Pondering deep questions?

思考深奧的問題？

Excitement about a big trip?

對一趟即將前往的旅行感到興奮？

Or is it stress about unfinished work,

還是因為事情沒完成所以感到有壓力？

an upcoming test,

一場即將到來的考試

or a dreaded family gathering?

或是令人害怕的家族聚會？

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

對許多人而言，這樣的壓力是暫時的，失眠的成因很快就能解決

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

但假如讓你失眠的壓力源就是害怕失眠本身呢？

This seemingly unsolvable loop is at the heart of insomnia,

這看似無解的迴圈就是失眠的最關鍵原因

the world's most common sleep disorder.

就是世界上最常見的睡眠障礙

Almost anything can cause the occasional restless night -

近乎任何一件事都可以造成偶發失眠

a snoring partner,

一位打呼的床伴

physical pain,

身體上的疼痛

or emotional distress.

或是情緒低落

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

而極端的睡眠剝奪，像是時差，會造成你的生理時鐘失調

wreaking havoc on your sleep schedule.

導致睡眠週期的大混亂

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

但多數狀況，睡眠剝奪是短期症狀

Eventually, exhaustion catches up with all of us.

最終，我們都逃不出疲累的手掌心

However, some long-term conditions like respiratory disorders,

然而，有些長期症狀像是呼吸系統疾病

gastrointestinal problems, and many others can overpower fatigue.

腸胃疾病和種種其他原因，這些因素還是可能凌駕在身體疲累之上

And as sleepless nights pile up,

無數個失眠夜堆疊起來

the bedroom can start to carry associations of restless nights wracked with anxiety.

房間就開始和不眠夜造成的焦慮產生連結了

Come bedtime, insomniacs are stressed.

睡覺時間一到，失眠症患者就感到有壓力

So stressed their brains hijack the stress response system,

壓力大到自己的大腦劫持了壓力應對系統

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

所以大腦就會形成「該戰呢？逃呢？還是僵在原地？」的激素

Cortisol and adrenocorticotropic hormones course through the bloodstream,

皮脂醇與促皮質素分泌進血流循環

increasing heart rate and blood pressure,

造成心跳加速與血壓攀升

and jolting the body into hyperarousal.

進而引起全身過度反應

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

在這樣的情況下，大腦開始尋覓潛在威脅

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

因此大腦不會忽視任何細微的不適，深夜的聲響也毫不放過

And when insomniacs finally do fall asleep,

而當失眠者終於快要踏入夢鄉時

the quality of their rest is compromised.

他們的睡眠品質早已大打折扣

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

大腦的主要能量來源是腦內葡萄糖

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

在健康的睡眠中，我們的代謝會變慢，這樣才能節省腦內葡萄糖，好在醒著的時候發揮作用

But PET studies show the adrenaline that prevents sleep for insomniacs

不過，腦部斷層掃描研究則指出，讓失眠者維持清醒的腎上腺素

also speeds up their metabolisms.

卻也同時加速失眠者的新陳代謝

While they sleep, their bodies are working overtime,

當失眠者睡著時，他們的身體已超時工作

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

燃燒腦內的能量供給大功臣葡萄糖

This symptom of poor sleep leaves insomniacs

這樣的劣質睡眠症狀造成失眠者

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

在醒著的時候感到疲倦、困惑、有壓力

which starts the process all over again.

接著又再觸發一次又一次的過程循環

When these cycles of stress and restlessness last several months,

當這樣的壓力與失眠不斷惡性循環，持續好幾個月後

they're diagnosed as chronic insomnia.

這些人就會確診為「慣性失眠」

And while insomnia rarely leads to death,

雖然失眠症很少直接導致死亡

its chemical mechanisms are similar to anxiety attacks

但失眠的化學機制卻和焦慮症異曲同工

found in those experiencing depression and anxiety.

這樣的結果是得自於那些經歷憂鬱與焦慮的患者

So suffering from any one of these conditions

所以擁有上述任何一個狀況

increases your risk of experiencing the other two.

都會增加你經歷憂鬱與焦慮的風險

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

所幸的是，還是有打破失眠惡性循環的方法

Managing the stress that leads to hyperarousal

管理由過度反應所造成的壓力

is one of our best-understood treatments for insomnia,

是目前我們了解最多的失眠治療法

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

良好的睡眠措施可以幫助你與睡眠之間的關係重修舊好

Make sure your bedroom is dark and comfortably cool

確保你的房間昏暗，保持在舒適的溫度

to minimize “threats” during hyperarousal.

盡可能最小化過度反應的威脅

Only use your bed for sleeping,

床只能用來睡覺

and if you're restless,

假如你還不想睡

leave the room and tire yourself out with relaxing activities

你可以離開房間、做些讓自己放鬆的活動來呼叫疲勞

like reading,

像是閱讀

meditating,

冥想

or journaling.

或寫日記

Regulate your metabolism by setting consistent resting and waking times

藉由設定一致的睡著與醒著的時間來維持穩定的新陳代謝

to help orient your body's biological clock.

讓你的生理時鐘可以適應

This clock, or circadian rhythm,

生理時鐘，我們用 biological clock 形容，也稱作 circadian rhythm

is also sensitive to light,

也對光線敏感

so avoid bright lights at night

所以晚上睡覺時，避開明亮的光照

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

這樣才能告訴你的身體「該睡覺囉！」

In addition to these practices,

除了以上方法外

some doctors prescribe medication to aid sleep,

有些醫生會開幫助睡眠的藥

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

但這些藥並非萬靈丹

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

非處方安眠藥 (藥局自行購買之安眠藥) 可能造成你嚴重成癮

leading to withdrawal that worsens symptoms.

引發讓症狀惡化的情況

But before seeking any treatment,

但在尋求任何治療之前

make sure your sleeplessness is actually due to insomnia.

先確認造成你失眠的原因為何

Approximately 8% of patients diagnosed with chronic insomnia

約有 8% 的病人確診為慣性失眠症

are actually suffering from a less common genetic problem

慣性失眠症是由較罕見的基因問題所致

called delayed sleep phase disorder, or DSPD.

稱作「睡眠相位後移症候群」，英文縮寫為 DSPD

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

DSPD 患者的生理時鐘顯然超過 24 小時

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

導致他們的睡眠習慣沒有和一般睡眠時數同步

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

所以在正常睡覺時段，他們在床上輾轉難眠

it's not due to increased stress.

原因並非漸漸累積的生活壓力

And given the opportunity,

如果有機會的話

they can sleep comfortably on their own delayed schedule.

他們可以在自己的「延遲睡眠時段」睡得舒舒服服

Our sleeping and waking cycle is a delicate balance,

我們的睡覺與醒著的循環處在巧妙的平衡

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

而這平衡也至關重要，維持我們的生理與心理幸福

For all these reasons,

就這些原因來看

it's worth putting in some time and effort

我們很值得花些時間、心力

to sustain a stable bedtime routine,

來維持穩定的睡眠規律

but try not to lose any sleep over it.

不要再為失眠感到焦慮了喔！