Insomnia:

Insomnia is a sleep disorder and one of the most severe problems worldwide. It can cause difficulty in staying asleep, falling asleep,  or waking up too early and is affecting people worldwide.

I will focus on delivering the details regarding insomnia in this article, including what insomnia is, its causes, symptoms, and treatment, and also some tips for improving your sleep quality to overcome insomnia. Let’s dive deep into the topic.

What is insomnia?

Insomnia is the inability to sleep properly to feel rested and refreshed. It is usually of two types: acute insomnia and chronic insomnia.

Acute is a type that is often short-lived, i-e for a few days or weeks. Stress, life events, or changes in your sleep environment or schedule often cause it. Acute insomnia usually resolves on its own once the triggering factor is gone.

Chronic is a type that occurs long-term, i-e for at least three months. It can occur thrice a week and interfere with your daily functioning. The factors that can cause chronic insomnia are poor sleep habits, or circadian rhythm disorders, different medical conditions, medications, and psychological issues aswell. Chronic insomnia may require professional treatment to address the underlying cause and improve sleep quality.

Causes of insomnia:

The causes of insomnia varies according to the severity and the type of your sleep disorder. Some of the common causes of insomnia are:

Stress: Long term stress can be a cause of insomnia. Stress can make falling or staying asleep very hard as it activates your nervous system and keeps your mind alert. Personal, professional, or environmental factors, such as work pressure, family problems, financial worries, noise, or light, can cause stress.
Anxiety: Anxiety is a mental health problem leading to fear, worry, or feeling of nervousness, ultimately affecting your sleep quality. Different situations or events, such as exams, interviews, or public speaking, can trigger anxiety. Anxiety can also be a symptom of an anxiety disorder, such as generalized anxiety disorder (GAD), panic disorder, or social anxiety disorder.
Depression: Depression is a mental illness that causes chronic sadness, loss of interest, hopelessness, or guilt. Depression can affect your sleep in different ways. Some people with depression may have trouble falling asleep or staying asleep, while others may sleep too much or have difficulty waking up.
Medical conditions: Certain medical conditions can cause or worsen insomnia by affecting your physical health, comfort, or hormones. Some medical conditions that can lead to insomnia are chronic pain, asthma, allergies, diabetes, thyroid problems, heart disease, reflux disease (GERD), menopause, or pregnancy.
Medications: Various medications can impact your sleep by causing side effects such as stimulation, sedation, or frequent urination. Antidepressants, stimulants, corticosteroids, beta-blockers, diuretics, or decongestants are some of examples of medications that can cause insomnia.
Poor sleep habits: Poor sleep habits are behaviors or routines that negatively affect your sleep quality or quantity. Some examples of poor sleep habits are irregular sleep schedules, napping during the day, using electronic devices before bed, consuming caffeine or alcohol close to bedtime, or using your bed for activities other than sleep or sex.
Circadian rhythm disorders: Circadian rhythm disorders are conditions that affect your internal biological clock that regulates your sleep-wake cycle. Circadian rhythm disorders can cause difficulty for you to fall asleep or wake up at the desired time. Some examples of circadian rhythm disorders are jet lag, shift work disorder, delayed sleep phase syndrome (DSPS), or advanced sleep phase syndrome (ASPS).

How to diagnose insomnia?

If you have trouble sleeping for more than a few weeks and it affects your daily functioning, you should see your doctor for a diagnosis and treatment plan. Your doctor will ask you about your medical history, sleep history, sleep habits, and lifestyle factors that may affect your sleep. Your doctor can also order some tests or perform a physical assessment to rule out any potential underlying medical issues that may cause insomnia.

Your doctor may also refer you to a sleep specialist for further evaluation and testing. A sleep specialist is a doctor who specializes in diagnosing and treating sleep disorders. A sleep specialist may use various tools and methods to assess your sleep quality and quantity, such as:

Sleep diary: A sleep diary is a record of your daily sleep patterns, such as when you go to bed, when you wake up, how long it takes you to fall asleep, how many times you wake up during the night, and how you feel during the day. A sleep diary can help you and especially your doctor identify any factors affecting your sleep quality or quantity.
Questionnaires: Questionnaires are standardized forms that ask you questions about your sleep habits, sleep problems, and daytime functioning. Questionnaires can help measure the severity and impact of your insomnia and other sleep-related issues, such as daytime sleepiness, mood, or quality of life. Some examples of questionnaires that are used to assess insomnia are the Insomnia Severity Index (ISI), the Pittsburgh Sleep Quality Index (PSQI), and the Epworth Sleepiness Scale (ESS).
Polysomnography: Polysomnography is a test that measures your brain waves, eye movements, heart rate, muscle activity, breathing, and oxygen levels in blood while you sleep. Polysomnography is usually done in a sleep laboratory, where you are hooked up to various sensors and electrodes that record your sleep data. Polysomnography can help diagnose or rule out other sleep disorders that may cause or worsen insomnia, such as sleep apnea, periodic limb movement disorder (PLMD), or narcolepsy.
Actigraphy: Actigraphy is a test that measures your movement and activity levels while you sleep and during the day. Actigraphy is usually done with a device that you wear on your ankle or wrist that records your motion data. Actigraphy can help estimate your sleep duration and quality, as well as your circadian rhythm and sleep-wake cycle.

