What keeps you up at night? Pondering deep questions? Excitement about a big trip?
是什么导致你晚上睡不着？思考某些深刻的问题？为旅行感到兴奋？
Or is it stress about unfinished work, an upcoming test, or a dreaded family gathering?
或者是因为各种压力，来自未完成的工作的、即将来临的考试的、或是来自可怕的家庭聚会的压力？
For many people, this stress is temporary, as its cause is quickly resolved.
对很多人来说，这种压力是暂时的，因为压力来源很快便会消失。
But what if the very thing keeping you awake was stress about losing sleep?
但是，如果那个导致你失眠的原因正是害怕失眠的压力呢？
This seemingly unsolvable loop is at the heart of insomnia, the world's most common sleep disorder.
这个看似无法解决的死循环是失眠的核心，世界上最常见的睡眠问题。
Almost anything can cause the occasional restless night -- a snoring partner, physical pain, or emotional distress.
几乎任何事情都可以造成一个不眠之夜：一个打呼噜的同伴，身体上的疼痛，或者情绪上的困扰。
And extreme sleep deprivation like jetlag can throw off your biological clock, wreaking havoc on your sleep schedule.
而像时差反应这样的极端睡眠剥夺会打乱你的生物钟，严重破坏你的睡眠时间表。
But in most cases, sleep deprivation is short-term. Eventually, exhaustion catches up with all of us.
但是在大多数的情况下，睡眠剥夺是暂时的。最终，疲劳会打败任何人。
However, some long-term conditions like respiratory disorders, gastrointestinal problems, and many others can overpower fatigue.
可是一些长期的症状，比如呼吸系统疾病，肠胃问题，还有很多其他原因，都给予疲劳打败我们的机会。
And as sleepless nights pile up, the bedroom can start to carry associations of restless nights wracked with anxiety.
随着不眠之夜越来越多，卧室开始与那些未眠夜关联起来，被焦虑所充斥。
Come bedtime, insomniacs are stressed.
每到睡觉时间，失眠患者便会感到压力。
So stressed their brains hijack the stress response system, flooding the body with fight-flight-or-freeze chemicals.
由于压力太大，患者的大脑开始干涉人体压力反应系统的运作，在人体产生大量抗击-逃避-或静止的化学物质。
Cortisol and adrenocorticotropic hormones course through the bloodstream, increasing heart rate and blood pressure, and jolting the body into hyperarousal.
皮质醇和促肾上腺皮质激素在血液中流动，提高心率和血压，以及刺激身体进入过度清醒的状态。
In this condition, the brain is hunting for potential threats, making it impossible to ignore any slight discomfort or nighttime noise.
在这样的情况下，大脑搜索潜在的威胁，让大脑无法忽视任何不适或者噪音。
And when insomniacs finally do fall asleep, the quality of their rest is compromised.
当失眠患者最终睡着了，他们的睡眠质量已受到影响。
Our brain's primary source of energy is cerebral glucose, and in healthy sleep, our metabolism slows to conserve this glucose for waking hours.
我们大脑最主要的能量来源是脑葡萄糖，在健康的睡眠中，我们的新陈代谢放缓，以保存脑葡萄糖供我们清醒时使用。
But PET studies show the adrenaline that prevents sleep for insomniacs also speeds up their metabolisms.
但是，PET（正电子发射断层扫描）研究显示，防止失眠患者睡眠的肾上腺素同样也加速他们的新陈代谢。
While they sleep, their bodies are working overtime, burning through the brain's supply of energy-giving glucose.
当他们睡觉时，他们的身体还在加班，消耗脑葡萄糖的能量。
This symptom of poor sleep leaves insomniacs waking in a state of exhaustion, confusion, and stress, which starts the process all over again.
睡眠不好的症状使得失眠患者在疲惫、困惑和充满压力的状态下醒过来，这个过程一晚又一晚的重复。
When these cycles of stress and restlessness last several months, they're diagnosed as chronic insomnia.
当压力和疲劳的循环持续几个月后，他们会被诊断为慢性失眠症。

And while insomnia rarely leads to death, its chemical mechanisms are similar to anxiety attacks found in those experiencing depression and anxiety.
虽然失眠症很少导致死亡，但它的化学机制与焦虑发作时产生的抑郁和焦虑的化学机制很相似。
So suffering from any one of these conditions increases your risk of experiencing the other two.
所以患上这些症状中的任何一种，会提高你患上另外两种症状的风险。
Fortunately, there are ways to break the cycle of sleeplessness.
幸好，是有方法可以打破失眠的循环。
Managing the stress that leads to hyperarousal is one of our best-understood treatments for insomnia,
管理导致高度觉醒的压力，是我们知道已知的治疗失眠的方法之一，
and good sleep practices can help rebuild your relationship with bedtime.
而且好的睡眠习惯可以重建你的睡眠时间。
Make sure your bedroom is dark and comfortably cool to minimize "threats" during hyperarousal.
确保你的卧室足够黑暗和凉爽，让高度觉醒中的“危险”达到最小。
Only use your bed for sleeping, and if you're restless,
你的床只用来睡觉，如果你睡不着，
leave the room and tire yourself out with relaxing activities like reading, meditating, or journaling.
离开卧室，做一些放松的活动让自己疲劳，比如阅读、冥想，或者写日记。
Regulate your metabolism by setting consistent resting and waking times to help orient your body's biological clock.
通过设置一致的休息和清醒时间调节你的新陈代谢，帮助适应你身体的生物钟。
This clock, or circadian rhythm, is also sensitive to light, so avoid bright lights at night to help tell your body that it's time for sleep.
这生物钟，或者生理节奏，对灯光也很敏感，所以在晚上要避免亮光，有助告诉你的身体现在是睡觉时间。
In addition to these practices, some doctors prescribe medication to aid sleep, but there aren't reliable medications that help in all cases.
除了这些方法外，一些医生会开有助睡眠的处方药物，但是没有可靠的药物能够解决所有的问题。
And over-the-counter sleeping pills can be highly addictive, leading to withdrawal that worsens symptoms.
而且非处方药很容易让人上瘾，导致依赖药物使得症状更糟糕。
But before seeking any treatment, make sure your sleeplessness is actually due to insomnia.
但是在寻求任何治疗方法前，确保你的失眠是由失眠症造成的。
Approximately 8% of patients diagnosed with chronic insomnia
大约8%被诊断为慢性失眠的病人，
are actually suffering from a less common genetic problem called delayed sleep phase disorder, or DSPD.
实际上患有不常见的遗传问题，被称为延迟睡眠期障碍，或者DSPD。
People with DSPD have a circadian rhythm significantly longer than 24 hours, putting their sleeping habits out of sync with traditional sleeping hours.
患有延迟睡眠期障碍的病人，他们的昼夜规律明显长于正常的24小时，导致了他们的睡眠习惯与传统的睡眠时间上的不一致。
So while they have difficulty falling asleep at a typical bedtime, it's not due to increased stress.
所以他们在通常的睡觉时间很难入睡，这不是因为压力的增加。
And given the opportunity, they can sleep comfortably on their own delayed schedule.
如果给予他们适合自己的睡眠时间表，他们可以非常舒服地睡觉。
Our sleeping and waking cycle is a delicate balance, and one that's vital to maintain for our physical and mental wellbeing.
我们的睡眠和清醒的周期是一个微妙的平衡，这个平衡对于维护我们身心健康非常重要。
For all these reasons, it's worth putting in some time and effort to sustain a stable bedtime routine, but try not to lose any sleep over it.
因为所有的这些原因，值得付出一些时间和努力，来维持一个稳定的睡眠习惯，并努力减少失眠。