patients diagnosed with chronic insomnia

被診斷出慢性失眠的 病人中，大約有 8%

are actually suffering from a less common genetic problem

其實是遇到了 一種少見的基因問題，

called delayed sleep phase disorder, or DSPD.

叫做睡眠相位後移症候群，

簡稱 DSPD。

People with DSPD have a circadian rhythm significantly longer than 24 hours,

有 DSPD 的人，生理節奏 會明顯比 24 小時還長，

putting their sleeping habits out of sync with traditional sleeping hours.

讓他們的睡眠習慣 和傳統的睡眠時段無法同步。

So while they have difficulty falling asleep at a typical bedtime,

所以，雖然在一般人的 上床時間他們很難入睡，

it’s not due to increased stress.

卻不是因為壓力增加而造成的。

And given the opportunity,

如果有機會，

they can sleep comfortably on their own delayed schedule.

他們也能夠依照他們的 延遲時間表舒適地睡一覺。

Our sleeping and waking cycle is a delicate balance,

我們的睡眠和清醒的循環 是個很脆弱的平衡，

and one that’s vital to maintain for our physical and mental wellbeing.

要維持我們的身心康樂， 這種平衡是很必要的。

For all these reasons,

基於所有這些理由，

it’s worth putting in some time and effort

是值得花些時間和心力

to sustain a stable bedtime routine,

來維持穩定的按時上床習慣，

but try not to lose any sleep over it.

但別為了維持這習慣煩心， 反而睡不著覺了。