Insomnia – Definition of Insomnia
Insomnia is a type of sleep disorder. An individual with insomnia finds it difficult to fall asleep, stay asleep, or both. People with insomnia often don’t feel refreshed when they wake up from sleep. According to guidelines from a physician group, insomnia is difficulty falling asleep or staying asleep, even when a person has the chance to do so. People with insomnia can feel dissatisfied with their sleep and usually experience one or more of the following symptoms:
- Low energy
- Difficulty in concentration
- Mood swings
- Decreased performance in school or at work
Insomnia is the most common of all sleep disorders, according to the APA or American Psychiatric Association. IN fact, the APA states that about one-third of all adults report insomnia symptoms. But between 6 to 10 percent of all adults have symptoms severe enough for them to be diagnosed with insomnia disorder.
Keep reading to learn more about the types of insomnia, cause and symptoms
Insomnia – Different types of insomnia
There are multiple ways to describe insomnia:
Acute – A brief episode of difficulty sleeping. Acute insomnia is usually caused by a life event, such as a stressful change in a person’s job, loss of a loved one, travel or change in time zones. Often acute insomnia resolves without any treatment.
Chronic – a long-term pattern of difficulty sleeping. Insomnia is usually considered chronic if a person has trouble sleeping or staying asleep at least 3 nights per week for 3 months or more. Some people with chronic insomnia have many causes. Check the causes of chronic insomnia below.
Comorbid – Insomnia that occurs with another condition, psychiatric symptoms such as anxiety and depression, are known to be associated with changes in sleep. Certain medical conditions can either cause insomnia or make a person uncomfortable at night as such cases with arthritis or back pain, which can lead to sleeplessness.
Onset – difficulty falling asleep at the beginning of the night.
Maintenance – The inability to stay asleep. People with maintenance insomnia wake up during the night and have difficulty in returning to sleep.
Insomnia – Symptoms and causes
Insomnia may the primary problem, or it may associate with other conditions. Chronic insomnia is usually a result of stress, life events, or habits that disrupt sleep.
- Stress – Concerns about work, school, health, finances, or family can keep your mind active at night, making it difficult to sleep. Stressful life events or trauma such as the death or illness of a loved one, divorce, or job loss, also lead to insomnia.
- Travel or work schedule – your circadian rhythms act as an internal clock, guiding such things as your sleep-wake cycle, metabolism, and body temperature. Disrupting your body’s circadian rhythms can lead to insomnia. Cause includes jet lag from traveling to a different time zone, working late, or change in work schedule.
- Poor Sleep habits – poor sleep habits include irregular bedtime schedule, naps, stimulating activities before bed, an uncomfortable sleep environment, and using your bed for work, eating or watches TV. Computers, TVs, video games, Smartphones or other screens just before bedtime can interfere with your sleep cycle, due to its blue light emitted by the screens, the brain will think it is day time, and it stimulates the brain, making it hard for melatonin hormones to act.
- Eating heavy meals late in the evening – having a light snack before bedtime is fine, however, eating too much may cause you to feel physically uncomfortable while lying down. Many people also experience heartburn, a backflow of acid and food from the stomach into the esophagus after eating, which may keep you awake.
Chronic insomnia may also be associated with medical conditions or the use of certain drugs. Treating the medical condition may help improve sleep, but insomnia may persist after the medical condition improves.
Additional common causes may include:
- Mental health disorders – Anxiety disorders, such as post-traumatic stress disorder, may disrupt sleep, awakening too early can be a sign of depression. Insomnia often occurs with other mental health disorders as well.
- Medication – many prescription drugs can interfere with sleep, such as certain anti-depressants and medications for asthma, or blood pressure. Many over-the-counter medications such as some pain medications, allergy, and cold medications, and weight-loss products, contain caffeine or other stimulants that disrupt sleep.
- Medical conditions – examples of conditions linked with insomnia include chronic pain, cancer, diabetes, heart disease, asthma, gastroesophageal reflux disease, overactive thyroid, Parkinson’s disease, and Alzheimer’s disease.
