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a woman with insomnia lying in bed, frustrated that she can't sleep

Having Difficulty Sleeping? It Could Be Insomnia

Signs, Symptoms and How to Treat Insomnia

Insomnia (the inability to fall or stay asleep) is one of the world’s most common sleep disorders. In many cases, insomnia is short-lived and develops as a result of something unrelated to your overall health (such as a stressful event). For some people, however, insomnia symptoms can persist for months or even years, and are often linked to other underlying medical conditions. Many sufferers often seek medical advice and information on how to treat insomnia.

Treatment options for insomnia are based on the causes of your sleeplessness, and may involve medications, therapy, or addressing problems with your sleep routine.

What Is Insomnia?

Insomnia is a sleep disorder that is characterized by an inability to fall asleep, to stay asleep or both. It is not known exactly how many people have insomnia, but it is common worldwide, with many studies estimating that it affects up to a third of the global population.

There is no single, encompassing insomnia definition, as bouts of insomnia may be mild or severe and can last anywhere between a few days and several years. Some people only get insomnia occasionally, and the condition clears up by itself after a few days or weeks. Others suffer with insomnia on a chronic basis (often as a result of an underlying medical condition) and may require treatment to overcome the disorder.

In cases of chronic insomnia, the effects of long-term sleep deprivation on the individual’s quality of life can be devastating. Often, the best way to tackle insomnia and improve your quality of sleep is to address the underlying reasons for your sleeplessness, whether medical, psychological, or environmental.

Understanding the Symptoms of Insomnia

The primary symptom of insomnia is difficulty sleeping, which is characterized by:

  • Difficulty falling asleep
  • Waking up during the night
  • Waking up too early

The sleep deprivation caused by insomnia can also cause a separate set of secondary symptoms, which may include:

  • Daytime fatigue or sleepiness
  • Feeling poorly rested upon waking
  • Irritability and mood swings
  • Depression or anxiety
  • Difficulty concentrating
  • Tension headaches
  • Gastrointestinal symptoms (such as diarrhea, nausea or constipation)
  • Social withdrawal
  • Feelings of anxiety around sleeping (sleep anxiety)
  • Increased clumsiness or a greater tendency to make mistakes
  • Headaches

Different Types of Insomnia

Insomnia can be classified into four separate categories, depending how long it persists for. The category you fall into will impact the question of how to treat insomnia. These four types of insomnia are:

Transient Insomnia

Transient insomnia is the mildest form of the condition and describes bouts of insomnia that last for less than a week. This form of insomnia is usually caused by temporary physical and psychological stressors such as stress, jet lag, a big life change, illness, or other factors relating to your environment. Transient insomnia usually clears up by itself without treatment and is non-recurring.

Intermittent Insomnia

Transient insomnia that does recur from time to time is known as intermittent insomnia.

Acute Insomnia

Acute insomnia (also known as situational or short-term insomnia) is a form of the disorder in which symptoms persist for several weeks.

Chronic Insomnia

This is the most severe form of insomnia, with symptoms lasting up to several months or even years. Chronic insomnia is usually a side effect of another underlying medical condition and can cause long-term sleep deprivation.

What Causes Insomnia?

Insomnia that is not linked to any other health or medical issue is known as primary insomnia. When insomnia arises as a result of other, underlying medical conditions, this is called secondary insomnia.

Insomnia may be caused by any number of factors surrounding your overall health, lifestyle, and sleep environment. If your insomnia arises from problems that are unrelated to your overall health, this is known as primary insomnia. Secondary insomnia describes insomnia that develops as a result of other, pre-existing medical conditions.

