Insomnia

Last updated date: 14-Jun-2023

Originally Written in English

Insomnia


Insomnia is a widespread sleep disorder that makes it difficult to fall asleep and to remain asleep. It can also make you awaken too early and unable to sleep again. When you get up, you might still be exhausted. Insomnia can deplete energy and mood as well as your well-being, job performance, and overall quality of life.

The amount of sleep required often varies from one person to another. However, the majority of adults require about seven to eight hours of sleep every night. Sometimes, insomnia can result in medical conditions such as hypertension, diabetes, and weight gain over time. Luckily, lifestyle and behavioral modifications can help you sleep better. Sleeping pills and cognitive behavioral therapy can also be helpful. 

 

Types of Insomnia 

The two main types of insomnia include;

  • Primary insomnia: This is when your sleeping issues are unrelated to any medical problem or condition. 
  • Secondary insomnia: This occurs when you have difficulty sleeping due to a medical condition such as asthma, arthritis, depression, heartburn, or cancer. It can also be because of pain, drugs; or substance abuse like alcohol.

 

Signs and Symptoms of Insomnia 

The most likely insomnia symptoms can include:

  • Anger, depression, or irritability
  • Difficulties paying attention, concentrating on tasks, or even remembering
  • Difficulty sleeping during the night
  • Getting up too early
  • Increased rate of accidents or errors
  • Not feeling rested following a good night's sleep
  • Persistent concerns about sleep
  • Tiredness or sleepiness during the day
  • Waking up in the middle of the night

If your inability to function normally during the daytime is due to insomnia, consult your medical provider. He or she will help determine the reason for the sleep disorder and evaluate the treatment choices. If your provider suspects you have a sleep disorder, you may be referred to the sleep clinic or a psychiatrist for additional testing. 

 

Causes of Insomnia 

Causes of Insomnia 

Insomnia can be acute (short-term), chronic (long-term), or sometimes come and disappear. Acute insomnia can last for one night or a few weeks, while chronic insomnia occurs for about three nights per week for three or more months. 

The causes of insomnia can vary based on the nature of sleeplessness you are experiencing. A variety of factors can contribute to acute insomnia, including:

  • Stress 
  • A distressing or traumatic event
  • Changes in the sleeping habits, such as sleeping in a new place or a hotel
  • Physical discomfort
  • A case of jet lag
  • Some medications

Chronic insomnia is defined as a disorder lasting at least three months and might be primary or secondary. The causes of primary insomnia are unknown. On the other hand, secondary insomnia arises as a result of another problem, which may include:

  • Health problems that cause sleeping difficulty, like back pain and arthritis
  • Psychological problems like anxiety or depression
  • Use of substances
  • Obstructive sleep apnea
  • Diabetes 

 

Risk Factors of Insomnia 

Almost every person experiences a sleepless night now and then. However, you are more likely to suffer from insomnia if you:

  • You are a female: Hormonal changes, especially during the menstruation cycle and during menopause, can be a contributing factor. Hot flashes and night sweats which are common during menopause can interfere with sleep. Furthermore, pregnancy often plays a role in sleep deprivation. 
  • You are above 60 years: Insomnia tends to worsen with age due to shifts in the regular sleeping habits and health.
  • Being under too much pressure: Temporary insomnia can occur due to stressful situations and events. Chronic insomnia can also be caused by severe or long-term stress.
  • Having a mental health problem or a physical medical issue: Most problems that affect mental or physical health can cause sleep disruption. 
  • Failure to keep a consistent schedule: Regular change of work shifts or traveling to a new place can interrupt the sleep-wake cycle.

 

Insomnia Diagnosis 

There are no particular tests to make an insomnia diagnosis. However, the medical provider can conduct a physical examination. It involves asking questions to know more about the sleep disorders and the symptoms you are experiencing. 

Also, reviewing your sleep history with the provider is essential in diagnosing insomnia. Your provider can as well go through your medical history and the prescribed drugs to check if they are interfering with sleep patterns. In other cases, your provider can recommend other insomnia tests and procedures such as: 

  • A blood test

Sometimes, the doctor might ask you to undergo a blood test so as to rule out particular health problems that can interfere with your sleep. Examples of these conditions are thyroid problems and low iron levels.