- Sleep-related disorders – sleep apnea causes you to stop breathing periodically throughout the night, interrupting your sleep. Restless legs syndrome causes unpleasant sensations in your legs and an almost irresistible desire to move them, which may prevent you from falling asleep.
- Caffeine, nicotine, and alcohol – coffee, tea, cola, and other caffeinated drinks are stimulants, drinking them late in the afternoon or evening can keep you from falling asleep. Alcohol may help you fall asleep, but it prevents deeper sleep stages and often causes an awakening in the middle of the night.
The cause of your insomnia will depend on the type of sleeplessness you experience. Short-term insomnia may be caused by stress, an upsetting or traumatic event, or changes in your sleep habits.
Chronic insomnia lasts for at least 3 months and is usually secondary to another problem or combination of problems including:
- Medical conditions which make it hard to sleep, such as arthritis or back pain
- Psychological issues, such as anxiety or depression
- Substance use
Insomnia can occur at any age however, is more likely to affect women than men. People with certain risk factors are more likely to have insomnia. These factors include:
- High levels of stress
- Emotional disorders such as depression or distress related to a life event
- Traveling to different time zones
- Sedentary lifestyles
- Changes in work hours or working night shifts
Certain medical conditions, such as obesity and cardiovascular disease, can also lead to insomnia. Menopause can lead to insomnia as well. Find out more about the causes of- and risk factors for –insomnia.
Symptoms may include:
- Difficulty falling asleep at night
- Waking up during the night
- Waking up too early
- Not feeling well-rested after a night’s sleep
- Daytime tiredness or sleepiness
- Irritability, depression or anxiety
- Difficulty paying attention, focusing on tasks or remembering
- Increases errors and accidents
- Ongoing worries about sleep
Insomnia – Diagnosis, treatments, and home remedies
Depending on your situation, the diagnosis of insomnia and the search for its cause may include:
Physical exam – If the cause of insomnia is unknown, your doctor may do a physical exam to look for signs of medical problems that may be related to insomnia. Occasionally, a blood test may be done to check for thyroid problems or other conditions that may be associated with poor sleep.
Sleep habits review – in addition to asking you sleep-related questions, your doctor may have to complete a questionnaire to determine your sleep-wake pattern and your level of daytime sleepiness. You may also be asked to keep a sleep diary for a couple of weeks.
Sleep study – if the cause of your insomnia isn’t clear, or you have signs of another sleep disorder, such as sleep apnea or restless legs syndrome, you may need to spend a night at a sleep center. Tests are done to monitor and record a variety of body activities while you sleep, including brain waves, breathing, heartbeat, eye movements and body movements.
Changing your sleep habits and addressing any issues that may be associated with insomnia, such as stress, medical conditions, or medications, can restore restful sleep for many people. If these measures don’t work, your doctor may recommend cognitive behavioral therapy, medications or both, to help improve relaxation and sleep.
Cognitive behavioral therapy
Cognitive-behavioral therapy for insomnia can help you control or eliminate negative thoughts and actions that keep you awake and is generally recommended as the first line of treatment for people with insomnia. Typically, CBT-I is equally or more effective than sleep medications.
The cognitive part of CBT-I teaches you to recognize and change beliefs that affect your ability to sleep. It can help you control or eliminate negative thoughts and worries that keep you awake. It may also involve eliminating the cycle that can develop where you worry so much about getting to sleep that you can’t fall asleep.
The behavioral part of CBT-I helps you develop good sleep habits and avoid behaviors that keep you from sleeping well. Strategies include in CBT-I treatments are:
- Stimulus control therapy – this method helps remove factors that condition your mind to resist sleep. For example, you might be coached to set a consistent bedtime and wake time and avoid naps, use the bed only for sleep and sex, and leave the bedroom if you can’t go to sleep within 20minutes.
- Relaxation techniques – Progressive muscle relaxation, biofeedback and breathing exercises are ways to reduce anxiety at bedtime. Practicing these techniques can help you control your breathing, heart rate, muscle tension, and mood so that you can relax.
