You have heard people go on and on about how sleeping is their favorite thing to do, haven’t you? They talk about how they are usually out cold before a strand of their hair makes contact with the pillow and they will be on dream number 4 by the time you are even considering hitting the sack. It rankles because you know that does not happen for you.
Falling asleep does not come naturally to you. Staying asleep for a couple of hours is nothing short of a miracle. What causes insomnia? Is it treatable? Fortunately, once you understand what causes your insomnia, then you can get a solution for it.
Insomnia can be caused by the following:
- Psychiatric conditions
- Medical conditions
- Unhealthy sleep habits
- Indulgence in certain substances
- Certain biological factors
Researchers are looking into the issue of the brain refusing to go into rest mode when it should. The brain has a sleep-wake cycle. When one is on, the other is off. Insomnia can come about as a result of either cycle going to the extreme in that there may be too much wake drive and too little sleep drive.
For you to begin your journey in figuring out how to resolve your sleep issues, you must first understand where the sleeplessness is coming from. It is not right to shrug it off and hope it rights itself.
What are the medical causes of insomnia?
There are a number of medical conditions that can cause insomnia. Sometimes, the symptoms of the malady will cause it. In some cases, the medical condition itself causes the difficulties in sleeping. Discomfort from a medical condition or the symptoms of one can make it very difficult to fall asleep or stay asleep.
Some conditions that may be held responsible for insomnia include:
- Nasal or sinus allergies
- Endocrine issues such as hyperthyroidism
- Gastrointestinal complications
- Chronic pain
- Neurological issues like Parkinson’s Disease
- Low back pain
There are medications that can also mess with your sleep. These include medicines taken for the following conditions:
- High blood pressure
- Thyroid disease
- Heart disease
- Common cold
- Nasal allergies
Insomnia could be a symptom of underlying sleep disorders such as sleep apnea or restless leg syndrome.
Sleep apnea: Your airway is obstructed in part or completely during sleep, resulting in pauses in breathing and reduced levels of oxygen. This causes the patient to have intermittent spells of wakefulness throughout the night which may result in insomnia.
Restless leg syndrome: A neurological condition in which you experience such discomfort that you need to move your legs. Patients with this condition may experience worse symptoms later on in the day, especially during periods of rest, as well as during the wake to sleep transition. Falling and staying asleep then becomes difficult.
If you experience regular episodes of sleeplessness, you may need to evaluate your health, both physical and mental, to find out if there may be underlying issues that could be a contributing factor. In some instances, there are some simple measures you can take to improve your sleep situation. For instance, turn the lights down low when you are in resting mode, avoid distractions such as electronic devices and the television and avoid coffee or any caffeinated beverages close to bedtime.
In extreme cases, you should seek the advice of a specialist. You might also want to begin a treatment regime for any underlying medical issues that might have been discovered.
As mentioned earlier, some of the issues that cause insomnia are mental. Let us review some of these psychiatric issues and how they may be responsible for causing you sleepless nights.
Psychological complications can make it very difficult to fall asleep. You have heard that one of the symptoms of depression is the tendency for a depressed person to stay in bed sometimes for days on end. This does not necessarily mean they are asleep. Sleep is sporadic. Insomnia itself can be a catalyst for changes in mood. A person that has had trouble sleeping might be cranky and irritable for no reason that you can point out. Insomnia, apart from enhancing mood swings, can also cause shifts in hormones and the physiology which can lead to psychiatric issues as well as insomnia.
Insomnia can be a symptom of depression. Severe insomnia is reported to be more prevalent in patients who have major depressive disorders. Insomnia has been known to worsen depression. Other symptoms of depression include:
- A general loss of interest in one’s surroundings and the activities therein
- Low energy or lethargy
- No motivation
- Feelings of hopelessness or melancholy
- Loss of appetite
If one has these symptoms and they also have insomnia, the results could be dire as one can make the other even worse. Fortunately, both insomnia and depression are treatable.
Many people suffer from some form of anxiety disorder. Some have it worse than others and must seek treatment for it. Feelings of worry or nervousness can keep you wide awake on a regular basis. Some anxiety symptoms that will cause sleeplessness to include:
- Reminiscing about past events.
- Excessive worrying about the future.
- Feeling overwhelmed by the present and the responsibilities thereof.
- Feeling overstimulated.
With these kinds of feelings running through one’s mind constantly, falling asleep can be a tall order. Anxiety can cause one to not only have difficulties falling asleep but also have constant sleep interruptions where they might wake up during the night and not be able to go back to sleep. The silence that comes with the night can bring on thoughts and fears that can keep you awake.
