What is Insomnia, its causes, symptoms, and treatment?

Insomnia is a condition where there is a persistent problem for one to fall or stay asleep. This may affect one’s mood, energy level, health, or even work performance. Adults need 6-8 hours of good sleep. Insomnia may be associated with other conditions or maybe the primary factor. It is classified into two:

1. Acute insomnia- it may last for a few days to weeks.
2. Chronic insomnia- may last for months to more.

Causes of insomnia

1. Stress from work, health, finances, and family may make it difficult for one to sleep. Stressful events such as death, divorce, job loss, and illness can also be contributing factors.
2. Poor sleep habits e.g. too much-watching TV, uncomfortable sleeping areas, and stimulating activities before sleeping. This may interfere with one’s sleep cycle.
3. Eating too much food late in the evening may make it difficult for one to fall asleep due to heartburn.
4. Use of some medications e.g. anti depressants that have caffeine and other stimulants in them.
5. Mental health disorders e.g. depression.
6. Sleep disorder e.g. sleep apnea where one’s sleep is interrupted at night.
7. Change of work /travel schedules. Circadian rhythm is the internal clock that guides one on when to sleep and stay awake. Disrupting it may lead to insomnia.
8. Use of caffeine, alcohol, or nicotine products. Consumption of these late in the evening makes it difficult to fall asleep.
9. Change in sleep pattern. Common with the increase in age. One may tend to sleep early and then wake up early.
10. Medical conditions e. g chronic pain, cancer, asthma or gastroesophageal reflux disease, etc.

Symptoms of insomnia

• Ongoing worries about sleep.
• Difficult falling asleep at night.
• Waking up too early.
• Daytime tiredness.
• Depression.
• Increased errors.
• Failure to pay attention to given tasks.
• Waking up during the night.
• One feels tired even after taking a night of sleep.

Risk factors

1. Lack of regular schedule e.g. traveling and change of shifts.
2. Stress.
3. Physical and mental health disorders.
4. Increase in age.
5. Gender due to shifts in hormones, pregnancy, menstrual cycle, and menopause women experience more insomnia than men.

Complications

• This can lead to mental disorders e.g. anxiety and depression.
• Increase risks of health diseases e.g. heart disease and high blood pressure.
• Lowers one’s performance in daily activities.
• Lowers reactions to events and thus prone to accidents.

Preventions

• Limit naps during the day.
• Keep a schedule that is regular.
• Being active thus promoting a good night’s sleep.
• Limit alcohol and caffeine use.
• Avoid eating too much before bedtime.
• Have a comfortable sleeping area.
• Having a relaxing bedtime ritual e.g. taking a warm bath.

Diagnosis

• Physical exam when the cause is unknown. Blood tests may be done to check for thyroid problems.
• Review sleep habits by filling out a questionnaire to determine sleep and wake patterns.
• Sleep study- where brain waves, breathing, heartbeat, eye, and body movements are monitored in a sleep center.

Treatment of insomnia

• Change of sleep habits.
• Addressing issues associated with insomnia e.g. stress, medical conditions.
• Cognitive behavioral therapy.Helps to control negative thoughts and actions that keep one awake. Strategies under it include:

1. Relaxation techniques. Progressive muscle relaxation and breathing exercises reduce anxiety before sleep. These techniques help to control breathing, muscle tension, heart rate, and one’s mood thus being able to relax.
2. Sleep restriction therapy decreases the time spent in bed. Also helps to avoid day naps. This helps to improve one’s sleep at night.
3. Light therapy – helps people who tend to sleep too early and wake up too early.
4. Passively remaining awake. The therapy is aimed at reducing the worry of being able to sleep, by getting in bed and staying awake rather than falling asleep.
5. Stimulus control therapy Helps to remove conditions in one’s mind that make one resist sleep e.g. setting a consistent bedtime and avoiding naps.

• Prescription of sleeping pills e.g. ramelteon, zolpidem, zaleplon etc. Not recommended for use for more than a few weeks.

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