Issue date: 10/20/08 Section: Money/Health

College students, whether a beginning freshman or fifth-year senior, all make sacrifices when it comes to managing and prioritizing their busy schedules. Unfortunately, and especially with upcoming midterms and paper deadlines drawing closer, the most common sacrifice is that of a good nights sleep. 

Although staying up late to finish homework on occasion does not indicate a problem, the continued habit could lead to insomnia.

Timothy Young, neurologist and sleep medicine specialist at Luther Midelfort-Mayo Health System, 1400 Bellinger St. said insomnia can affect people of any age

"College students can develop insomnia due to the many pressures they face. Juggling a class schedule, work schedule, sports and social activities can make it difficult to shut off the mind at the end of the day," Young said.

Sharat Ahluwalia, neurologist and director of the Marshfield Clinic Sleep Center, 1002 W. Clairemont Ave., said insomnia can be broken down into many categories.  He also states that although some forms of insomnia may be out of a person's control, there are many steps to determine the extent and causes of the disorder, as well as how to prevent and maintain good sleeping habits in a busy lifestyle.


Types of insomnia

Young says that sleep specialists break insomnia down into two main types: sleep initiation insomnia and sleep maintenance insomnia.

"The first means having trouble falling asleep and the second means having trouble staying asleep," he said. "There is often overlap between the two in a single individual."

Insomnia can also be organized by time. Ahluwalia said that two main categories are acute insomnia, which can last anywhere from a month to three months, and chronic insomnia, which lasts over long periods of time.

One other category he mentioned is called cyclical insomnia, which means the insomnia occurs in cycles over a longer period of time. It is usually associated with a mental disorder like manic depression, bipolar disorder or alcoholism. When insomnia is associated with disorders like manic depression, it usually means that during the person's manic phase, they cannot sleep and then they plunge into depression and sleep too much.

Ahluwalia specifically said that with all of these categories, it is the cause that determines the duration of the insomnia.


Causes of insomnia

Junior Raquel Ystad understands what it's like not to be able to fall asleep when she wants to and said she has trouble going to bed before midnight on most school nights.

"I'm usually up until (midnight to 12:30 p.m.) doing homework or on the computer," Ystad said. "I only get about six hours of sleep because I have 8 a.m. classes every morning."

For many college students, homework and studying are major causes of sleep loss, as well as other stressors that disrupt a student's usual routine, Young said.

"For example, a dramatic event in the life of a college student, such as the death of a grandparent or even something more subtle, such as making the transition to school in the fall can throw off the sleep rhythms," Young said.

He said that sometimes insomnia develops from other health problems independently, but occasionally signs of anxiety and depression will be seen.

Ahluwalia said that most of the causes are behavioral. For instance, if someone lives a very sedentary life, gets very little exercise, takes long naps and drinks too much caffeine. Also, he said that people with very anxious personalities or who procrastinate tend to build habits of not sleeping enough.

"Psychiatric conditions, medical conditions, and medications also affect sleep. If someone has depression or bipolar disorder or if they have a medical condition like congestive heart failure, poor breathing, or pain in their back and other body parts," Ahluwalia said. "Some medications can throw off sleep cycles as well."


Counting sheep isn't helping

Freshman Ben Jonas, who usually goes to bed at 1 a.m. says he just can't fall asleep until his mind settles.

"I usually crash in front of the TV if I can't sleep and just wait until I'm tired enough," he said.

Since most cases of insomnia are behavioral, they are more easily treated with a few changes in a daily routine.

Young said that short-term insomnia does not usually present a health danger.  Most people experience insomnia on a short-term basis only.

However, Ahluwalia said that if the insomnia continues it will affect a persons' mood, causing them to be irritable and possibly cause depression. It also affects concentration and memory and may weaken the immune system, making it easier for people to get sick.

Young said that worrying about not being able to fall asleep makes things worse.

"If a student begins to develop insomnia, practical approaches are to avoid caffeine products in the afternoon or evening, to make sure that the sleeping environment is comfortable and quiet, and to avoid activities such as video games or loud music when it's time to wind down," Young said.

He also recommends exercise as another good way to help the body relax.

Young also said some people use alcohol as a treatment for insomnia. It does help with sleep initiation, but it can produce early morning awakenings with difficulty getting back to sleep.

If people find that changing some basic habits have not sufficiently helped, Young suggests most over-the-counter sleep aids are fine for short-term use. However, if the insomnia continues for longer than a few weeks, Young recommended that the situation should be discussed with a doctor.

Being health concious is also important.

"I emphasize to my patients that taking good care of their physical and mental health is often the best prevention for insomnia," Young said. "Burning the candle at both ends may only produce a brighter, but shorter, candle."

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