If this happens over a long period of time, your anxiety will only get worse and could even turn tragic. You are constantly plagued by feelings of dread and may even suffer panic attacks when you think about your inability to sleep. Insomnia and anxiety then become a lethal combination that must be arrested by seeking treatment. Experts can help you with cognitive and mind-body techniques that aid in getting an anxious person to sleep. Also, you can learn some healthy sleep habits that can help alleviate insomnia and anxiety.
There are certain lifestyles that are believed to trigger insomnia. You may not be having any physical or psychological health problems, but you leave a life that interferes with the normal sleep patterns. These can create insomnia or make insomnia which is already present due to other issues even worse.
Here are a few examples of how certain lifestyles can lead to sleep deprivation:
- Sleeping in to make up for lost sleep – This can mess with your body’s clock and make it difficult to fall asleep at night.
- If you work all day then work at home in the evenings, your body will find it difficult to relax and you might also have a lot on your mind when bedtime rolls around. If you work on the computer, the light can make you more alert such that falling asleep takes longer.
- Your work involves shifts (sometimes you work the day shift and other times you are on the night shift) – Your body’s clock may get confused by the irregular hours since sometimes you are expected to sleep during the day and others you are asleep during the night. Period changes to your schedule may not do you any favors where sleep is concerned.
- Taking afternoon naps may work for some people, but can mess up the sleep schedule for others.
Hitting the club regularly might sound like fun and might show that you have a healthy social life, but you might actually be making your body adapt to unhealthy schedules that could problematic in the future. This is because clubbing consists of late nights and oftentimes, copious amounts of alcohol.
Insomnia sometimes begins with one severe episode which may be as a result of receiving bad news or even exciting news. You start getting up in the dead of the night to get a drink (usually not water or warm milk) or to get some work done since you are awake anyway. This could turn into a long-term problem with insomnia. In fact, it could develop into chronic insomnia.
Should this happen, you should get the problem addressed right away. If your lifestyle is to blame for your insomnia, you may need to consider making changes which include getting to bed at regular hours in the long term. Sleep experts are equipped with techniques that can help you get your insomnia sorted out. If you have tried it on your own and it has not worked, it is important that you seek professional help.
What you ingest could be causing you sleepless nights. Furthermore, your eating patterns and activities could be doing you more harm than good. Food and drinks play a major role in the chemical processes in our bodies. If you are having trouble sleeping, take a look at the following to see if you might be indulging in the wrong foods or substances.
- Caffeine: This is a stimulant. Having a mug of coffee with your dinner might not be the wisest thing to do, especially if you have a sleep disorder. Most people need at least one cup of coffee in the morning to start the day off. Some celebrities have actually confessed that they do not want anyone to speak to them before they have had their morning coffee. That is how powerful caffeine is. Taken in moderation, caffeinated drinks are alright for most people. Excess intake of the same has been known to cause at least one symptom of insomnia in the consumers. Caffeine can stay in your system for as long as eight hours. The effects, therefore, do not wear off immediately. You can stay alert for a really long time. This is not a drink to be taken close to bedtime.
- Alcohol: While alcohol has been known to cause drowsiness and may even cause you to fall asleep initially, it may also disrupt your slumber later on in the night.
- Nicotine: This one is also a stimulant and can, therefore, keep you too alert for sleep. Nicotine is found in substances such as cigarettes and other tobacco products. Do not smoke close to bedtime if you plan on having a full night’s uninterrupted sleep. In any case, smoking is damaging not only to you but also for those around you. If you indulge, you should make an effort to quit.
- Heavy meals: Avoid these close to bedtime. They make you feel full and sometimes bloated which does not make for healthy uninterrupted sleep. The best habit you can develop where food is concerned is to eat a light meal before bedtime. Also, do not eat just before you go to bed. Avoid eating spicy foods before bedtime as well. Those ones can give you epigastric issues or heartburn and interfere with your sleep.
There are neurotransmitters in the brain which are known to be in charge of sleep and wakefulness. Many chemical processes in the brain may be to blame for interfering with sleep. They could also be the reason why some people seem to be prone to insomnia and struggle with it for years without being able to find a solution. It has been established that even when they follow expert advice and adhere to the treatment and advice that is given, these people continue suffering from insomnia.