Causes of Primary Insomnia

Primary insomnia describes insomnia that is caused by factors that are not related to any other medical condition. These may include:

  • A stressful event (such as starting a new job, ending a relationship, or moving to a new area)
  • Disturbances in your sleep environment (like excessive noise or light)
  • Drinking caffeine late at night
  • Eating late at night
  • Disruptions to your usual sleep schedule (possibly as a result of jet lag or working late over a series of nights)

Causes of Secondary Insomnia

Secondary insomnia is caused by underlying medical conditions. Common health problems that may lead to secondary insomnia include:

  • Restless leg syndrome
  • Sleep apnea
  • Conditions that cause pain or discomfort at night
  • Anxiety or depression
  • Endocrine problems (such as hyperthyroidism)
  • Use of certain medications

The Potential Health Risks of Insomnia

Transient and acute forms of insomnia usually pass within a few days or weeks, may not require treatment, and rarely have any lasting health effects.

However, the consequences of the long-term sleep deprivation that affects people with chronic insomnia (lasting a month or longer) can be severe. The immediate effects of sleep deprivation (including difficulty concentrating, irritability and daytime fatigue) can negatively impact quality of life.
In the long-term, the loss of sleep caused by insomnia can contribute to far more serious health problems, including:

  • High blood pressure
  • Heart disease
  • Heart attack
  • Stroke
  • Diabetes mellitus
  • Seizures
  • Obesity
  • Increased inflammation
  • Asthma attacks
  • Anxiety and depression
  • A weakened immune system
  • Heightened sensitivity to pain

Other potential complications and side-effects of insomnia can include:

  • Increased risk of accidents (caused by impaired concentration and coordination)
  • Loss of sex drive
  • Impaired memory
  • Impaired judgment

Treatment Options for Insomnia

For many people, periods of insomnia are brief and pass without treatment. However, if your symptoms persist for more than a few days or start to significantly affect how you feel in the daytime, there are many treatment options that may help you to get back to a healthy sleep pattern.

Home Remedies for Insomnia

Home remedies are often the first treatment option for people with mild insomnia, and usually involve practicing good "sleep hygiene", practicing relaxation techniques before bedtime, or using natural remedies as soothers.

Sleep Hygiene Training

Insomnia is often caused by poor sleep hygiene; that is, disruptive bedtime behaviors that make it harder for you to sleep. Commonly suggested changes to these habits include:

  • Avoiding caffeinated drinks in the evening
  • Avoiding rigorous exercise in the evening
  • Avoiding eating late at night
  • Minimizing your use of screens near bedtime

Natural Remedies

Some essential oils are thought to promote restfulness and sleep. Lavender, chamomile, and cedar wood are among those most commonly used to treat insomnia.

Meditation

Mindfulness meditation is a powerful relaxation technique that may help combat insomnia. Studies have found that regular sessions of meditation effectively reduced insomnia symptoms and increased sleep quality in people who practiced the technique regularly.

Psychological Treatments for Insomnia

Cognitive behavioral therapy (CBT) is often recommended to treat insomnia, and is thought to treat the disorder even more effectively than sleep medications. CBT focuses on helping people with insomnia identify and address the behavioral and thought patterns that stop them from sleeping. Popular CBT strategies include:

  • Relaxation techniques such as meditation.
  • Stimulus control therapy, which aims to identify factors relating to your sleep habits that condition your mind to stay awake. Strategies may include sticking to a set bedtime, avoiding naps, and only using your bedroom for sleep.
  • Sleep restriction creates a mild form of sleep deprivation by restricting your time in bed and avoiding naps. By making you more tired, this method can make it easier for you to fall asleep the following night.

Medical Treatments for Insomnia

If your insomnia proves resistant to non-pharmaceutical treatment options, your doctor may recommend sleep medication. More commonly known as "sleeping pills", these drugs may be prescribed or bought over the counter and will be recommended based on the severity and duration of your condition.

Prescription Sleeping Pills

There are many prescription medications that can help you fall asleep, though doctors don’t usually recommend using these for longer than a few weeks. Benzodiazepines are the most commonly prescribed of these, but your doctor will make a recommendation based on the type and duration of your insomnia.

Over-the-counter Sleeping Pills

These often contain antihistamines, which may make you drowsy. Other over-the-counter sleeping pills may contain melatonin or certain herbal extracts.

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