Insomnia is defined as difficulty initiating or maintaining sleep, or both, despite adequate opportunity and time to sleep, leading to impaired daytime functioning. Insomnia may be a cause of or result of poor quality and/or quantity of sleep.
Insomnia is very common. Ninety percent of the general population has experienced acute insomnia at least once. Approximately 10% of the population may suffer from chronic (long-standing) insomnia.
The problem affects people of all ages including children, although it is more common in adults and its frequency increases with age. In general, women are affected more frequently than men.
TYPES OF INSOMNIA
Insomnia is most often classified by duration:
- Transient insomnia – Less than one month
- Short-term insomnia – Between one and six months
- Chronic insomnia – More than six months
However, insomnia can also be classified as:
- Primary insomnia: this is Insomnia that is present with no other co-existing disease. Most of the studies on treating insomnia have been done with people who have primary insomnia.
- Co-morbid insomnia: When insomnia exists in conjunction with another medical or psychiatric condition. Co-morbid insomnia does not have to be caused by or change with the co-existing disorder. Most cases of insomnia belong to this category. Sometimes, having insomnia can make the medical or psychiatric condition worse and hinder its treatment. For example, people with depression and insomnia do not respond as well to depression treatment as depressed people without insomnia.
SYMPTOMS OF INSOMNIA
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
- Increased errors or accidents
- Ongoing worries about sleep
CAUSES OF INSOMNIA
Primary causes of insomnia include:
- Stress related to big life events, like a job loss or change, the death of a loved one, divorce, or moving
- Things around you like noise, light, or temperature
- Changes to your sleep schedule like jet lag, a new shift at work, or bad habits you picked up when you had other sleep problems
- Your genes. Research has found that a tendency for insomnia may run in families.
Secondary causes of insomnia include:
- Mental health issues like depression and anxiety
- Medications for colds, allergies, depression, high blood pressure, and asthma.
- Pain or discomfort at night
- Caffeine, tobacco or alcohol use, as well as use of illicit drugs.
- Hyperthyroidism and other endocrine problems
- Other sleep disorders, like sleep apnea or restless leg syndrome
- Alzheimer’s disease and other types of dementia
- PMS and menopause
LIFE STYLE CHANGES /SELF HELP
There are a number of things you can try to help yourself get a good night’s sleep if you have insomnia.
- Setting regular times for going to bed and waking up
- Relaxing before bed time – try taking a warm bath or listening to calming music
- Using thick curtains or blinds, an eye mask and earplugs to stop you being woken up by light and noise
- Avoiding caffeine, nicotine, alcohol, heavy meals and exercise for a few hours before going to bed
- Not watching TV or using phones, tablets or computers shortly before going to bed
- Not napping during the day
- Writing a list of your worries, and any ideas about how to solve them, before going to bed to help you forget about them until the morning
Some people find over-the-counter sleeping tablets helpful, but they don’t address the underlying problem and can have troublesome side effects.
TIPS FOR PREVENTING INSOMNIA
Chronic insomnia may necessitate prescription medication, cognitive-behavioral therapy, and other types of formal treatment. For some people, practicing healthy lifestyle habits and good sleep hygiene can alleviate insomnia symptoms and help them sleep more soundly. The following sleep hygiene measures can be beneficial for people with insomnia:
- Limiting or eliminating naps, especially late in the day
- Restricting the use of alcohol, caffeine, and tobacco products in the evening
- Avoiding late-night meals
- Limiting screen time prior to bedtime
- Maintaining a healthy diet and exercise regularly during the day
- Follow a consistent sleep schedule that includes the same bedtimes and wake-up times every day
- Use your bedroom, and mattress, for sleep and sex – avoid working, playing video games, and other stimulating activities
Sometimes, medications are used to treat insomnia.
An example of an over-the-counter (OTC) medication that can be used for sleep is an antihistamine, such as diphenhydramine (Benadryl).
Medications like this can have side effects, especially long term, so it’s important to talk to a doctor before starting yourself on an OTC medication for insomnia.
Prescription medications that may be used to treat insomnia include:
- Eszopiclone (Lunesta)
- Zolpidem (Ambien)
Talk with your doctor before using any medications or supplements to treat your insomnia.
There might be dangerous side effects or drug interactions. Not every “sleep aid” is appropriate for everyone.