- Sleep restriction – this therapy decreases the time you spend in bed and avoids daytime naps, causing partial sleep deprivation, which makes you more tired the next night. Once your sleep has improved, your time in bed is gradually increased.
- Remaining passively awake – also called paradoxical intention, this therapy for learned insomnia is aimed at reducing the worry and anxiety about being able to get to sleep by getting in bed and trying to stay awake rather than expecting to fall asleep.
- Light therapy – if you fall asleep too early and then awaken too early, you can use light to push your internal clock. You can go outside during times of the year when it’s light outside in the evenings, or you can use a lightbox. Talk to your doctor about recommendations.
Insomnia – Lifestyle and home remedies
No matter what your age, insomnia usually is treatable. The key often lies in changes to your routine during the day and when you go to bed, these tips may help.
- Stick a consistent sleep schedule – Keep your bedtime and wake time consistent from day to day including on weekends.
- Stay Active – Regular activity helps promote a good night’s sleep. Schedule exercise at least a few hours before bedtime and avoid stimulating activities before bedtime.
- Check your medications –if you take medications regularly, check with your doctor to see if they may be contributing to your insomnia. Also check labels of OTC products to see if they contain caffeine or other stimulants, such as pseudoephedrine.
- Avoid or limit day time naps –naps can make it harder to fall asleep at night. If you can’t get by without one, try to limit a nap no more than 30 minutes and don’t nap after 3 PM
- Avoid or limit caffeine and alcohol as well as nicotine intake –all of these can make it harder to sleep, and effect can last for several hours.
- Don’t tolerate pain –If a painful condition bothers you, talk to your doctor about options for pain relievers that are effective enough to control pain while you are sleeping.
- Avoid eating heavy meals before bed –a light snack is fine, and you may help avoid heartburn, drink less liquid as well before bedtime so you won’t have to urinate as often during the night.
Tips at bedtime
- Make your bedroom comfortable for sleep – as mentioned above as well, remember to keep your bedroom only for sleep and sex, other activities especially stimulating activities such as watching TV and browsing social media should be done elsewhere.
- Find ways to relax before entering your bedroom – try to put your worries and planning aside when you get into bed. A warm bath or a massage before bedtime can help prepare you for sleep. Create a relaxing bedtime ritual such as taking a hot bath, listening to sleep music, breathing exercises, yoga or prayer.
- Avoid trying too hard to sleep – the harder you try, the more awake you will become. Read in another room until you become very drowsy, then go to bed to sleep. Don’t go to bed too early, or before you are sleepy.
- Get out of bed when you are not sleepy – sleep as much as you need and then get out of bed, do not spend time in bed if you are not sleepy, this way your mind will be trained that bed means to sleep only.
Insomnia – alternative medicines
Many people never visit their doctor for insomnia and try to cope with sleeplessness on their own. Although in many cases safety and effectiveness have not been proved, however, some people try therapies such as:
- Melatonin – the over-the-counter supplement is marketed as a way to help overcome insomnia. It is generally considered safe to use melatonin for a few weeks, but no convincing evidence exists to prove that melatonin is an effective treatment for insomnia, and long-term safety is unknown
- Valerian – this dietary supplement is sold as a sleep aid because it has a mildly sedating effect, although it hasn’t been well-studied. Discuss valerian with your doctor before trying it. Some people who have used it for long-term may have had liver damage, although it is not clear if valerian caused the damage.
- Acupuncture – there is some evidence that acupuncture may be beneficial for people with insomnia. But more research is needed. If you choose to try acupuncture along with your conventional treatment, ask you’re to find a qualified practitioner.
- Tai-chi and Yoga – there are some studies suggest that the regular practice of yoga and tai chi can help improve sleep quality. Sure enough, it might help as both tai chi and yoga are breathing exercises.
Insomnia – Caution regarding herbal and dietary sleep aids
Most over-the-counter natural sleep aids are not mandated or approved by the Food and Drug Administration, however, there are trusted brands to look for that would be great sleep aids or sleep supplements to try. Some products though can be harmful and some may cause more harm if you are taking other medications, this is why it is best to consult your doctor first.