Symptoms of insomnia
You know you have insomnia if you have the following symptoms:
- You feel sleepy during the day
- You are irritable
- You struggle to concentrate
- You exhibit struggles with memory
If you suspect you may be having issues with sleep, give your doctor a visit for a proper diagnosis and prescription of sleep medication such as Rozerem. This may include:
- A physical evaluation which is important for ruling out or unearthing medical problems which may be to blame for your insomnia
- A medical history check
- A sleep history check
The doctor may require you to keep a sleep diary for a few weeks to keep track of your sleep patterns and how you feel in the daytime. Your partner, if you have one, may also be expected to provide information about the quality and quantity of your sleep. Should the need arise, your doctor will refer you to a sleep clinic for further tests and evaluation.
Non-medical relief for insomnia
the young have no reason to experience insomnia because most people think insomnia is stress related. From what has been mentioned earlier in this article, there are other causes of insomnia aside from psychiatric issues.
However, it is important to develop healthy sleep patterns when you are younger because as the years pass by, sleep tends to become elusive.
Insomnia involves a host of other issues such as:
- Inability or difficulty falling asleep
- Interrupted sleep
- Restless sleep
- Waking up too early in the morning
Negative effects of insomnia
How many times have you heard people say how they do not need much sleep? Some even claim that sleep interferes with their money-making hustles. Such an attitude can get one into serious trouble with regard to sleep and even cause one to develop insomnia. Sleeplessness is not good for anyone’s health. Here are a few reasons why:
- You are rather irritable during the day.
- Insomnia causes fatigue.
- You are drowsy during the day when you should be working.
- It weakens the immune system making it easier for you to fall ill.
- Sleeplessness can increase the risk of conditions such as diabetes, heart disease, and high blood pressure.
- Insomnia contributes to chronic pain.
- It makes psychiatric conditions such as depression and anxiety worse.
- It reduces your concentration and focus which directs affects your productivity at work.
- It interferes with your motor function making it dangerous for you to drive.
- It decreases your ability to reason out rationally when faced with even the most mundane issues.
What is sleep hygiene? Have you ever come across the term before? Well, it is a collection of habits that will cause you to fall asleep more easily and more deeply. These habits can be developed by the self, but if find that you have challenges, you can always seek help. Here is a list of sleep habits you can develop on your own to get better sleep.
- Develop a regular sleep schedule and stick to it. Simply put, if you decide bedtime is 10:00 PM and wake-up time is 6:00 AM, you should follow that schedule every day of the week.
- Develop an exercise schedule. You may decide to be doing some cardio exercises for, say, 40 minutes every day or four days of the week. Relaxing exercises such as yoga can be done before bedtime as they help with sleep. More rigorous exercises can be scheduled for morning workouts.
- Indulge in some basking during the day. Alternatively, open your blinds in the morning and let in some natural light. During the wintry months, a lightbox would come in handy. Light helps to wake the brain up and sets your body’s rhythms to normal.
- Your bedtime and wake-up routine should be regular.
- Do some exercises to relax your muscles as well as breathing exercises before you hop into bed help to relax you and put your brain into sleep mode.
- Take a warm bath with relaxing bath salts also helps with relaxing your body and letting the tension go.
- The ambiance in your sleeping quarters matters a lot. A comfortable bed, a warm room, soft lighting, and warm colors help to create a relaxing atmosphere. Loud colors and bright lights will not help with your sleeping issues one iota. Also, ensure your room is either silent or if soft music does the trick, have it in there. A comfortable pillow is also necessary. If you need to, use earplugs and cover your eyes with an eye mask.
- Avoid working or watching your favorite shows in bed.
- Go to bed when you feel sleepy. Avoid crashing out on the couch however tempting that is. Likewise, get out of bed if you are tossing and turning.
- Your clock should not be in your line of view. You do not want to keep checking the time and you will do that if you can see the clock face.
- If you must have your mobile phone or other gadgets with you, turn the alerts off.
- Keep a ‘worry journal’ where you can jot down anything that is worrying you. You can revisit it in the morning and take care of it then. When you write your worries down, you set your mind at rest with the knowledge that you will not forget the concern as you have written it down.
- If you are still awake twenty minutes later, get out of bed and do something that will relax you such as reading. You will return to bed later.
- Avoid obsessing about falling asleep. That will not help at all.
- Do not work on your computer late at night. In fact, put it away altogether at least one hour before bedtime. If you have pending work, you will have to do it the following day.
You should not:
- Drink caffeinated drinks after noon. Caffeinated drinks include energy drinks, iced tea, coffee, tea, soda, and other fizzy drinks.
- Have a second or third glass of wine with your dinner. Alcohol might make you drowsy but it is also likely to disrupt your sleep some time during the night when your mind is gearing up for the deep sleep session.
- Take any stimulants after dinner even if some, like chocolate, come in the form of dessert. Other stimulants you should stay well away from include nicotine and specific medications which have the ability to keep your brain alert.
