How long you sleep has nothing to do with how well you sleep.
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Do you toss and turn in bed, falling asleep just to wake up again? Do you take plenty of hypnotics but still fail to fall asleep? According to a survey issued by the Taiwan Society of Sleep Medicine in 2013, 1 out of 5 people in Taiwan suffer from insomnia, including difficulty falling asleep, waking up early, poor sleeping quality, etc. Research also shows that the percentage of insomnia in the public grows with age.
Insomnia refers to “difficulty falling/staying asleep or waking up tired without any mental or physical problems. Such conditions may last for months or years.”It’s difficult to determine whether someone has had sufficient sleep simply through how long they have slept because that depends on the individual. Some need only four to five hours a day while other need ten hours a day to feel replenished. Insomnia is a symptom not an illness. Just like fevers or abdominal pains, insomnia is a sign of illness. You must look for the underlying cause and treat it instead of just treating insomnia.

The Brain Structures of Insomniacs and Healthy People Are Different
A research team in the U.K. discovered that the brain structure of insomniacs is different to those that can fall asleep easily. For insomniacs, the volume of the grey matter in three parts of their brains are smaller. How much the volume at the bottom of the prefrontal cortex has shrunk is also closely correlated with the level of insomnia: the greater the complaint, the smaller the volume. We know that the purpose of the prefrontal cortex has something to do with making decisions and solving problems and these two functions are impaired from sleep deprivation. But whether the change in the structure is the cause or result of insomnia still requires more research.

Cognitive Behavioral Therapy for Insomnia is more Effective than Hypnotics
Cognitive behavioral therapy (CBT) is a relatively slower treatment than hypnotics but has great long-term effects. The primary purpose is to correct distorted cognitions of sleep and poor sleeping habits in insomniacs.According to statistics, Taiwan consumes around 320 million hypnotics a year, which is an incredibly high number. But long-term reliance on hypnotics will result in side effects such as hypersomnia, slow reactions, impaired memories, etc. Long-term use may also build up drug resistance where taking the hypnotic will help you fall asleep but the quality of sleep will not be ideal.When targeting patients with chronic insomnia, aside from instructing them how to properly use the medicine, we will also employ CBT to assist in easing the insomnia. There are many medical researches that can now testify to the treatment’s effectiveness in helping insomnia patients. The American Medical Association published a medical research paper in its June 2006 journal, indicating that patients that have received CBT have shown expressed improvement in sleeping quality. After six months of continuous treatment, the patients show continued signs of improvements. Most importantly, CBT does not produce any side effects.
CBT is ideal in dealing with primary insomnia patients whose sleep is affected by sudden events such as pressure, illness, medication, etc. Once these short-term problems are solved, the insomnia should subside as well but insomnia still exists in these patients primarily due to poor sleep behavior and thought patterns. CBT can help these insomniacs improve sleeping efficiency and slowly wean them off of medication by teaching them proper sleep hygiene and correct their thought behavior.
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