Insomnia: definition, types, causes, symptoms, diagnosis, treatment and medication
Definition of insomnia
Insomnia is a type of sleep disorder, characterized by difficulty falling asleep, staying asleep or both. The resulting tiredness can affect the quality of a person’s life, making it difficult to concentrate or function as usual during the day. Insomnia is the most common of all sleep disorder according to the American Psychiatric Association (APA).
The APA states that about one-third of all adults report insomnia symptoms. But between 6 to 10 per cent of all adults have symptoms severe enough for them to be diagnosed with insomnia disorder. Insomnia can occur at any age and is more likely to affect women than men. Also affects older people than younger ones. It’s more common among adults.
Types of Insomnia
There are two major types of Insomnia:
Acute or short-term insomnia
A brief episode of sleeping difficulty. When you have occasional trouble with quality sleep for up to three months. This lasts for a short period
Chronic or long-term insomnia
A long-term pattern of difficult sleeping. It occurs at least three times a week for more than three months.
Chronic insomnia can be divided into;
- Primary insomnia: This means your sleep problems aren’t linked to any other health condition or problem.
- Secondary insomnia: This means that your sleep problem is usually secondary to another problem or a combination of problems.
It means you have trouble sleeping because of a health condition (like asthma, depression, arthritis, cancer, or heartburn); pain; medication; or substance use (like alcohol).
The causes of your insomnia will depend on the type of insomnia you experience.
Primary or Short-term insomnia may be caused by stress, an upsetting or traumatic event, things around you like noise, light, or temperature etc or changes to your sleep habits like jet lag.
Secondary or long-term insomnia can be as a result of some health issues like depression and anxiety, Medications for colds, allergies, depression, high blood pressure, and asthma, continuous alcohol, Caffeine and tobacco use, Hyperthyroidism and other endocrine problems, other sleep disorders, like sleep apnea or restless legs syndrome etc
Generally, Insomnia can be caused by various factors such as psychiatric, psychological and medical conditions, unhealthy sleep habits, specific substance use, and/or certain biological factors.
1. Medical Causes of Insomnia
There are many medical conditions (some mild and others more serious) that can lead to insomnia. In some cases, a medical condition itself causes insomnia, while in other cases, symptoms of the condition cause discomfort that can make it difficult for a person to sleep.
Examples of medical conditions that can cause insomnia are:
Arthritis, Asthma, Chronic pain like Lower back pain, Nasal/sinus allergies, Obesity, Cardiovascular disease, Gastrointestinal problems such as reflux, Endocrine problems such as hyperthyroidism, Neurological conditions such as Parkinson’s disease
2. Psychological causes
Issues, such as stress, anxiety or depression. Other common emotional and psychological causes include anger, worry, grief, bipolar disorder, and trauma.
3. substance use
Certain substances used could be the cause of your insomnia, you could be treating another medical condition but the particular medication could be affecting you. If you take any of the following medicines and are having sleep disruptions, talk with your doctor. Do not stop any medicines if you have not consulted with your doctor. Medications that can cause insomnia include:
- Selective serotonin reuptake inhibitors (antidepressants such as Prozac® and Zoloft®)
- Dopamine agonists (includes some medications for Parkinson’s disease)
- Psychostimulants and amphetamines
- Caffeine, alcohol and tobacco
- Cold medicines and decongestants
- Medications to lower blood pressure (alpha agonists, beta-blockers)
- Appetite suppressants
The symptoms of insomnia can vary significantly from person to person. The major symptoms include difficulty falling or staying asleep and not feeling well-rested. People may also experience a lack of concentration or slowness inactivity, depression, headache, or irritability. Typical symptoms of insomnia are described in more detail below:
1. Difficulty falling asleep or staying asleep
People affected by insomnia may lie in bed for hours, but find they are unable to fall asleep Or sometimes even when they fall asleep, they often wake during the night because they find it difficult staying asleep. This problem can last for long periods, leading to severe sleep deprivation that has a very negative impact on daily life.