- Eat a heavy meal at dinner. Also, avoid having your meals too close to bedtime. You cannot relax on a full belly.
- Use your electronic devices for long periods before bedtime.
- Watch TV for too long before bedtime either. It overstimulates the mind and makes it slow to the relaxation process thus making it more difficult to fall asleep.
- Take daytime naps. They interfere with your sleep and wake-up schedule.
Sometimes, the sleep hygiene technique is not enough to get you to sleep. Maintaining your newly acquired sleep habits is not easy. You must be very disciplined and determined to keep it up. However, if you have followed the sleep hygiene routine faithfully and it has not helped you much, then you might need some sleep therapy such as cognitive behavioral therapy for insomnia.
The bottom line is, you need to address any issues that may be causing your insomnia and change your sleep habits. You might have to be put on medication or attempt natural therapies.
Cognitive behavioral therapy for insomnia
CBT-I or cognitive behavioral therapy for insomnia is a therapy aimed at helping someone suffering from insomnia to control or get rid of negative thoughts and behavior that make it difficult for them to fall asleep. This therapy is said to be even more effective than medication.
The cognitive bit of the therapy helps you to recognize thought patterns and beliefs that interfere with your ability to fall asleep. You are assisted in changing these thought patterns and beliefs so that you have less or eventually nothing that keeps you awake with worry at night. It also helps you deal with worrying about falling asleep to the extent that you are unable to fall asleep.
The behavioral bit is aimed at helping you to form good sleep habits and avoid any behavior that will keep you from falling asleep, such as overindulgence in substances that keep you alert or watching too much television at night. Once you are able to kick these bad sleep habits, then you are able to fall asleep and stay asleep. The strategies your therapist will apply include:
- Stimulus control therapy – This involves getting rid of factors that condition the brain to reject or resist sleep. Your therapist will coach you to set a regular sleep schedule and stick to it. You will understand the importance of avoiding daytime naps and using your bed for the purpose it is meant for. Sometimes we tend to use our beds as workstations. You will be trained to leave your bed if you are not sleepy and only go back when you are ready to sleep.
- Relaxation techniques – These include breathing exercises and muscle relaxation techniques such as yoga. You are also trained how to reduce anxiety at bedtime for example by noting down what you are worried about for consideration the following day.
- Sleep restriction – This includes avoiding naps during the day and diminishing the time you spend in bed. Once you are able to follow this advice and your sleep has improved, then the time you spend in bed is increased.
- Paradoxical intention – This therapy aims at gradually getting rid of worry and anxiety so that you can fall asleep more easily and sleep through the night.
- Light therapy – This involves the use of natural light to help regulate your body rhythms. Your doctor can recommend how to use natural light or a lightbox to adjust your internal clock.
The intention is to get your body and mind tuned to a healthier sleep schedule by possibly making changes to your lifestyle to accommodate better sleep.
If you must use medication, it is best to have your doctor prescribe the pills for you. Doctors recommend using the pills for a few weeks, but there are medications that are recommended for long-term use, such as Rozerem (Ramelteon). Avoid buying over-the-counter medication which may not work as expected and may come with adverse side effects. Also, the key should be getting a long-term solution for your insomnia.
Additionally, talk to your doctor about the possible effects the medication prescribed may have on you and come up with possible ways to combat the effects. The advantage of getting prescription medication from a qualified health practitioner if you have someone to have this discussion with and find possible alternatives if you react to a particular medication.
These are only intended for short-term use. They contain antihistamines which make you drowsy. Antihistamines can cause effects such as:
- Daytime sleepiness
- Cognitive decline
- Difficulty in passing urine
These effects may be more pronounced in older adults. If you must use these, then ensure that you get a prescription from your doctor.
Insomnia can be treated if you are determined to get rid of it. You must be willing to change your daytime and bedtime routines.
- Be faithful to your schedule.
- Exercise. Even a brisk walk every day is good exercise.
- Keep your doctor informed about any medications you are on. They could be the culprit.
- Do not take naps during the day. If you feel sleepy, get active.
- Avoid stimulants especially after noon.
- See your doctor about any pain or uncomfortable conditions such as reflux.
- Ensure your sleeping quarters are comfortable with regard to bedding and ambiance.
- Eat light meals way before bedtime and do not take too much fluids. You want to avoid waking up to use the bathroom too often.
Insomnia is uncomfortable and can cause you a lot of woes if not checked, but it is treatable with the right approach and determination from the patient. Self-discipline combined with the right medication from a qualified health practitioner as well as therapy can cure insomnia.
Co-founder of Counting Sheep and Sleepaholic