Treatment of insomnia:

The treatment of insomnia depends on the type, cause, and severity of your sleep problem. The main goals in the treatment of insomnia are to improve your sleep quality and quantity, reduce your daytime impairments, and enhance your well-being. The treatment of insomnia may involve one or more of the following approaches:

1. Cognitive-behavioural therapy for insomnia (CBT-I): CBT-I is a type of psychotherapy that aims to change your thoughts and behaviours that can have an impact on your sleep. CBT-I involves various techniques and strategies, such as:
   • Stimulus control therapy: This technique helps you associate your bed and bedroom with sleep and sex only and avoid any other activities that may keep you awake, such as watching TV, working, or eating. It also helps you establish a regular sleep schedule and avoid napping during the day.
   • Sleep restriction therapy: This technique helps you limit the time you spend in bed to the amount of time you actually sleep, plus 15 minutes. This helps increase your sleep drive and efficiency and reduces the time you spend awake in bed. The time you spend in bed is gradually increased until you reach your optimal sleep duration.
   • Relaxation training: This technique helps you reduce your physical and mental tension before bed and cope with any stress or anxiety that may affect your sleep. It involves various methods, such as deep breathing, progressive muscle relaxation, meditation, or guided imagery.
   • Cognitive therapy: This technique helps you identify and challenge any negative or unrealistic thoughts or beliefs that may interfere with your sleep, such as worrying about the consequences of not sleeping enough or having unrealistic expectations about your sleep needs. It also helps you replace them with more positive and realistic ones, such as accepting some variability in your sleep quality or quantity or focusing on the benefits of good sleep hygiene.
   • Sleep hygiene education: This technique helps you learn and practice good habits that promote healthy and restful sleep, such as:
     • Keeping a consistent bedtime and wake-up time, even on weekends
     • Avoiding caffeine, nicotine, alcohol, or heavy meals close to bedtime
     • Creating a comfortable, quiet, dark, and cool sleeping environment
     • Avoiding exposure to bright light at night and getting enough exposure to natural light during the day
     • Engaging in regular physical activity, but not too close to bedtime
     • Avoiding using electronic devices before bed or using blue-light-blocking glasses or apps
     • Having a relaxing bedtime routine, such as listening to relaxing music, taking a warm bath or reading a book.
     • CBT-I is considered the first-line treatment for chronic insomnia, as it has been proven to be effective, safe, and long-lasting. CBT-I can be delivered by a trained therapist in individual or group sessions or through online programs or apps.
2. Medication: Medication can be used to treat insomnia in some cases, especially if it is severe or caused by another medical condition. However, medication should not be used as the sole or long-term treatment for insomnia, as it may have side effects, interactions, tolerance, dependence, or withdrawal symptoms. Medication should be used under the guidance of your doctor, who will prescribe the appropriate type, dose, duration, and frequency of use for your specific case. Some examples of medications that can be used to treat insomnia are:
   • Benzodiazepines: These are sedative-hypnotic drugs that act on the brain’s GABA receptors to induce relaxation and sleepiness. They could make it easier for you to sleep and stay asleep. However, they can also cause side effects such as drowsiness, memory impairment, confusion, dizziness, or falls. They can also lead to tolerance, dependence, or withdrawal symptoms if used for too long or stopped abruptly.
   • Non-benzodiazepine and non-benzodiazepine hypnotics are also sedative-hypnotic medications that act through your neurons’ GABA receptors but have distinct chemical structures than benzodiazepines. They also can help you sleep quicker and remain asleep for longer, with fewer negative side effects and lower danger of developing tolerance or dependence. But, they could result in some negative side effects, like nausea, headache or even atypical dreams. They may also interact with other substances or alcohol. Some examples of non-benzodiazepine hypnotics include zolpidem (Ambien) and zaleplon (Sonata), and Eszopiclone (Lunesta).
   • Melatonin receptor agonists are substances which mimic the action of melatonin, which is a hormone that regulates the cycle of sleep and wakes. They may help you fall asleep quicker and regulate your circadian rhythms, especially in the case of jet time or shift work disorder. They cause fewer adverse effects than other sedative-hypnotic medications. However, they may produce some unwanted side consequences like drowsiness, headaches, or dizziness. They also can interact with other medications or supplements that alter the level of melatonin. One example of a melatonin receptor antagonist is the ramelteon (Rozerem).
   • Antidepressants: These are medicines that alter the levels of neurotransmitters like serotonin, norepinephrine and dopamine that are found in your brain. They are mostly used for treating anxiety and depression issues. However, some may also offer sedating effects and can aid in sleeping better. However, they may cause adverse consequences like the increase in weight, sexual dysfunction and dry mouth. They also can interact with other medications or alcohol. Examples of antidepressants that are employed to treat insomnia include trazodone (Desyrel) and mirtazapine (Remeron), or doxepin (Silenor).
   • Antihistamines: These are medicines that block the actions of histamine, a substance that triggers allergic reactions and inflammation. They are mostly used to treat colds, allergies and coughs, but certain of them may offer sedative effects and can aid in sleeping better. However, they may cause adverse consequences such as drowsiness, dry eyes, dry mouth, and urinary retention. They may also interact with other medications or alcohol. Antihistamines are some examples that are employed to treat insomnia, including diphenhydramine (Benadryl) and doxylamine (Unisom), and hydroxyzine (Vistaril).
3. Alternative therapies: These are alternative therapies that do not require medical methods which can help you relax and rest better. Examples of alternative therapies include:
   • Herbal remedies are compounds that are derived from plants and have therapeutic properties. Some of the herbal remedies that can aid in sleeping are lavender, chamomile lemon balm, and passionflower. However, some herbal remedies can result in adverse effects, interactions or contamination issues. Therefore, you should talk to your doctor before taking the remedies.
   • Aromatherapy: Aromatherapy refers to the application of essential oils extracted from plants to produce pleasant scents that can have therapeutic effects. Essential oils that can aid in insomnia include sandalwood, bergamot and lavender or jasmine. Aromatherapy can be done by inhaling the essential oils by inhaling them directly or diffusing them into the air, or applying the oils to your skin. Aromatherapy can cause adverse effects, allergic reactions or other interactions, so it is recommended to make sure to be sure to follow the directions.
   • Acupuncture: Acupuncture refers to an ancient Chinese treatment method which involves insertion of needles in specific areas of your body in order to boost the flow of Qi and improve the balance of your energy. Acupuncture is a great treatment for insomnia by reducing anxiety, stress as well as inflammation, pain, and. However, it is possible that acupuncture could cause adverse effects, infections or contraindications. Therefore, you should consult with an acupuncturist with a license who adheres to the proper standards for hygiene and safety
   • Massage Techniques: Massage is a method which involves applying pressure and movements on your soft tissue and muscles in order to alleviate pain and tension. Massage can aid in reducing insomnia by calming your mind and body by improving blood circulation and also releasing endorphins. But, it is possible that massage can cause adverse effects, contraindications or other interactions. Therefore, you should consult a licensed massage therapist who understands the medical history of you and your needs

