SAY GOOD NIGHT TO INSOMNIA

SAY GOOD NIGHT TO INSOMNIA
Gregg D. Jacobs, Ph.D.
New York: Henry Holt & Co., 1998
219 pages, hardback, $23.00
ISBN 0-8050-5547-9

Reviewed by Lynne Lamberg

One hundred percent of insomniacs following the drug-free plan detailed in this book say they sleep better, and 90 percent cut or quit their use of sleeping pills, the author reports. Jacobs, who developed his behavioral medicine insomnia program at Harvard Medical School's Beth Israel Deaconess Medical Center, says even persons suffering from insomnia for many years can improve dramatically in only six weeks. Thousands of troubled sleepers, he reports, have used this program successfully.

His book, he says, is not only about conquering insomnia. "It is also about changing yourself and your life in more fundamental and powerful ways." When you sleep well, he maintains, you feel more energy and joy; are more productive, calmer, and optimistic; cope better with stress; and enjoy personal relationships more.

It sounds like magic, but Jacobs' well-organized, easy to follow, step-by-step guide may turn skeptics into believers.

Insomnia is a learned problem, he maintains, and it can be unlearned. He first provides a general introduction to sleep and sleeping pills, and then starts readers down a path of self-discovery and change. Readers are asked to complete a 60-second daily diary for the first week to document their baseline patterns.

Questionnaires help readers explore how thoughts and behaviors, as well as stress at work and home, may be sabotaging their sleep. Jacobs also reviews medical problems that disrupt sleep. His writing is clear, friendly, and jargon-free.

Negative sleep thoughts, from "My insomnia is going to cause health problems," to "How will I function today after such a horrible night of sleep?" often are inaccurate and distorted, Jacobs says, especially when they occur in the quiet and darkness of the night. Offering scientific evidence to refute such notions, he seeks to replace myths with more accurate, positive thoughts about sleep. He includes a long list: "My performance will not suffer significantly if I get my core sleep (about five and one-half hours)." "I'm probably getting more sleep than I think." "My daytime functioning is not affected only by my sleep." My favorite, "Since I have survived nights of insomnia before, I can do it again."

In the second week, readers work on improving sleep efficiency by sticking to a regular wake-up time, restricting the time allotted for sleep, and taking a brief mid-day rest or nap. In the third week, readers focus on exercise, exposure to bright light, and understanding the effects of caffeine, nicotine, and alcohol.

The fourth week's lesson teaches the relaxation response. (Jacobs' mentor, Herbert Benson, an early investigator of biofeedback, meditation, and relaxation techniques, wrote a foreword to the book.) In ensuing weeks, readers continue to develop their new skills. Self- assessment tests along the way enable readers to monitor their progress closely.

It's hard to forsake long-standing behaviors, even when you know they're unhealthy. Jacobs acknowledges the challenge of this task and offers plenty of support. He helps readers see that slow and steady progress yields a big payoff. This is a superb self-help guide.

An excerpt from this book and a link to the author's website may be found at Henry Holt and Company, Inc.