Insomnia

Learn what causes insomnia, its effects and treatment options.

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  1. What is Insomnia?
  2. Diagnosing Insomnia
  3. What Causes Insomnia?
  4. Help for Insomnia
  5. More Information for Insomnia

What is Insomnia?

Insomnia is a common sleep disorder in adults. Most doctors define insomnia simply as too little sleep or poor-quality sleep. This can include sleep problems such as having trouble falling asleep, staying asleep, waking up too early, waking up during the night and struggling to fall back asleep, and waking up feeling tired despite a full night’s sleep.

Sleep problems can have a number of different causes, including stress, anxiety or too much caffeine. No matter the cause, not getting enough sleep can have serious effects on your daily life. People with insomnia can experience symptoms including sleepiness, fatigue, low energy, bad mood, depression and decreased concentration. Lack of sleep also increases the risk of having an accident, making a serious mistake or using poor judgement.

How much sleep do you actually need? The amount varies between individuals. Research shows most people need between 7-8 hours of sleep each night, although as few as 5 hours or as many as 9 hours can be normal.

Who Suffers From Insomnia?

Insomnia can affect anyone from children to the elderly, although sleep problems tend to increase with age. People who are over 60 years old and women going through menopause are more prone to insomnia, probably due to decreased levels of melatonin in the brain.

What is Healthy Sleep?

To understand the causes of insomnia, let’s take a look at how the sleep cycle works. The amino acid L-tryptophan (found naturally in certain foods) is converted into 5-HTP and is used by the body to manufacture the neurotransmitter serotonin.

Serotonin is transformed into a sleep hormone called melatonin by the pineal gland in the brain. The pineal gland only becomes active after dark. By regulating levels of melatonin, our bodies create the “sleep-wake cycle”, or circadian rhythm. Sufficient production of serotonin and melatonin is critical for healthy sleep patterns.


Diagnosing Insomnia

If you have long-term difficulties sleeping, seek a professional medical evaluation. Keeping a sleep diary for a week or two—in which you record waking/sleeping hours, quality of sleep, and symptoms—can help your doctor better understand your insomnia symptoms.

Symptoms include having trouble falling asleep, problems staying asleep, waking up during the night and being unable to fall back asleep. Signs can also include waking up feeling tired despite a full night’s sleep.

During your appointment, your doctor will review your sleep journal, take a medical history and sleep history, and do a physical exam. Other questions may include whether or not you snore, have sleep apnea, experience any physical pain or have other medical conditions or emotional concerns. Based on your doctor’s assessment, he or she will recommend appropriate treatment. You may be referred to a sleep disorders center or psychologist for further evaluation.

What are the Different Types of Insomnia?

The inability to fall or remain asleep can take many different forms and has multiple causes.

There are two main types of insomnia:

  • Sleep-onset Insomnia – problems falling asleep, also called Initial Insomnia
  • Sleep-maintenance insomnia – waking during the night and early in the morning

Many people have a combination of these two types. Insomnia can also be chronic (nearly every night) or intermittent (occasional). People with chronic insomnia can experience primary insomnia, which is not related to another medical condition or environmental condition, or secondary insomnia, which is caused by another medical problem or a poor sleeping environment.

What Causes Insomnia?

There are many possible causes of insomnia. Usually, it’s a sign that something in our life is not right or out of balance. About half of all cases are linked to psychological causes such as depression, anxiety and stress.

If you’re trying to figure out your triggers, ask yourself a few simple questions. Do you:

  • Stay up late watching TV, visiting websites or looking at your phone?
  • Drink too much coffee or alcohol?
  • Keep irregular hours?
  • Nap during the day?
  • Have an uncomfortable sleeping environment?
  • Worry constantly?
  • Work shift work?

Other causes can include:

  • Sleep apnea
  • Snoring
  • Bladder problems
  • Prostate problems
  • Serotonin deficiency
  • Low levels of melatonin in the brain (common among the elderly)
  • Magnesium or iron deficiency
  • Jet lag
  • Hormonal imbalance
  • Excessive consumption of caffeine or other stimulants
  • Side effects of prescription medication (especially anti-depressants)
  • Hypoglycemia

How to Get Help for Insomnia

Treatment depends on the individual situation. In many cases, disrupted sleep resolves without treatment, especially if it’s related to jet lag or temporary stress. If sleep problems continue long-term, become a regular occurrence or begin to make you feel overly tired and unproductive, ask for help.