Tips to manage insomnia:

Alongside the above treatment options, There are a few actions you can take to combat insomnia and increase your quality of sleep and quantity. Here are some helpful tips and resources to help manage insomnia:

Get help: Insomnia can make you feel depressed or isolated. It can also impact your relationships, performance at work or confidence in yourself. It’s not necessary to struggle with insomnia by yourself. You can get help from your family members therapists or even friends to help you cope up with insomnia. They will be able to offer practical, emotional, or even professional advice. You can also get valuable experience from others suffering from same disease by joining the online communities where you can talk about your experiences and difficulties you are facing as well.
Educate yourself: Be aware of the fact that insomnia can be overwhelming, confusing, or even frightening. There may be a lot of questions or doubts regarding your sleep issues and the best way to deal with it. You can learn more about insomnia through reading articles, books, podcasts, blogs, or articles that offer reliable and scientifically-proven information and advice. You may also ask your physician or your therapist any questions you might have regarding the diagnosis, treatment or prognosis. The more you are aware of insomnia greater confidence and energized you’ll feel about overcoming it.
Do your best to self-care. Insomnia can impact every aspect of your health negatively. You can take care of yourself by taking treatment of your body and mind and doing things that keep you feel healthy and happy. Self-care can be practised by eating a balanced and healthy diet and drinking plenty of water and exercising regularly, managing your stress, staying away from substances that could affect your sleep, maintaining healthy habits of hygiene, having regular checks and treating any medical issues by expressing your feelings by engaging in hobbies and activities you like and spending time with friends who are supportive of you, and seeking out professional assistance when needed.
Be patient. Insomnia can be a hassle and a pain to handle. It could take a while and some effort to determine the most effective treatment for your condition and then to observe the results. You might also encounter difficulties or relapses along the route. It is important to be at peace with yourself and your progress and never let your dreams go. It is important to be proud of your accomplishments and thank yourself for the effort you put into it. Keep in mind that insomnia can be treated and managed, and you can improve your quality and quantity of sleep with the proper treatment and guidance.

FAQs:

1. What is the first line of treatment for chronic insomnia?

For insomnia, the CBT-1 technique is the first line of treatment as it is long-lasting, safe and effective.

2. What are the different types of insomnia?

There are two types of insomnia acute and chronic insomnia. Acute lasts for short duration, while chronic can last from a week to 3 months.

3. When should I seek medical help from insomnia?

You should consult with the health care consultant when insomnia continues for several weeks and interferes with your daily life.

4. What are the natural remedies for insomnia?

The natural remedies for insomnia are herbal supplements, meditation, aromatherapy and yoga.

5. Can children and teenagers suffer from insomnia?

Yes, children and teenagers suffer from insomnia due to stress or excessive use of electronic devices.

Affan Lateef

Hi, I’m Affan lateef , a pharmacist by profession. I have a degree in pharmacy and over 5 years of experience helping people achieve their health goals. I write about various topics like health, artificial intelligence in health, mental health, diet and weight loss. Follow me here on these platforms given below.