Insomnia is the inability to get the amount of sleep we need to wake up feeling rested and refreshed. Because different people need different amounts of sleep, insomnia is defined by the quality of sleep and how we feel after sleeping not the number of hours we sleep or how quickly we doze off.
Even if we are spending eight hours a night in bed, if we feel drowsy and fatigued during the day, we may be experiencing insomnia. Insomnia includes a wide range of sleeping disorders, from lack of quality of sleep to lack of quantity of sleep.
Insomnia is said to be present when you regularly find it hard to fall asleep or stay asleep. It has several patterns. You may have trouble getting to sleep initially. Or even if you can fall asleep, you might not be able to stay asleep for as long as you would like. Also you may wake up during the night and not be able to go back to sleep for a long time. Many people have two of the above problems, or even all three. Because of these, you might feel tired during the day.
What causes insomnia?
Insomnia may be the primary problem, or it may be associated with other conditions. 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.
• Some medicines and drugs, e.g. asthma or blood pressure medication, caffeine, alcohol or smoking
• Chronic pain and other uncomfortable illnesses
• Stress at work or in your personal life
• A friend or loved one passing away
• Anxiety and worrying, including worrying about not getting enough sleep
• Another sleep problems Chronic insomnia may also be associated with medical conditions or the use of certain drugs. Treating the medical condition may help improve sleep, but the insomnia may persist after the medical condition improves
Who is at risk?
Older people with poor health have a higher risk. Also women have twice the rates compared to men. This may be related to higher rates of anxiety and depression, which can be associated with insomnia. Shift workers have a higher risk too.
Types of insomnia
There are two types of insomnia primary and secondary. Primary insomnia is sleeplessness that cannot be attributed to an existing medial, psychiatric or environmental cause (such as drug abuse or medications). Secondary insomnia is when symptoms of insomnia arise from a primary medical illness, mental disorders or other sleep disorders. It may also arise from the use, abuse or exposure to certain substances.
Doctors use a number of approaches to diagnose insomnia and understand a person’s unique symptoms. Some of these measures can be done at home, while others require an office visit or an appointment at a sleep clinic.
There are many ways to improve sleep that involve psychological and behavioural steps.
Cognitive behavioural treatments for insomnia (CBTi), relaxation techniques, and general sleep hygiene guidelines can help many people with sleep difficulties. There is no definite test for insomnia. Doctors use many different tools to diagnose and measure insomnia symptoms, some of which involve asking the questions in the office, having fill out logs and questionnaires, performing certain blood tests, or doing an overnight sleep study. All of these tests help the doctor understand the patient’s personal experience with insomnia and create the right treatment plan.
Sleep is as important to health as a healthy diet and regular physical activity. Whatever is reason for sleep loss, insomnia can affect both mentally and physically. People with insomnia report a lower quality of life compared with people who are sleeping well.
Complications of insomnia may include: Lower performance on the job or at school Slowed reaction time while driving and a higher risk of accidents Mental health disorders, such as depression, anxiety disorder or substance abuse Increased risk and severity of long-term diseases or conditions, such as high blood pressure and heart disease.
Going to sleep and waking up at the same time every day can create a steady pattern which may help to prevent or treat insomnia. Avoidance of vigorous exercise and any caffeinated drinks a few hours before going to sleep is recommended, while exercise earlier in the day is beneficial. The bedroom should be cool and dark, and the bed should only be used for sleep. These are some of the points included in what doctors call “sleep hygiene”.
•Cognitive behavioral therapy (CBT): CBT can have beneficial effects that last well beyond the end of treatment. It involves combinations of the following therapies:
Cognitive therapy: Changing attitudes and beliefs that hinder your sleep Relaxation training: Relaxing your mind and body
Sleep hygiene training: Correcting bad habits that contribute to poor sleep
Sleep restriction: Severely limiting and then gradually increasing your time in bed
Stimulus control: Going to bed only when sleepy, waking at the same time daily, leaving the bed when unable to sleep, and avoiding naps, using the bed only for sleep and sex
•Over-the-counter products: Most of these sleep aids contain antihistamine. They can help you sleep better, but they also may cause severe daytime sleepiness. Other products, including herbal supplements, have little evidence to support their effectiveness.
•Prescription sleeping pills: Prescription hypnotics can improve sleep when supervised by a physician. The traditional sleeping pills are benzodiazepine receptor agonists, which are typically prescribed for only short-term use. Newer sleeping pills are non-benzodiazepines, which may pose fewer risks and may be effective for longer-term use.
•Unapproved prescription drugs: Drugs from a variety of classes have been used to treat insomnia without FDA approval. Antidepressants such as trazodone are commonly prescribed for insomnia.
Others include anticonvulsants, antipsychotics, barbiturates and non-hypnotic benzodiazepines. Many of these medications involve a significant level of risk.