 

There isn’t a magic cure, but most treatment options try to address the underlying cause. Options may include psychotherapy, visualization and relaxation techniques or drug treatments. Remember to ask your doctor about all treatment options, so you can make an informed decision. Some health care providers are quick to prescribe sleeping pills, although they have known side effects and can be highly addictive.

 

Drug Treatments

Although sleeping pills can seem like a quick fix, many doctors realize that medication should be a last resort due to the risk of addiction and side effects. Sleeping pills can help in some cases, but they are not a cure for insomnia. They offer temporary relief and should generally only be used for a few days to allow the body to rest (for example, after a very traumatic event).

 

Regular use can lead to rebound insomnia as a withdrawal from the pills and addiction. Side effects can include drowsiness the next day, increasing the risk of accidents and clumsiness. Prescription insomnia medications include melatonin receptor agonists, benzodiazepine hypnotics and non-benzodiazepine hypnotics. These medications may be unsafe to use if you have certain other medical problems. Before agreeing to drug therapy, be sure to explore all your options for improving sleep without medication.

 

Non-Medical Treatments (Cognitive Behavioral Therapy)

Often insomnia is related to a psychological state such as stress, anxiety, depression or burnout. Some form of psychotherapy may be recommended if a medical cause for sleep problems isn’t found. Therapy can help recondition your sleeping habits and restore a healthy sleep-wake pattern.

 

Visualization and Relaxation Techniques

Visualization can be a helpful technique when you’re struggling to sleep. Picturing a relaxing, tranquil place in your mind can help quiet the mind and body. Other relaxation techniques such as guided imagery, deep breathing exercises, mindfulness, guided sleep meditation and progressive muscle relaxation also have great success.

 

Stimulus control limits the types of activities that happen in the bedroom, in order to break unhealthy associations between the bedroom environment and wakefulness.

Tips for Coping with Insomnia

Try to stick to a sleep time routine. Try to get to bed at the same time each night and wake up at the same time each morning.

Reduce sleeping hours. Too much sleep can actually cause insomnia! Try cutting your time in bed by 1 hour for two weeks and see if this helps.

Get rid of the bedroom clock. Set an alarm so you don’t oversleep, but hide it (so you’re not constantly aware of the time or how much sleep you’re missing).

Keep active during the day. Get at least 30 minutes of exercise daily, but avoid exercise at bedtime.

Wind down each day and learn to relax. Find ways to reduce stress and set aside time each night to unwind and relax from the day’s business. Take a hot bath, drink some herbal tea, or do a calming activity that you enjoy such as writing, reading or working on a puzzle.

Stop trying so hard. The worst possible thing to do when you can’t sleep is to try and force yourself to sleep. Rather, read or watch TV until you feel drowsy and then try again.

Avoid caffeine and other stimulants. Stop drinking coffee and tea at least 6 hours before bedtime. Nicotine, chocolate and sugar also act as stimulants and should be avoided. Alcohol interferes with sleep and can cause frequent waking and restless sleep.

Good bedtime snacks include a glass of warm milk, banana or turkey sandwich, which all contain L-tryptophan and can help make you drowsy.

Avoid naps. If you must nap, make it a power nap of no more than 20 minutes, and never after 3PM.

Improve your sleeping environment. Invest in dark curtains to block out all light, earplugs if noises disturb you, and a comfortable mattress. Also ensure a comfortable sleeping temperature.

Try a natural remedy. Remedies like Sleep EssentialsPack™, SerenitePlus™ for Restful Sleep and Good Night Sleep™ for Relief of Occasional Sleeplessness support restful sleep.

 

References:

  1. “Insomnia.” National Sleep Foundation. Accessed September 25, 2019. https://www.sleepfoundation.org/sleep-disorders/insomnia
  2. “Understanding Insomnia: The Basics.” WebMD. Accessed September 25, 2019. https://www.webmd.com/sleep-disorders/understanding-insomnia-basic-information
  3. “Insomnia.” Medline Plus. Accessed September 25, 2019. https://medlineplus.gov/insomnia.html
  4. “Everything You Need to Know About Insomnia.” Healthline. Accessed September 25, 2019. https://www.healthline.com/health/insomnia
  5. “Insomnia.” U.S Department of Health and Human Services, Office of Women’s Health. Accessed September 25, 2019. https://www.womenshealth.gov/a-z-topics/insomnia 
  6. “Insomnia treatment: Cognitive behavioral therapy instead of sleeping pills.” Mayo Clinic. Accessed September 25, 2019. https://www.mayoclinic.org/diseases-conditions/insomnia/in-depth/insomnia-treatment/art-20046677
Reviewed by Master Herbalist, Mary Ellen Kosanke