Insomnia: Causes, Symptoms & Treatment
What is Insomnia?
On average, we sleep one and a half hours less per night than our ancestors did 100 years ago and with today’s fast pace and lifestyle, nearly 50% of the adult population in the US is sleep deprived. This is partly due to longer working hours, increased commuting times, or looking after babies and young children but is also due to insomnia.
Insomnia refers to the disrupted sleep or difficulty experienced when falling asleep or staying asleep. People who experience insomnia are often frustrated and dissatisfied with their sleeping patterns. Usually, these people experience extensive fatigue, difficulty concentrating, mood disturbances, unproductivity and low energy.
Table of Contents:Causes & Symptoms
Physiology of Sleep
Causes & Symptoms of Insomnia
One of the main causes of Insomnia is stress, but it is common that Insomnia may be associated with other conditions.
Here are some of the common causes of Insomnia
- Stress: concerns about life, school, kids, family, work or finances can lead to Insomnia.
- Travel: Your daily routine acts as an internal clock. There may be days that you need to travel for work or leisure and this can disrupt your body’s routine, leading to Insomnia.
- Poor sleeping habits: irregular bedtime, naps or an uncomfortable environment can lead to sleep deprivation. This includes irregular screen time.
- Eating late: having a meal or snack before bedtime is not wise. You may begin to feel physically uncomfortable while attempting to get some rest.
- Nicotine, caffeine & alcohol: coffee or caffeinated drinks are known as stimulants. Drinking stimulants late in the evening or afternoons can cause Insomnia at night.
- Medical conditions: Cancer, Diabetes, overactive Thyroids, Parkinson’s and Alzheimers can lead to insomnia.
Treatment of Insomnia
- In some patients with extreme insomnia, behavioral therapies may be used such as relaxation therapy with special techniques to calm you and relax your muscles.
- Cognitive therapy is a useful technique for sufferers that often display unrealistic sleep expectations. These expectations can lead to performance anxiety due to excessive effort at trying to control the amount and quality of sleep. Cognitive therapy identifies these beliefs about sleep by replacing them with more adaptive and realistic beliefs and shifting of attention.
- Progressive muscle relaxation is a technique in which you are instructed to tense and relax different muscle groups throughout the body one by one to reduce the muscle tension that is often observed among insomniacs at night and during the day.
- Biofeedback is a method of providing visual or auditory feedback to you to help you control certain physiological factors such as muscle tension, ultimately encouraging you to become more inclined to sleep.
- Imagery training is a visualization used to focus on pleasant or neutral thoughts in order to diminish cognitive arousal.
- Sleep restriction is another method that initially allows only a few hours of sleep per night while gradually increasing the nightly sleeping time. The amount of time in bed is shortened to match the amount of time asleep.
- Reconditioning is a method that teaches you to associate your bed with sleeping and not daytime naps. Called stimulus control, this is a technique where you are trained to re-associate your bed and the bedroom with rapid sleep onset.
- Drug treatment or medication may be effective in preventing physiological insomnia when all other methods are unsuccessful but it is important to diagnose any underlying medical or psychiatric condition and treat this too as the prolonged use of medication, without addressing the root cause, may result in dependency. Hypnotic or sleep inducing medications should only be used for a few days at a time in order to try and break a pattern of sleeplessness while addressing any underlying problem.
- If depression has been diagnosed, then antidepressants can be effective in helping you to overcome the depression and so sleep better.
Insomnia & the Physiology of Sleep
You and I function according to a natural cycle that repeats itself every 24 hours. The name of this cycle is the circadian rhythm and it controls our sleeping cycle and our waking cycle.
Interestingly, when it gets dark, the cells in the retina of the eye send a message directly to a special part of our brain. The pineal gland then produces the hormone melatonin and this causes a drop in our body temperature and sleepiness. At the same time, there is a reduction in those chemicals in our body which are responsible for arousal.
Most people are then ready for sleep.
This sleep is characterized by two distinct states, non-REM sleep and REM sleep. Both states alternate in 90 to 110 minute cycles while a normal sleep pattern has 4-5 cycles so you can see how this makes up our roughly 8 hour night’s sleep. However these cycles of sleep have been compared to going up and down a stairway.
Non REM sleep which takes up about 75% of the sleep cycle has 4 stages ranging from light dozing to deep sleep.
- Stage 1 is the dozing stage and a period of very light sleep when we start to relax. It is during this stage that you may experience the sensation of falling and jerking suddenly into wakefulness which is called a hypnic jerk.
- Stage 2 is characterized by a lack of eye movements and a time of light sleep. You could still be woken up fairly easily.
- Stage 3 is when deeper sleep is experienced and you would become more difficult to wake up.
- Stage 4 is a time of very deep sleep and if you are woken during such deep sleep, you will probably feel sleepy and disoriented for several minutes.
The deep sleep you experience in stages 3 and 4 is called delta sleep and it is the most restful kind of sleep.
REM sleep (Rapid Eye Movement) takes up about 25% of our sleeping cycle.
REM sleep is when most dreaming takes place along with periodic eyelid fluttering, muscle paralysis and irregular breathing. At this time, the brain blocks signals to our body’s muscles so that we remain immobile during our dreams and do not thrash about and act them out.
Sleep is a very necessary and important function in our daily lives and essential to our physical and emotional well being. Without enough daily sleep, our ability to perform even the simplest task can be severely reduced. Sleep restores our body and mind, allowing the body to rest and the mind to do a lot of sorting out such as organizing our long term memory, absorbing new information as well as repairing and renewing tissue, nerve cells and even biochemicals.
The longer you stay awake, the more sleep you need.
So if you are awake for 36 hours, you may well need to sleep for 18 hours to catch up again thereby allowing the body to reverse the effects of sleepiness by sleeping. The body reacts to a lack of sleep by having daytime drowsiness so that you are inclined to go to sleep early or to sleep in late. The ideal amount of sleep you need is the amount needed to feel refreshed and well rested in the morning so that you stay alert all day.
You can therefore see how debilitating insomnia can be and how we need to find out the reason or reasons for any insomnia we may be suffering as well as treating the symptoms of the condition itself.
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