Everyone earns for a good sleep. After an arduous process, like hard labor, long travel, hours of talking, strenuous thinking, emotional trauma and so on getting a good night rest is what you want. But unfortunately, sleep is not an easy visitor. You twist and turn in the bed praying for that sweet oblivion from the real world. But the more you try for it, the more elusive it seems. When hours pass by, without any sign of sleep coming your way, you start thinking: Do I have insomnia?
Insomnia, also known as sleeplessness, is a sleeping disorder in which a person has trouble sleeping. It is characterized by the difficulty in falling asleep or staying in the sleeping state long enough even when someone has the chance to do so. People with insomnia describe a general dissatisfaction with their sleep quality. Insomnia can last for a short spell of a single night to a few days, to long ones lasting over a month.
Who Experiences Sleeplessness?
It is estimated that 10 to 30 percent of adults have insomnia and up to 50 percent of people experience it at least once a year. Old people are more vulnerable than young, and women are more vulnerable than men towards insomnia. Insomnia can affect those light sleepers and deep sleepers alike.
Due to occupational problems and other factors disrupting the circadian rhythm, some people are more likely to experience insomnia. They include:
Some narcotics and hallucinogens have proven to reduce sleep. Those who frequently use these are prone to insomnia than others who don’t.
Sleeplessness in students is usually attributed to anxiety and stress due to imminent exams and high expectations.
Those who travel through different time zones experience sleeping difficulties. Usually, they become normal once they overcome jet-lag. But frequent travelers have trouble getting consistent sleep.
Due to hormonal changes in pregnancy, many women experience insomnia. Some medicines taken during pregnancy can also be the reason for sleeplessness.
People Who Work in Shifts
Shift workers constantly have to change their sleep timing. This uneven sleep practice cause difficulty in sleeping or disturbed sleep.
It is proven that people above the age of 65 experience trouble getting to sleep.
Like pregnant women, menopausal women also undergo hormonal changes that can negatively affect their sleep.
People With Mental Health Disorders
Those who are diagnosed with depression, anxiety, schizophrenia and other mental disorders experience sleeplessness.
What Are the Problems Caused by Insomnia?
The disturbance in sleep pattern can have very far-reaching physical and mental effects. Insomnia patients typically experience low energy level and day time sleepiness. They become very irritable and gets easily provoked. They also experience trouble focussing and learning. It also affects their mood and they seem depressed most of the time. Insomnia patients become more accident prone as they have trouble focussing. It can lead to motor vehicle accidents, industrial accidents and so on.
A major cause of insomnia is psychological problems. Stress, depression, anxiety, fear, emotional or mental tension can reduce sleep. Mental disorders such as bipolar disorder, clinical depression, generalized anxiety disorder, post-traumatic stress disorder, schizophrenia, obsessive-compulsive disorder, dementia, and ADHD can also cause insomnia.
Pain and diseases can disturb a person’s sleep. Pain due to injury hyperthyroidism, heart failure, hyperthyroidism, heartburn, restless leg syndrome, and so on can cause insomnia. Some people experience sleeplessness at the time of menopause.
Certain neurological disorders, brain lesions, or a history of traumatic brain injury can cause insomnia.
Use of Alcohol and Psychoactive Drugs
Insomnia be caused in some people due to the use of substances like caffeine, cocaine, amphetamines, methylphenidate, aripiprazole, MDMA, modafinil, nicotine, certain medications, or excessive alcohol intake.
Frequent Change in Routine
Disturbances of the circadian rhythm, due to jet lag and working in shifts can cause an inability to sleep some times.
What are the different types of insomnia?
When sleeplessness lasts for a short period, typically less than a week, it is classified as transient insomnia. It can be due to simple reasons like change in sleep pattern like going to bed late, or due to changes in the sleep environment. However, it can also be due to severe depression, or by stress.
When sleeplessness lasts longer, at least for the period of a month it is termed Acute Insomnia. Patients experience inadequate or disturbed sleep and hence affects the quality of sleep.
In this syndrome, insomnia lasts longer than a month. It can be caused due to different physical and mental disorders. People with high levels of stress hormones or shifts in the levels of cytokines are more prone than others to have chronic insomnia. Chronic insomnia can cause double vision, muscular weariness and hallucinations.
Signs and Symptoms of Insomnia
There are many signs that point towards insomnia. They include
Difficulty for Sleep Onset
The first symptom is difficulty falling asleep. If you cannot find a comfortable sleeping position and you twist and turn in the bed, you can have sleeplessness.
If you wake up intermittently during the night and find it difficult to go back to sleep again, it can be due to insomnia.
Inability to Focus
Those who did not get sufficient sleep usually find it difficult to focus on anything. They find concentrating on daily tasks difficult. In the long term, it can affect their memory.
Low Energy Level
If you experience low energy level and sleepiness during the daytime, it can be due to insomnia. Due to this you become more irritability and may experience depression or anxiety
How to Diagnose Insomnia?
The scale in which insomnia is widely measured is the Athens insomnia scale. The scale measures sleep patter considering eight different parameters related to sleep. The results are tabulated and an overall score is given which represents the sleep quality of the diagnosed patient.
Diagnosis should be done only by a qualified professional of any sleep disorder so the appropriate measures can be taken. The patient’s past medical history and a thorough physical examination need to be done so as to eliminate other medical conditions that could be the cause of insomnia.
