What is insomnia?
What is insomnia?
Insomnia is a highly prevalent sleep disorder that regularly affects millions of people worldwide. In short, individuals with insomnia find it difficult to fall asleep and/or stay asleep.
Insomnia commonly leads to daytime sleepiness, lethargy, and a general feeling of being unwell both mentally and physically.
Insomnia is commonly separated into three types:
- Transient insomnia - occurs when symptoms last from a few days to a few weeks.
- Acute insomnia - also called short-term insomnia. Symptoms persist for several weeks.
- Chronic insomnia - this type lasts for months, and sometimes years. According to the National Institutes of Health, the majority of chronic insomnia cases are secondary, meaning they are side effects or symptoms resulting from another primary problem.
Although insomnia can affect people of any age, it is more common in adult females than adult males. The sleeping disorder can undermine school and work performance, as well as contributing to obesity, anxiety, depression, irritability, concentration problems, memory problems, poor immune system function, and reduced reaction time.
Insomnia has also been associated with a higher risk of developing chronic diseases.
What causes insomnia?
Insomnia can be caused by physical factors as well as psychological factors. There is often an underlying medical condition that causes chronic insomnia, while transient insomnia may be due to a recent event or occurrence.
Insomnia is commonly caused by:
Disruptions in circadian rhythm - jet lag, job shift changes, high altitudes, environmental noise, heat, or cold.
Psychological issues - people with mood disorders such as bipolar disorder, depression, anxiety disorders, or psychotic disorders are more likely to have insomnia.
Medical conditions - brain lesions and tumors, stroke, chronic pain, chronic fatigue syndrome, congestive heart failure, angina, acid-reflux disease (GERD), chronic obstructive pulmonary disease, asthma, sleep apnea, Parkinson's and Alzheimer's diseases, hyperthyroidism, arthritis.
Hormones - estrogen, hormone shifts during menstruation.
Other factors - sleeping next to a snoring partner, parasites, genetic conditions, overactive mind, pregnancy.
Media technology in the bedroom - researchers from the University of Helsinki, Finland, reported in the journal BMC Public Health that media technology in the bedroom disrupts sleep patterns in children. They found that children with TVs, computers, video games, DVD players, and mobile phones in their bedrooms slept considerably less than kids without these devices in their bedrooms. In addition, a study conducted by Rensselaer Polytechnic Institute found that back-lit tablet computers can affect sleep patterns.
Who gets insomnia?
Some people are more likely to suffer from insomnia than others; these include:
- Shift workers with frequent changes in shifts (day vs. night)
- The elderly
- Drug users
- Adolescent or young adult students
- Pregnant women
- Menopausal women
- Those with mental health disorders
Signs and symptoms of insomnia
Insomnia itself may be a symptom of an underlying medical condition. However, there are several signs and symptoms that are associated with insomnia:
- Difficulty falling asleep at night
- Waking during the night
- Waking earlier than desired
- Still feeling tired after a night's sleep
- Daytime fatigue or sleepiness
- Irritability, depression, or anxiety
- Poor concentration and focus
- Being uncoordinated, an increase in errors or accidents
- Tension headaches (feels like a tight band around head)
- Difficulty socializing
- Gastrointestinal symptoms
- Worrying about sleeping
Tests and diagnosis
A sleep specialist will usually begin a diagnostic session by asking a battery of questions about the individual's medical history and sleep patterns. A physical exam may be conducted to look for conditions that could be causing insomnia. Similarly, doctors might screen for psychiatric disorders and drug and alcohol use.
For somebody to be diagnosed with an insomnia disorder, their disturbed sleep should have persisted for more than 1 month. It should also negatively impact the patient's wellbeing, either through the distress that results or the disturbance in mood or performance.
A sleep specialist is trained to determine whether the symptoms are being caused by an underlying condition. The patient may be asked to keep a sleep diary to help understand their sleeping patterns.
More sophisticated tests may be employed, such as a polysomnograph, which is an overnight sleeping test that records sleep patterns. In addition, actigraphy may be conducted, which uses a small, wrist-worn device called an actigraph to measure movement and sleep-wake patterns.
Treatment options for insomnia
Some types of insomnia resolve when the underlying cause is treated or wears off. In general, insomnia treatment focuses on determining the cause.
Once identified, this underlying cause can be properly treated or corrected. In addition to treating the underlying cause of insomnia, both medical and non-pharmacological (behavioral) treatments may be used as therapies.
Non-pharmacological approaches and home remedies for insomnia include:
- Improving "sleep hygiene" - not sleeping too much or too little, exercising daily, not forcing sleep, maintaining a regular sleep schedule, avoiding caffeine at night, avoiding smoking, avoiding going to bed hungry, and ensuring a comfortable sleeping environment.
- Using relaxation techniques - such as meditation and muscle relaxation.
- Cognitive therapy - one-on-one counseling or group therapy.
- Stimulus control therapy - only go to bed when sleepy, avoid watching TV/ reading/ eating/ worrying in bed, set an alarm for the same time every morning (even weekends), avoid long daytime naps.
- Sleep restriction - decrease the time spent in bed and partially deprive the body of sleep, this increases tiredness ready for the next night.
Medical treatments for insomnia include:
- Prescription sleeping pills
- Over-the-counter sleep aids