For some, it’s difficulty falling asleep. For others, waking in the middle of the night endlessly staring at the slowly ticking clock. Then there’s rousing a long while prior to the alarm, or non-restorative sleep.
Many people report poor sleep; around 30% of the adult population. But when we look to the insomnia diagnostic criteria set out by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) — the veritable Bible of mental disorders — the correct use of the term insomnia is estimated to affect approximately 6% of our global community.
Considering insomnia is linked to both weight gain and a higher risk of chronic disease, combined with the immediate toll it takes, it is important to learn more about this common disorder: What is it? What symptoms those with insomnia suffer? And what are the possible causes and treatments?
What Exactly is Insomnia?
According to the DSM-IV, insomnia is a disorder of “initiating or maintaining sleep, or nonrestorative sleep, for at least 1 month” and with at least one of the following also:
- Cognitive challenges, like reduced memory and concentration
- Poor performance in daily life and relationships
- Mood disturbances, including irritability
- Unsurprisingly, sleepiness during the day
- Motivation and energy that has got up and gone
- Proneness to errors and accidents
- Linked tension headaches or tummy symptoms in response to sleep loss
- Being worried about the next night sleep… (or maybe whether you’ll ever sleep well again?)
- Insomnia may be acute, lasting only for a short period of time. Or it may be chronic, lasting more than three long months.
What Can Cause Insomnia?
Most times insomnia has a cause or causes, but at other times not. Physical and psychological factors may be a trigger. There may be causative underlying conditions, yet once solved, the insomnia may still remain. Below are common causes thought to spark insomnia:
Stressful life events, including positive — the birth of a child or a marriage, or traumatic — such as the illness of a loved one, job loss or divorce, could all cause insomnia. Worrying about issues such as school, work, family, or finances can steal our sleep-filled nights.
Poor sleep habits
An irregular bedtime schedule, uncomfortable sleep environment, stimulating activities before shut eye, watching TV, playing video games whether on computer or a smartphones, are all capable of interfering with your sleep cycle and triggering a significant bout of insomnia.
Travel or work schedule
Declaring a regular assault on your body’s circadian rhythm will not end well. This is part of the reason why shift workers have a higher mortality (that’s death!) rate. Jet lag, keeping odd hours, or working late could all adversely effect your internal clock, disrupt your sleep-wake cycle and triggering insomnia.
Psychological causes of insomnia
There may be an underlying mental disorder that brings about altered sleeping patterns, including anxiety disorders like post-traumatic stress disorder, depression, bipolar disorder or psychotic disorders.
Medical causes of insomnia
There are also medical links with insomnia, including in those with chronic pain (including arthritis), diabetes, congestive heart failure, asthma, Parkinson’s and Alzheimer’s diseases and obstructive sleep apnea.
Certain medications can contribute to insomnia, including certain antidepressants (called selective serotonin re-uptake inhibitors), anticonvulsants, decongestants, those used to lower high blood pressure, steroids and drugs to treat chronic obstructive pulmonary disease. Have a talk to your doctor if you are suffering from poor sleep and taking any medications that you feel may be contributing.
Caffeine, alcohol and nicotine
Caffeinated drinks such as coffee, cola, and tea are stimulants and can facilitate poor sleep. Nicotine withdrawals can increase wakefulness. And even though alcohol may send you quickly off to the land of nod, it is also capable of waking up in the wee small hours of the night.
Sleep-related disorders like sleep apnea, a condition where you stop breathing periodically throughout the night, can disturb your sleep. Thus the name! Also, restless legs syndrome, a strange but not uncommon condition with the unpleasant and irresistible desire to frequently move your legs, can turn sleep into a constant battle.
What Are the Risk Factors of Insomnia?
The risk of developing insomnia is higher in some individuals, including:
- Women: the hormonal changes that occur during the menstrual cycle and menopause can cause sleep issues
- Elderly: Altered sleep patterns are common as we become older, especially for people over the age of 65
- People with mental or physical conditions, as we discussed above
- People that suffer from chronic stress
- Shift workers
How Can I Prevent Insomnia?
The news to aid your sanity is, insomnia is treatable. Let’s look at both scientific and anecdotal evidence to secure sound sleep.
Behavioral therapies. These may consist of:
Cognitive behavioral therapy; a psychological approach that acts to change unhelpful or unhealthy thoughts and so behaviors.
Relaxation techniques may help, including meditation and progressive muscle relaxation.
Stimulus control therapy is designed to reduce anxiety or arousal experienced when going to bed. Advice includes only going to bed when sleepy, using bed for sleep and sex only, getting out of bed when unable to sleep and, as above, setting a regular wake time.
Sleep restriction therapy. Sounds counterintuitive, doesn’t it? This therapy decreases the time spent in bed with the aim of creating a mild sleep deprivation in order to promote earlier sleep onset, deeper sleep and to lessen the variation in sleep patterns over the course of multiple nights.
Good sleep habits form the foundation for insomnia prevention and treatment:
- Ensure you maintain a regular to bed and wake time, even on weekends
- Stay active — regular activity helps promote a good night’s sleep. Ensure you adhere to a daily exercise routine
- Check your medications to ensure they are not contributing to your insomnia
- Avoid or limit caffeine and alcohol, and work toward quitting smoking
- Avoid large meals and beverages before bedtime
Medicinal approaches are available as well; see you doctor to discuss these options.
While insomnia is common and frustratingly exhausting, there are positive steps and proven strategies you can implement to win the sleep war. With this sleep disorder often triggered by another driver, continuing even past their resolution, or occurring due to an unknown cause, professional help is key.
To a wonderful slumber!