Insomnia: What It is, Symptoms, Causes And Treatment

A common sleep disorder where you face issues with falling or staying asleep is insomnia. Difficulties in getting back to sleep or early morning awakenings are important parts of this sleep disorder. It can be an acute, short-term or chronic, long-term issue that may also keep coming and going. The most common causes of the condition include family pressures, traumatic events or stress at work. It can last for months and even longer.

As per studies, approximately 93% of Indians do not get sufficient sleep because of the intrusion of modern devices and changing lifestyles. Most cases of long-term insomnia are secondary, which means they are a side effect or symptom of some other issue, like a certain medical condition, other sleep disorders or certain medicines. Substances like alcohol, tobacco and caffeine can also cause this condition. 

Sometimes chronic insomnia is primary, which means any other condition has not caused it.

Symptoms of Insomnia

Major signs of the condition include:

• Fatigue
• Daytime sleepiness
• Memory and concentration problems
• Grumpiness

Chronic or long-term insomnia may show symptoms like:

• Difficulty falling asleep
• Difficulty getting back to sleep after waking up at midnight
• Depressed mood
• Irritability
• The trouble with school, work or social performance
• Decreased motivation
• Sleepiness
• Increased mistakes or accidents
• Behavioural problems, such as aggressiveness or hyperactivity
• Discontent with or worries about sleep
• Not feeling refreshed or recharged after sleep

Causes of Insomnia

Stress is one of the most common insomnia causes along with habits or life events that disrupt sleep. Treating the underlying insomnia causes can resolve the condition, but it may take several years. The most common insomnia causes include:

• Stress: 

Concerns about school, work, finances, family and health can keep you from sleeping at night. Trauma and stressful life events like illness or death of a known person, job loss or divorce may also cause insomnia.

• Work or Travel Schedule: 

Your circadian rhythms are your internal clock that guides your metabolism, body temperature and sleep-wake cycle. Disturbing your body’s circadian rhythms can also cause insomnia. Significant causes of circadian rhythm disruption include working early or late shifts, changing shifts frequently, and travelling across different time zones.

• Overeating Late in the Evening: 

It’s fine to have a light snack at bedtime, but excessive eating in the evening may make you feel physically uncomfortable when you lie down. You may also experience backflow of food and acid from your stomach into the oesophagus after eating and heartburn that can keep you awake.

• Poor Sleeping Habits: 

Things like stimulating activities during bedtime; irregular bedtime schedule; uncomfortable sleep environment; using your bed for eating, watching TV and work, and naps are poor sleeping habits that can lead to insomnia over time. Playing video games or using TVs, computers and smartphones before bed can also disturb your sleep cycle.

Other common insomnia causes include:

• Mental Health Problems: Other mental health problems like depression, anxiety and post-traumatic stress disorder may disturb sleep and cause early morning awakenings.

• Medical Conditions: Common medical conditions associated with insomnia include cancer, chronic pain, heart disease, diabetes, asthma, overactive thyroid, Alzheimer’s disease, GERD or gastroesophageal reflux disease and Parkinson’s disease.

• Medicines: Different prescription medicines can also disrupt your natural sleep cycle. These include medicines for blood pressure or asthma and antidepressants. Many over-the-counter medicines for pain, allergies and colds, and weight loss products, can also disrupt sleep because of their caffeine content.

• Alcohol, Nicotine and Caffeine: Cola, tea, coffee and other caffeinated beverages are stimulants that can disturb your sleep if you have them late in the evening or afternoon. Tobacco contains nicotine which is also a stimulant that can disturb your sleep. Alcohol induces sleep but prevents the deeper sleep stages and causes midnight awakenings.

• Sleep-Related Conditions: You may feel uncomfortable sensations in the legs because of restless leg syndrome and an urge to move them, which may prevent you from getting proper sleep. Sleep apnea is another condition that hinders you from breathing periodically throughout the night, thus causing sleep disturbances.

Treatment of Insomnia

Acute or short-term insomnia heals on its own. Chronic insomnia treatment includes:

1. Sleep Hygiene Education:  

This can help you develop a healthy lifestyle through proper exercise and diet. A doctor may provide information about insomnia treatment, its causes and symptoms, and the stressors that may trigger sleeplessness. You may also learn about different methods to reduce environmental factors like noise, light, mattress and temperature that may disturb your sleep.

1. Cognitive Behavioural Therapy: 

The therapy involves stimulus control, which aims to change wrong beliefs about sleeping. The therapy also suggests actions that may trigger sleep, like:

• Avoiding daytime naps
• Hitting to bed only when you feel sleepy
• Using the bedroom only for sleeping
• Working out regularly for a minimum of 20 minutes but 4 to 5 hours before bedtime
• Maintaining a regular wake and sleep routine
• Avoid caffeinated beverages like soft drinks and coffee and test them later during the day.
• Creating the ideal sleep environment in your bedroom. Working on noise, temperature and avoiding the use of high-intensity lights.

1. Sleep Restriction Therapy: 

It involves limiting the amount of time you spend in bed, and this further prevents excessive daytime sleepiness and induces sleep early on.

1. Behavioural Intervention:

 This can help you adopt good sleep hygiene while eliminating behaviours incompatible with sleep, like worrying and lying in bed.

1. Relaxation Therapies: 

Therapies like biofeedback techniques and progressive muscle relaxation reduce arousal. Attention focusing and imagery training can also help reduce pre-sleep cognitive arousal. These procedures can also help you with sleep disruption caused due to stress.

1. Medicines: 

Medicines like Benzodiazepines, Zaleplon, Zolpidem and Zopiclone, Ramelteon, Eszopiclone, TCAs or Tricyclic antidepressants and antihistamines can alleviate sleeplessness by improving hormonal imbalance and treating underlying psychological conditions.

Conclusion

Sleep is as crucial as regular exercise and a balanced diet for your health. Regardless of the reason for sleeplessness, insomnia may affect you both physically and mentally. The best is to contact an expert. They will guide you to manage the issues that disrupt your sleep.