2. Not feeling rested
This inability to sleep through the night can mean people wake up without feeling properly rested and refreshed. This is often due to their sleep only being a light sleep or disturbances that disrupt the stages of sleep needed for adequate rest
3. Sleepiness in the daytime
People affected by insomnia often find they feel exhausted and sleepy throughout the day. They may rely on a high caffeine intake to keep them awake throughout the day. However, increasing the intake of this stimulant only worsens the sleep problems already being experienced during the night. Individuals with insomnia should avoid drinking caffeinated drinks or any other substance that might disrupt sleep.
4. Lack of focus and concentration
Insomnia can decrease mental function and lead to problems thinking, concentrating, or paying attention. This can have a huge negative impact on people’s performance at work or school.
As mentioned earlier, Other symptoms include: Headaches, Irritability, Anxiety, Depression, Gastrointestinal problems
To diagnose insomnia, your doctor will ask about your medical history, sleep history, bedtime routine, and lifestyle, and conduct a physical examination to check for other medical problems. Though Insomnia is Usually self-diagnosable
Doctors make a clinical diagnosis of insomnia if both of these criteria apply:
- Sleep difficulties occurring at least three nights a week for a minimum of three months.
- Sleep difficulties creating major distress or functional difficulties in a person’s life.
They could ask certain questions such as:
- Does it take you more than 30 minutes to fall asleep, or do you wake up during the night and have trouble returning to sleep, or do you wake up earlier than desired?
- Do you have daytime symptoms such as fatigue, moodiness, sleepiness or reduced energy?
- Do you give yourself enough time in bed to get at least 7 hours of sleep each night?
- Do you go to bed in a safe, dark and quiet environment that should allow you to sleep well?
If you answered “yes” to all of these questions, then you may have insomnia.
After that, your doctor will discuss treatment options
Insomnia – Treatment
The treatment for insomnia depends on its underlying cause. The treatment could consist of improving sleep habits, behaviour therapy and identifying and treating the underlying causes accordingly. Sleeping pills may also be used but should be monitored for side effects. So generally, treatment includes Therapy, Lifestyle and Medication. One could make use of either of them or all of them combined.
i. Cognitive-behavioural therapy
Cognitive-behavioural therapy for insomnia (CBT-I) can help you control or eliminate negative thoughts and actions that keep you awake and is generally recommended as the first line of treatment for people with insomnia. CBT-I can include techniques for stress reduction, relaxation and sleep schedule management. Typically, CBT-I is equally or more effective than sleep medications.
2. Lifestyle drug
i. Light therapy
The exposure to bright light at specific times helps to reset the body’s sleep clock.” As mentioned above, light therapy can effectively be used to treat a type of insomnia that consists of difficulty falling asleep at night and desiring to sleep in the next morning.
ii. Sleep hygiene
Sleep hygiene is a set of bedtime habits and rituals you can do every night to improve how you sleep. Have a regular sleep schedule and avoid caffeine, TV, phone or laptop before bed as light inhibits the production of melatonin, which is a hormone that aids sleep. Also, avoid large meals and beverages. In many cases, by practising good sleep hygiene and changing your sleep habits you can improve your sleep.
Regular exercise as been seen to improve the quality of sleep in insomnia patients, with similar comparable benefits to therapy and medication.
Your medical provider may prescribe a medication to treat your insomnia. Sleeping pills that are approved to treat insomnia are called “hypnotics”. Medication is only used to treat insomnia on a short-term basis, as prescription sleeping pills are known to have potentially harmful risks. You may build a tolerance to these medications over time. Some medications that treat other problems also may help you sleep. Your provider can decide which medication is best for you. You should only take medication when supervised by a medical provider.
A few common types of medications for insomnia, called sleeping pills or hypnotics, include:
Benzodiazepines. Examples are triazolam, estazolam, temazepam, quazepam, and flurazepam.
Non-benzodiazepines. These ‘Z drugs,’ as they’re known, include zolpidem, zaleplon, and eszopiclone.
In conclusion, consulting a medical practitioner to work out the root of your sleeping problems is the best way to find a treatment path that suits you — whether it’s therapy, lifestyle changes, medication, or a combination of all three.
Kindly hit on the share button and leave your comments below