Insomnia

What Is Insomnia?

Almost everyone goes through bouts of sleeplessness from time to time. It happens to the average person about once a year. That's the cost of being human and having the capacity to worry about the future and chew over the past.

Chronic insomnia, however, is marked by difficulty falling asleep or staying asleep, or by waking up too early. If it takes you 30 minutes or more to fall asleep, or if you're awake for 30 minutes or more during the night at least three times a week—for a month or more—you're officially suffering from insomnia. Approximately 50 to 70 million Americans have a sleep or wakefulness disorder, according to the Centers for Disease Control and Prevention. Insomnia has major effects on mood as well as on alertness. It is also a classic symptom of depression.

Short-acting sleeping pills may improve sleep and next-day alertness, but the best way to handle a bout of insomnia is to do nothing; the body's sleep mechanism tends to right itself, if given the chance. The most effective treatments for chronic insomnia are behavioral techniques that eliminate sleep anxiety and allow the body's own sleep cycle to kick in.

Symptoms of Insomnia

Insomnia can present in several different ways. People suffering from insomnia find it difficult to fall asleep, wake up frequently in the middle of the night and have trouble going back to sleep, wake up too early in the morning, and/or awaken feeling tired. Insomnia may cause daytime fatigue and reduced energy levels. Individuals with insomnia may also experience weakened coping skills, difficulty paying attention and concentrating, memory problems, and trouble performing even routine tasks.

But most of all, insomnia affects mood. The chronic sleep disruption of insomnia appears to be the single biggest trigger for depression and irritability.

Causes of Insomnia

Stress is the primary cause of insomnia, but there are also physical conditions that can bring on the condition. Your doctor should rule these out first. They include sleep apnea, overactive thyroid, certain medications, and gastrointestinal problems, such as gastroesophageal reflux.

Lack of sufficient physical activity during the day can interfere with the body's drive for sleep. Substance abuse can also be a major sleep disruptor.

Insomnia most often occurs in response to how people handle a bad night or a few bad nights of sleep. People often try to compensate for a brief sleepless period by sleeping later, napping in the afternoon, having a few drinks before bed, or going to bed early. But those actions only lessen the body's natural sleep drive or cause more early wakefulness. Because the anxious brain quickly learns to associate the bedroom with wakefulness, a self-defeating cycle takes on a life of its own.

Some people are at risk of insomnia by virtue of such environmental factors as shift work and jet lag. People who do not get enough exposure to sunlight during the day can also have trouble sleeping. And such factors as drinking too much caffeine or overheating a bedroom can also interfere with sleep.

Treatments for Insomnia

A short-term bout of insomnia is best handled by doing nothing. It's important not to compensate by staying in bed longer or napping during the day.

Chronic insomnia responds well to behavioral treatments aimed at eliminating anxiety and stopping the behaviors that wind up worsening and perpetuating the condition.

Cognitive behavioral therapy targets the thoughts and actions that disrupt sleep. It may include relaxation training to reduce anxiety. It focuses on establishing a sleep schedule that restricts the time you spend in bed awake.

All effective treatments for insomnia encourage good "sleep hygiene." Good sleep hygiene includes:

  • Sleeping and waking at the same time every day (including on weekends)
  • Learning simple meditation and practicing it before bedtime
  • Getting adequate exercise during the day
  • Limiting caffeine consumption and restricting it to mornings
  • Avoiding alcohol, which is a great sleep disrupter
  • Keeping the bedroom dark, especially as one gets older
  • Keeping the bedroom cool (and sleeping under blankets)

Children and Teens

Young children need 10 to 11 hours of sleep, experts say. Problems with little ones and sleep often occur when early bedtimes are not strictly enforced. And children with ADHD frequently suffer from sleep problems.

Teenagers, who are famous for staying up late and sleeping in, are a sleep-deprived group. Experts estimate that a full quarter of adolescents suffer from insomnia. And a recent study found that teens who go to bed after midnight are 20 percent more likely to develop depressive symptoms than are those who go to bed before 11 p.m.

Women and Insomnia

People of all ages and walks of life can suffer from insomnia. Studies say that about one in four women are currently experiencing insomnia symptoms. Women are especially sensitive to irregular sleeping habits because of the hormonal changes they experience during pregnancy and perimenopause.  

Insomnia can cause women to have more accidents, with falls being especially common, especially for the elderly. Women with insomnia are at risk for certain health problems, including diabetes and high blood pressure. Women are also more likely to suffer from depression, which is linked to sleeplessness.

Insomnia and Depression

Depression is a major cause of insomnia, and yet it's also a symptom. For some people, depressive symptoms will appear before the onset of sleeping problems, while others will notice insomnia symptoms first. Due to the similarity of symptoms, insomnia can be misdiagnosed as depression, and vice versa.

The mood-sleep connection often plays out in a frustrating cycle for sufferers of either condition: Anxiety and rumination keep them up at night, and the lack of restorative sleep triggers a worse state of mind the next day. The relationship between depression and insomnia can also complicate treatment in the case of certain medications and therapies.

Sleep Basics

What are the keys to coping with insomnia effectively and getting a good night’s rest? Experts advise people with insomnia to develop good “sleep hygiene.” Individuals with insomnia will benefit from creating a tranquil space just for sleep that is dark and comfortably cool. They should avoid substances that can aggravate insomnia symptoms, such as caffeine and certain medications. They may wish to establish a routine that involves healthy eating, exercise, meditation, or other stress-reducing practices. It may also be helpful for them to keep a journal and share their insomnia experiences with their partner or other trusted loved one. Remember: Insomnia is, for the most part, temporary and can be treated in time.

CONNECTED TOPICS

Sleep, Anxiety

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