Sleep is essential for physical and emotional wellbeing of an individual. Everyone experiences occasional sleep disturbances; however, frequent and repetitive alterations in sleep could indicate an underlying health problem. Some of the common sleep disorders include difficulty in falling asleep, inconsistent sleep, drowsiness during the day and a feeling of exhaustion on waking up. Lack of sleep may hamper your concentration and affect the performance of your activities of daily living. Lack of sleep can also lead to depression, mood swings, or other health problems.
Insomnia is a sleep disorder characterized by a difficulty in falling asleep or inconsistent sleep throughout the night resulting in too little or poor-quality sleep and a feeling of exhaustion when you wake up.
There are two forms of insomnia:
Primary insomnia: This refers to insomnia without any underling health condition or problem.
Secondary insomnia: This type is caused by medical conditions such as depression, heartburn, asthma, arthritis, and cancer as well as medication, pain, and certain substances such as alcohol.
Insomnia can be acute or chronic. Acute insomnia lasts from one night to a few weeks while with chronic insomnia, the sleep disturbances occur at least three nights per week, for more than a month.
Causes of Insomnia
Acute insomnia can result from stress, physical discomfort, a poor sleeping environment such as too much noise, light or inappropriate temperature, and working evening or night shifts. The use of certain medications such as those used to treat colds, allergies, depression, high blood pressure, and asthma may also affect sleep.
Secondary insomnia may have an underlying medical disorder such as depression or anxiety, chronic stress, or chronic pain.
Symptoms of Insomnia
The most common symptoms of insomnia include:
- Trouble falling asleep.
- Frequent awakening during the night and not being able to get back to sleep.
- Waking up early in the morning.
- Feeling tired and exhausted on waking up.
Other symptoms include irritability, daytime sleepiness, poor concentration and memory.
Diagnosis of Insomnia
Your doctor will diagnose insomnia based on your medical history, including history of your sleep pattern, and a physical examination. You may need to keep a sleep diary, for a week or two before you see your doctor, to document the time of day you fall asleep and wake up, any changes in your daily sleep routine or bedtime routine, and how you feel during the day. Your doctor may also talk to your bed partner about your sleep pattern. Your doctor may also recommend a sleep study to help rule out other types of sleep disorders such as sleep apnea.
Polysomnogram (PSG): A PSG is the most commonly used test for the diagnosis of sleep apnea. This test records the brain activity, eye movements, oxygen and carbon dioxide levels in your blood stream, heart rate and rhythm, breathing rate and rhythm, air flow through your mouth and nose, and body muscle movements.
Treatment for Insomnia
Acute or short-term insomnia does not require any treatment and can be often prevented or cured by practicing proper sleep habits. However, if insomnia affects your functional abilities, your physician may prescribe sleep inducing medication, for a limited period of time.
To treat chronic insomnia, your doctor will first treat any underlying medical health problems that are interfering with your sleep. If insomnia continues, behavioral therapy may be recommended to modify behaviors, which can worsen insomnia, and also learn new behaviors to promote good sleep. Other behavioral techniques such as relaxation therapy, sleep restriction therapy and reconditioning may also be helpful in improving your sleep.
Relaxation therapy: This helps reduce or eliminate night time stress, body tension and anxiety. The goal is to calm the mind so you are able to fall asleep.
Sleep restriction therapy: This is a type of behavioral treatment in which your sleep efficiency is improved by initially limiting your sleep time.
Reconditioning: This approach helps your body to associate bed and bedtime with sleep. The person is usually advised to use bed only for sleep and sex. You are taught to go to bed only when sleepy. During the reconditioning process you should avoid short naps and go to bed at the same time every night. If unable to sleep, leave your bedroom and do something else until you feel sleepy.
Sleep hygiene refers to any sleep practice that can help one achieve a good night's sleep or resolve insomnia. Good sleep hygiene practices include the following:
- Maintain a regular sleep schedule.
- Avoid napping during the day as it can make you less sleepy at night.
- Avoid stimulants such as caffeine, nicotine, and alcohol during late hours of the day.
- Exercise regularly, but not close to bedtime.
- Avoid large meals close to bedtime.
- Adjust the bedroom environment so that the room is not too hot or cold, or too bright.
- Establish a bedtime routine such as reading a book, listening to music, or taking a bath that help you relax before sleep.
- Make sure that you do not use your bedroom for anything other than sleep and intimate relations.
- If you can't sleep, leave your bedroom and do something else until you feel sleepy.
- Make a plan about all the things you have to do the next day, so that you don't worry about it when trying to sleep.
Insomnia is a sleep disorder characterized by trouble falling asleep or disturbed sleep throughout the night. A lack of restful sleep can affect your ability to perform your daily activities. Simple lifestyle changes can improve your sleep quality. See your doctor or a sleep specialist if you think that you have insomnia.