Insomnia: What is it?
Insomnia is a lack of sleep or sleep of poor quality that affects normal day-to-day functioning.
Some people have insomnia when they cannot fall asleep or wake up often at night and find it difficult to get back into bed. Others experience insomnia by waking too early or having a lack of sleep. It can be temporary or chronic.
Everyone experiences a few bad nights or temporary (short-term) insomnia. Chronic insomnia lasts more than one month.
You should seek medical advice if you cannot sleep for more than a month or weeks, or it affects your day-to-day functioning.
Introduction to insomnia
Rest and regeneration of the body and mind are essential to health. Sleep is the period in each 24-hour cycle when we are unaware and unconscious. Sleep can be divided into two types:
- Non REM sleep
- The body is still, but the brain is not. Our body releases hormones into the bloodstream to repair itself.
- Rapid Eye Movement Sleep
- It is a recurring sleep pattern that occurs throughout the night. About one-fifth of our total sleep time is spent in REM sleep. During REM, the brain is active, muscles are relaxed, and our eyes rush from side to side. We also dream.
As we near morning, we dream more and switch between REM sleep and non-REM.
In a normal sleep cycle, there will be short periods when we are awake. They last for one to two minutes and occur every two hours. They usually need to be noticed. If we are anxious, or there is another thing going on (noises outside, our partner’s snoring), then it is more likely that we will remember.
How much sleep do we need?
It is not the length of your sleep that matters but how well you sleep. The amount of sleep required changes throughout a person’s lifetime.
- Babies sleep about 17 hours per day.
- Children aged nine to ten need nine or ten hours of sleep daily.
- Some people can function well on as little as 4 hours of sleep, while others require up to 11 hours.
Older people need the same amount but will only get one deep sleep at night, usually the first three to four hours. After that, they are more likely to wake up.
As we age, we also tend to sleep less. Sleeping at night can be a problem for older people, especially if they nap during the day.
What happens if I don’t sleep?
You will feel tired, but your mental or physical health will not be affected.
After a few sleepless nights, you may start to notice that:
- Tired all the time
- Sleeping during the day
- It is difficult for you to concentrate
- It is difficult for you to make decisions
- You feel depressed
It can be dangerous to drive or operate heavy machinery. Lack of sleep can also increase our risk for high blood pressure, diabetes, and obesity.
Insomnia: Causes, Risk Factors, and Treatment
Insomnia can be a sign of another issue. A variety of factors can cause insomnia.
Psychological Factors
Insomnia is a common tendency.
During times of stress, some people are more susceptible to insomnia than others.
Some people react to stress with a headache, while others get stomach pains or aches. It can help to know that insomnia is likely and will not last long.
Persistent stress
Sleep problems can be caused by relationship problems, an ill child, or a job that is not fulfilling. Stress management can help you treat insomnia.
Learned insomnia – Psychophysiological
You may be worried about your ability to function during the day if you cannot sleep well. You may try to sleep more at night. It usually makes the situation worse.
You may find that some things you did to prepare for bed remind you why you have trouble sleeping. You will be wide awake when you change into your nightwear and turn off the lights.
Some people who have psychophysiological insomnia can fall asleep quickly, even when not in bed. Some people with psychophysiological insomnia may fall asleep on the couch while watching TV, reading the newspaper, or driving.
Psychophysiological insomnia can be triggered by a few poor nights of sleep in a given month.
Insomnia: Diagnosis
A psychiatrist will examine the medical and sleep histories of people with insomnia. An overnight sleep study might be recommended if there is suspicion of a primary disorder such as sleep apnea.
Your doctor will be able to determine if your lack of sleep is due to a physical condition, medication prescribed, or an emotional problem. He can then make the appropriate treatment and recommendations. Your doctor may ask you to keep a sleeping and waking diary for a few weeks.
Insomnia Treatment
The treatment will vary depending on the cause. Most often, a combination of behavioral approaches and medication is offered.
Better sleep hygiene can be beneficial to almost everyone. Sleep disorders can be treated by working with your doctor to identify the cause and treatment.
If your doctor diagnoses insomnia as primary, you should consider behavioral therapy and then talk about the correct use of sleeping pills.
Good Sleep Hygiene
Here are some simple tips to help you sleep well:
Do not go to sleep unless you feel sleepy.
Do something else if you’re not tired at bedtime. You can read a book or magazine, listen to some soft music, or even browse through it. You can distract your mind from worrying about sleep by doing something relaxing but not stimulating. This will distract your mind and relax your body.
Common (Psychological) Behavioral Approaches
Relaxation therapy
You can fall asleep faster if you relax your mind before bed. Learning the techniques to relax effectively takes a lot of practice.
Stimulus Control Therapy
Do not read, watch TV or eat in bed. You should not watch TV, read or eat in bed. No matter how little you sleep, get up every morning simultaneously.
Avoid daytime napping. This technique will help you to associate bedtime and the bed with only sleep.
Sleep restriction therapy
Some people with insomnia spend too long in bed trying to fall asleep. Reduce your time in bed by how much you spend sleeping on a typical night (minimum 5 hours).
Every day, I get up at the same hour. After a week of the same bedtime, move it 15 minutes forward each week until you are getting enough sleep. Maintain the same schedule each day.
Cognitive Therapy
Replace negative thoughts with positive ones (e.g., “I won’t be able function tomorrow if I don’t sleep 8 hours at night” or “I’ll get sick if I don’t sleep 8 hours at night”), such as, “If I can relax in bed peacefully, my body will look after itself.”
Medication for insomnia
Sleeping tablets have been used for a long time, but now we know:
- They only work a little bit.
- You feel tired and irritable afterward.
- You have to take them more often to achieve the same result.
- Some people develop an addiction to sleeping tablets. Sleeping tablets can lead to physical or psychological dependence.
- The newer sleeping pills (Zolpidem, Zopiclone) seem to share many problems with older drugs like Valium and Ativan.
Sleeping pills should be taken for short periods (less than two weeks), for example, if your anxiety is so high that you can’t sleep.
After consulting your doctor, you should gradually reduce the dosage if you’ve been taking sleeping pills for a while. Antidepressant tablets can be helpful in some cases.