  • Record of your sleep patterns

Your provider can ask you to keep a sleep diary for one to two weeks. It should include bedtime, wake-up time, naps, and caffeine taking, among other things. This data can assist your provider in determining the habits or behaviors that are disrupting your sleep. 

  • Completion of a sleep study

In some cases, the cause of insomnia is unknown, or you may be showing symptoms of a different sleep disorder, like sleep apnea. In these cases, you might have to spend the night in a sleep facility where tests are performed to monitor and take a record of various body activities as you sleep. These activities can include brain waves, heartbeat, breathing, body movements, and eye movements.

 

Insomnia Treatment 

Most people can regain restful sleep by changing their sleeping habits and treating any underlying problem that may be causing their insomnia. These problems can be stress, health conditions, or drugs. However, when these approaches fail to improve your sleep and relaxation, the medical provider may suggest one or a combination of the following insomnia treatment options: 

Cognitive-behavioral therapy for insomnia:

In most cases, cognitive behavioral therapy for insomnia (CBT-I) is beneficial in managing or eliminating the negative habits and thoughts that make you stay awake. Generally, this therapy is given as the first line of treatment for individuals who suffer from insomnia. CBT-I is typically as effective as or even more effective, unlike sleeping pills. 

The cognitive component of CBT-I educates you to identify and change any beliefs that interfere with your sleep ability. It might assist you in managing or eliminating the negative worries and thoughts that make you awake at night. The treatment can also entail breaking the cycle of worrying too much about getting sleep, making it hard to fall asleep. 

CBT- I behavioral component assists you in adopting good sleep patterns and avoiding behaviors that prevent you from having a good night's sleep. Examples of the CBT-I strategies include; 

  • Relaxation methods: Anxiety can be reduced at bedtime by progressive muscle relaxation, breathing exercises, and biofeedback. These techniques can help you relax by allowing you to regulate your breathing, mood, heart rate, and muscle tension.
  • Stimulus control therapy: Practicing this technique assists in the elimination of factors that trigger your mind to resist sleep.
  • Sleep deprivation: This therapy reduces the amount of time you spend while in bed and discourages daytime naps. Hence, it results in partial sleep deprivation, making you exhausted the next night. 
  • Light therapy: In a situation where you fall asleep and then wake up too early, you can consider light to help you reset your internal clock.
  • Stay passively awake: This therapy aims to reduce anxiousness and worry about not being able to sleep by going to bed and attempting to remain awake instead of expecting to sleep.

Prescription drugs:

Prescription sleeping drugs

Prescription sleeping drugs can assist you in falling asleep, staying asleep, or even both. Medical providers normally do not advise taking prescription sleeping pills for more than several weeks at a time. However, some drugs are approved and recommended for prolonged use. Examples of these pills include:

  • Eszopiclone (Lunesta)
  • Zaleplon (Sonata)
  • Ramelteon (Rozerem)
  • Zolpidem (Ambien, Intermezzo, Edluar, Zolpimist)

On the contrary, prescription sleeping medications may cause daytime drowsiness and increase the risk of falls, or they may become habit-forming. Hence, you should first consult your medical provider about these pills and their potential side effects. 

 

Preventing Insomnia 

Proper sleeping habits (sleep hygiene) often help you beat insomnia disorder and sleep better. Generally, the following tips will be beneficial if you are struggling with sleep deprivation:

  • Before going to bed, avoid taking caffeine, large meals, and alcohol.
  • Ensure that you are physically active in the daytime, preferably outside.
  • Reduce your intake of caffeine, such as coffee, chocolate, and soda during the day and in particular at night.
  • Get to bed and wake up at the same time every day, even during the weekends. 
  • Put away the laptops, TVs, smartphones, and any other screens for about 30 minutes before going to bed.
  • Stop smoking.
  • Make your bedroom a quiet, dark, and cool haven.
  • Relax with a good book, calming music, or meditation.

 

Conclusion 

Insomnia is typically a common issue. It can be caused by a variety of issues, including physical or mental health. In other cases, insomnia occurs due to environment or by lifestyle factors like alcohol or caffeine consumption and shift at work. 

Sleep deprivation can cause a wide range of issues, from mild tiredness to severe illness. Therefore, if you have persistent difficulty sleeping and believe it interferes with your daily life, consult a doctor. He or she can help determines the underlying reason and suggest a suitable solution.