After the test, when all other conditions are ruled out, a study is done on the sleep history of the patient. The comprehensive sleep history taken should include sleep habits, medications taken by the patient including prescribed and unprescribed. The data will also include the quantities of alcohol consumption, nicotine and caffeine intake and so on. Though the medical conditions are ruled out, the sleep history will take into consideration the recent diseases, injuries or illnesses. The sleeping environment which includes the bedroom, the type of bed, noise at night is also looked into.
How to Keep a Record of the Sleep Pattern?
A very beneficial method to tackle insomnia is to keep a record of the sleep pattern. For this, sleep specialists recommend keeping a sleep diary. The diary should include the precise time of going to bed, hours of total sleep time, time taken to fall asleep, number of intermittent awakenings, a history of use of medications both to induce sleep and for curing any other illness. The diary should also mark the time of awakening, and overall opinion of the patient about the quality of sleep.
The sleep pattern can also be recorded by using instruments like Actigraph. This is a non-invasive device that measures movement. The unit is usually in a wrist-watch-like package worn on the wrist. The movements of the actigraph unit undergoes are continually recorded.
Once a comprehensive idea of the sleep pattern is achieved, it is possible to critically analyze and find effective methods to curb the problem. In some cases, simple practices of keeping sleep hygiene will reduce insomnia. But in some others, right medication will have to be taken under the instruction of a medical practitioner.
In some cases, patients may need to do another test to determine insomnia. They would have to do an overnight sleep study to. During the sleep, they will be connected to some devices to measure the quality of sleep including a polysomnogram and the multiple sleep latency test. Specialists in sleep medicine will consider 81 major sleep disorder diagnostic categories and arrive at conclusions. This helps the expert to avoid misdiagnosing the problem.
For instance, patients with some disorders, including delayed sleep phase disorder, are often misdiagnosed with primary insomnia. In the case when a person has trouble on the onset of sleep and they are able to get undisturbed sleep once they start sleeping, the person may not be an insomniac. It can be trouble in the circadian rhythm.
Insomnia can be a side-effect
In many cases, insomnia is co-morbid with some diseases. It can also be due to side-effects from medications, or a psychological problem. It is estimated that almost half of all diagnosed insomnia is related to psychiatric disorders.
In some cases, insomnia predates many psychiatric problems like depression. In fact, it is possible that insomnia represents a significant risk for the development of a subsequent psychiatric disorder. Recent studies prove that 60 % and 80% of people with depression suffer from the problem. Some medical experts are of the opinion that this can be due to treatment used for depression.
How to Prevent Insomnia?
Preventive measures can be taken for insomnia once the type is identified. It can include medication, cognitive behavioral therapy, and lifestyle changes. The basic idea of lifestyle changes is to create a routine. Going to sleep and waking up at the same time each day can create a steady pattern which may help to prevent insomnia.
Watch What You Take In
Some food items can affect the sleep cycle. If you can’t sleep, try avoiding the following items:
Some people believe that alcohol is a sedative and hence can be used to induce sleep. But in actuality, overconsumption of alcohol can cause disturbed sleep and will reduce sleep quality. The result is that you wake up feeling drowsy.
Smoking cigarettes or tobacco products can have a negative effect on your sleep, especially if used close to bedtime. As nicotine is a stimulant, it can make it hard to fall asleep and to sleep well through the night. Smoking can induce insomnia and damage to your health. If you smoke, it is time to quit.
Everyone is aware that caffeine is a stimulant. Many people use caffeine to kick start their day. Caffeine can be used in moderate amounts, but excessive use can cause insomnia. A survey conducted by the National Sleep Foundation in 2005 found out that people who drank four or more than four cups of caffeinated drinks a day were more likely than those who drank zero to one cup daily to experience at least one symptom of insomnia at least a few nights each week. Another problem with caffeine is that it will stay in the body for up to eight hours. It is hence better to not consume food or drinks with caffeine before going to bed.
Most people due to their tight schedules in the morning prefer to take a proper meal at dinner. The bad news to those is that a heavy meal close to bedtime can disrupt the sleep. If you are planning to have a large meal take it at least 3 hours before going to bed.
Changing the Lifestyle
By adopting some healthy lifestyle practices you can avoid insomnia. They are:
A sedentary lifestyle is one of the reasons for insomnia. While exercising body releases chemicals called Endorphins. They create a feeling of wellbeing and reduces pain. It also acts against depression. However, vigorous exercise should be avoided as it can negatively affect the sleep.
Listening to Relaxing Music
Music is good medicine to calm your nerves. Those having difficulty sleeping due to anxiety can listen to soothing music which will help them to sleep:
Take care to create a calm atmosphere for sleeping. Keep the bedroom suitable to rest by making it dark and cool. Completely avoid any distractions like mobile phones, clocks, and television.
Avoid Morning Naps
It can be difficult to get to sleep if you took a nap in the morning. If you experience insomnia avoid siesta.
Stick to a Routine
Make sure to go to bed at the same time every day. Avoid late night parties as it can affect your routine. Once your brain gets used to the time you go to bed, you will naturally feel sleepy at that time.
Try Relaxing Activities Before Sleeping
Learn some breathing exercises and practice it before going to bed.
Don't Push It
If you are not feeling sleepy, get up and start reading a book. Trying very hard to sleep will actually reduce the chances of falling asleep