How People Cope with Insomnia

How People Cope with Insomnia

Introduction and aims 

            Insomnia is a term used in reference to a symptom or a complaint of difficulty getting to sleep (Doghramji & Doghramji 2007). It usually presents as repeated difficulty with getting to sleep, limited sleep duration, poor quality of sleep, and staying asleep (sleep consolation). There is compelling evidence from available literature to indicate that insomnia has a negative effect on an individual's overall quality of life (Sateia & Buysse 2016). For example, LeBlanc (2007) revealed that individuals with insomnia were generally characterised by a lower quality of life in comparison with individuals classified as “good sleepers”. Different people suffering from insomnia present with different experiences with this condition. The aim of this research is to examine the strategies adopted by individuals suffering from insomnia, in dealing with the condition.  Qualitative data about the experiences of these individuals shall be collected from the website: Revolutionhealth.com then analysed using Thematic Analysis.

Description of approach and analytic process

The researcher downloaded data on coping strategies of people with insomnia from the 'stories' section of the website: revolutionhealth.com. This is a health-based website that allows users to locate health-based information. The website also encourages visitors to take part in online discussions. To locate this website, the researcher relied on such terms as “insomnia”, 'stories', and 'messageboard'. Thematic Analysis was used to analyse the collected qualitative data. Braun and Clarke (2006) have described thematic analysis as qualitative analytic technique for “identifying, analysing and reporting patterns (themes) within data” (p. 79). By organising data into themes, thematic analysis enables the researcher to capture something valuable about the data in regards to the study's research question. In this sense, the theme symbolise a certain level of patterned meaning or response within data set (Braun & Clarke 2006). Bazeley (2009) argues that in order for themes to fulfil their full potential, they must be linked to form an exploratory model or coordinated picture. 

Namey et al. (2008) opine that thematic analysis is regarded the most suitable technique for analysing qualitative data in that it enables the researcher to link an analysis of how a theme recurs to one of the entire content.   This confers intricacy and accuracy to the “whole” meaning of the study, thereby enhancing the study. Since qualitative research calls for understanding and collectin of various data and elements (Creswell 2003), thematic analysis thus affords the researcher an opportunity to comprehend the prospect of any question in a detailed manner (Marks & Yardley 2004). Braun and Clarke (2006) maintain that thematic analysis enables the researcher to establish concisely how various concepts are related, and to draw comparisons with the replicated data.

While collecting the data, ethical issues were observed by concealing the real names of the visitors to the website who had posted on their experinces with insomnia.

Analysis

In this section, an attempt was made at analysing the data retrieved from the website:  revolutionhealth.com, using thematic analysis. The purpose of this analysis is with a view to establishing the recurring patterns among themes on how identified from the experiences of persons with insomnia, based on their posts on the website. The data collected from the website was analysed in line with a three-stage procedure of qualitative data analysis as provided in literature (Creswell 2007)

Below is a table of participants their nationalities, gender, and age.

Theme 1: Describing the experience:

            This theme delineates the manner in which individuals who participated in the discussion on insomnia on the 'stories' section of the website revolutionhealth.com.  In this case, the theme represents how participants recount their experience with this particular sleep disorder. The theme entails expression of participations' external and internal experiences with insomnia, further developing into two other related sub-themes namely: mental state, sleep quantity and quality.

1.2Mental state

Various participants have endeavoured to question their mental state, and this is a clear of the extent to which insomnia has affected them psychologically: “Most of my friends, family don't understand why I have this problem because they sleep just fine and I should as well. But I don't and never have it is the most frustrating thing it makes me so mad that i cannot be like everyone else.” Other participants are a bit more forthcoming: “I am not exactly neurotic, but it is probably close.” These examples are a sign that participants endeavour to 'externalise the internal' by laying bare on the website what they probably have never discussed with their families and friends.

1.3Sleep quantity and quality: participants also posted on the severity of their sleep “For the past four years I sleep about 2-3 hours a night and go at least two nights”, poor quality of life “ and get up with 2 hours of poor quality sleep and then try to muddle through the day”, and additional anxiety “ my racing thoughts are so bad that I can't sleep.” Davidson et al. (2009) report that people seeking help for insomnia describe their sings and symptoms with more rigorousness than individuals with related symptoms but who fail to seek medical attention.

Theme 2: Managing Insomnia

            This theme encompasses sections of the individual posts on how participants handled various ways of managing insomnia, including simple coping strategies “I am thinking that if I can relax at night and forgot all of my worries, I may be able to get to sleep earlier.” to relaxation techniques “Then I tried yoga.  20 minutes before bed totally relaxes me and helps to sleep through the night”. Medication was a predominant component of this particular theme “ 3 years ago my doctor started me on Ambien and for the first time in my life I was able to get 6 to 8 hours of sleep.” Reger-Nash, Smith and Juckett (2014) opine that various strategies have been shown to be useful in enabling people diagnosed with insomnia achieve sound sleep. The National Sleep Foundation (2011) recommends that one should participate in 30 minutes of physical activity everyday ensure that they get to bed at the same time every night. Keeping a sleep diary is also recommended in order to enable you monitor your sleeping pattern (Osenga 2014). The National Institute for Clinical Excellence (NICE) only recommends medication for short periods and even then, only in case of chronic cases (NICE 2004). Nevertheless, insomnia sufferers view sleeping pills as an easy and immediate solution to their sleeping problems (Morin et al. 2006). This sentiment reverberates among some of the responses posted by participants: “I can honestly say, "XYREM HAS CHANGED MY LIFE!" I get about 6 hours of sweet, restful, regenerative sleep most nights and even on the nights I only get 4 hours I feel so much better the next day that it is not even comparable to the life before.”

Conclusion

            A thematic analysis of the data collected has helped to reveal two key themes in regards to insomnia: describing the experience, and coping with the sleeping disorder. These findings contribute to the existing body of knowledge regarding self-disclosure via the internet. It is a clear testament to the fact that an increasingly larger number of individuals are now turning to online discussion forums as a platform for self-disclosure. The findings reveal that not only are people disclosing their symptoms and experiences with insomnia, but also their coping strategies in a bid to release the frustration and anxiety borne out of their inability to sleep. The use of the internet as a tool for self- disclosure, discussing experiences and coping strategies pose both challenges and opportunities for people suffering from insomnia. In terms of benefits, a social network structures would facilitate in the delivery of group therapy, thus allowing users to exchange practical information and support.

References

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Davidson, J.R., Aime, A., Ivers, H., & Morin, C. (2009). Characteristics of individuals with insomnia who seek treatment in a clinical setting versus those who volunteer for a randomized controlled trial. Behav Sleep Med, 7, 1, 37-52

Morin, C.M., LeBlanc, M., Daley, M., Gregoire, J.P., & Merette, C. (2006). Epidemiology of insomnia: Prevalence, self-help treatments, consultations, and determinates of help-seeking behaviors. Sleep Medicine,7, 2, 123-130.

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Doghramji, K., & Doghramji, P. (2007). Clinical Management of Insomnia. Professional Communications.