*Nothing in this article should be construed as medical advice. If you have any questions, please contact your physician.*
At some point in time, we’ve all been there. It’s time for bed, you need to get up early the next morning, but for some reason, you can’t sleep. While this can be a normal, infrequent experience for most of us, if this happens often, it may have a specific diagnosis: insomnia.
What is Insomnia?
Put simply, insomnia is a common sleep disorder that makes it difficult to fall asleep, stay asleep, or get back to sleep after waking up. Insomnia is one of the most prevalent sleep disorders affecting adults in the United States. As of 2017, roughly 1 out of 7 adults were affected by long-term, chronic insomnia.
The symptoms of insomnia can manifest themselves like the definition of the condition suggests: difficulty sleeping. There are a few key things to look out for when understanding whether insomnia is affecting a specific person. Common symptoms of insomnia include:
- Waking up before your alarm goes off
- Feeling not rested or tired upon waking up
- Trouble falling asleep after going to bed
- Waking up often during the night
- Only sleeping for short periods of time
More than just feeling tired in the morning, the symptoms of insomnia can lead to other unfortunate conditions.
- Mood disorders. Insomnia is linked with depression and anxiety, amongst other mood disorders.
- Lifestyle alterations. Lack of sleep can lead to general irritability, lack of interest in normal activities, and difficulty in relationship formation.
- Work complications. A good night’s sleep is important in memory, retention, and understanding, each of which can be important in a healthy work life.
Causes of Insomnia
Each case of insomnia is different, so the root cause of one person’s insomnia may drastically differ from another person’s. Generally, cases of insomnia can be divided into the length of experience of symptoms: chronic (long-term) or acute (short-term). Chronic cases are usually defined as episodes lasting greater than one month. Acute cases are defined as those episodes lasting less than one month. Let’s take a look at some of the most common triggers for insomnia.
Stress is one of the most commonly reported associations with insomnia. The exact cause of stress can come from a multitude of life events: an increase in work responsibilities, the birth of a child, the death of a family member, or financial troubles. Worse, lack of sleep can make work or childcare more difficult, adding to the stress. This positive feedback loop is a topic of study at many institutions.
It is also possible for insomnia to be secondary to other sleep-related disorders, like sleep apnea. Sleep apnea is a condition in which a person’s breathing is interrupted several times during the course of night’s sleep. This punctuated breathing pattern causes the individual to wake-up, thereby contributing to insomnia. But, many other conditions are linked to insomnia including cancer, heart disease, Parkinson’s disease, Alzheimer’s disease, and asthma.
Have you ever noticed that when traveling between timezones, your body seems to want to sleep and wake according to your home time? This is because our body’s internal clocks are controlled by our circadian rhythms. This is, essentially, a constantly-running 24-hour clock that tells our brain when we’re tired, sleepy, or hungry.
When work or life forces a new schedule onto you, this will cause an imbalance between your body’s circadian rhythm and the time on the clock. For example, let’s say a person normally works a 7am to 5pm shift at a hospital. They change positions, and they work the night shift from 9pm to 7am. That person may likely feel very drowsy while at work, and then, even though they have been up for quite some time, they still have trouble falling asleep at 8am.
Any number of drugs can have adverse effects on sleep quality. Drugs that have neurologically stimulating effects, like caffeine, can make falling asleep extremely difficult. Some prescription drugs can also lead to poor sleep quality. Diuretics, anti-depressants, and steroids have all been linked to higher rates of insomnia.
Thankfully, while there are a number of various causes of insomnia, there are also a varied number of treatment options.
Cognitive Behavioral Therapy
Cognitive behavior therapy for insomnia (CBT-I) is a type of therapy that attempts to eliminate the root cause of negative, worrying, or anxious thoughts that can often be the cause of insomnia. Broadly, the treatment can be understood through two different mechanisms of action.
The first is the cognitive component. This teaches patients to identify, understand, and eliminate negative, racing thoughts. It is predicated on the belief that these thoughts are the primary cause of a person’s insomnia.
The second component is behavioral. Within this realm, a therapist will look to identify patterns of behavior that are causing poor sleep quality. This could possibly result in the diagnosis of an underlying condition like sleep apnea or depression. In this case, treatment may shift to a disease-specific regiment like a CPAP machine or anti-depression medication.
In the absence of an underlying medical condition, the therapist will attempt to identify routines that will improve sleep quality. This may involve less technology or screen time before bed, a change in diet or exercise, or even meditation.
Generally speaking, prescription medications for insomnia are prescribed on a short-term basis. They can help patients break acute cycles of insomnia and start the process of recovery from chronic insomnia. They can be addictive, and in the long run, they can be damaging to overall sleep quality. That being said, they are extremely effective when used safely under the guidance of a physician. Common brands include Lunesta, Rozerem, Sonata, and Ambien.
When discussing sleep apnea, the multitude of variable can become overwhelming. There are so many causes, side effects, and treatments. For this reason, if you or someone you love may be experiencing anything we discussed in this article, you should not hesitate to contact your physician.
Written by: Patrick O'Hare