What Is Insomnia?

Insomnia is a sleep disorder that occurs when a person has difficulty falling asleep and/or staying asleep, even when the opportunity to sleep is sufficient. It is the most common sleep complaint and can affect anyone. A person who has insomnia wakes up feeling tired and unrefreshed. Lower levels of energy can result in obesity, lower performance, slower reaction time, psychiatric issues, irritability, risk of illness due to lowered immunity, and substance abuse. In addition, existing illnesses or other medical conditions can become more severe. All of these complications caused by insomnia lead to the likelihood of a lowered quality of life for anyone experiencing them.

There are two types of insomnia based on cause. Primary insomnia occurs when the sleep issues are not directly related to any other health problem or condition. Secondary insomnia occurs when the sleep issues are due to environmental, medical, medicinal, or psychiatric reasons. Insomnia is also categorized based on frequency and duration. Acute insomnia is short-term, from one night to three weeks, and is generally resolved on its own. Chronic insomnia is long-term, lasting more than three weeks, and sometimes relies on various treatments and therapies.

Causes of Insomnia

Insomnia may be due to one or more of a number of causes. They include but are not limited to the following:
Room temperature, light, and noise are factors in your sleeping environment that can interfere with sleep. Other sleep disrupters include pets that make your bed their bed and snoring bed partners. Mattresses and pillows that are past their best condition can also come between you and a good night’s sleep.
Illnesses and medical conditions such as arthritis, heart failure, cancer, lung disease, stroke, Parkinson’s disease, the need for frequent urination, gastro esophageal reflux disease (GERD), Alzheimer’s disease, an overactive thyroid, pregnancy, and menopause can cause insomnia. In addition, some sleep disorders like restless leg syndrome or sleep apnea can also cause insomnia. Pain, limited mobility, or discomfort associated with an illness, medical condition, or sleep disorder may cause problems with falling or staying asleep.
Stress has long been considered to be a factor that affects a person’s well-being. Concerns about home, school, work, family, finances, and health may make it difficult for a person to get to sleep, stay asleep, or fall back to sleep after waking during the night.
Because insomnia may be caused by a mental health disorder, it is often a symptom that leads to a mental health diagnosis. Depression, bi-polar disorder, and anxiety disorders including post traumatic stress disorder are examples of mental health disorders that often cause insomnia.
Eating a heavy meal, drinking alcohol, watching television, playing video games, or using a computer before going to bed can result in a level of stimulation that will make falling asleep difficult. Other poor sleep habits include not keeping a regular sleep schedule and using your bed for purposes other than sleep or sex.
A person’s circadian rhythms work in 24-hour cycles to regulate the body’s physiological processes, including sleep. When the rhythms are disrupted, insomnia can be a result. Work shift changes and traveling across time zones are examples of reasons why a person might have to try to sleep during the day when there is sunlight and noise. Any change or interference with one’s normal sleep schedule disrupts the rhythms and can result in insomnia.
Caffeine and nicotine are stimulants that can prevent you from falling asleep at night. Controlled stimulants such as amphetamines and cocaine do so as well. Stimulants can also cause you to wake up during the night. Alcohol and sleeping pills are sedatives that help you fall asleep faster. However, alcohol prevents deep sleep stages and may cause you to wake up during the night. The body can build up a tolerance to some sleeping pills resulting in insomnia when the pills are no longer used.
The likelihood of having insomnia increases with age. As we get older, changes in activity levels, sleep patterns, health conditions, and amounts and types of medications increase the chances of having insomnia.
Insomnia can be a side effect of both nonprescription and prescription drugs. Allergy medicines, antidepressants, corticosteroids, heart and blood pressure medicines, and stimulants are among the prescription medications that may affect sleep. Common over-the-counter medications may contain stimulants that cause sleep interference.

Symptoms of Insomnia

A person with insomnia may experience one or more symptom. They include but are not limited to the following:

  • Problems with falling asleep, staying asleep, and/or waking and not being able to go back to sleep
  • Waking up too early
  • Tiredness, low energy, low motivation during normal waking hours
  • Worries or frustration about sleep
  • Problems with concentration, memory, and focus that result in a lowered performance at work or school and/or an increase in accidents or errors
  • Tiredness upon waking even after having the right conditions for a full sleep session
  • Tension headaches and/or gastrointestinal distress
  • Anxiety, depression, and/or irritability

Treatment for Insomnia

The treatment for insomnia depends on the type of insomnia with which a person is diagnosed. Acute insomnia is short-term, from one night to three weeks, and is generally resolved on its own with no treatment required. Chronic insomnia is long-term, lasting more than three weeks, and sometimes relies on treatment in order to make it go away. In either case, insomnia is treatable.

In the case of both acute and chronic insomnia, health problems or underlying medical conditions must be treated first. It is possible that the insomnia will improve as your health problem or medical condition improves. If medications are suspected to be the cause of your insomnia, they will likely be changed. Other treatments for insomnia include the following:

Good sleeping habits contribute positively to alertness during your normal waking hours and to quality sleep during your normal sleeping hours. Consistence in following them day to day is very important. Good sleep habits include the following:

  • Be active during normal waking hours.
  • Take short naps or better yet, avoid them altogether.
  • Avoid or limit alcohol and caffeine.
  • Avoid nicotine products.
  • Control painful conditions.
  • Make and adhere to a sleep schedule.
  • Do not eat or drink heavily before bedtime.
  • Use your bed for sleeping and sex only.
  • Make your bedroom comfortable by eliminating noise, light, and extreme temperatures.
  • Follow a relaxing bedtime ritual that involves a quiet activity.
  • Get out of bed if you can’t sleep or as soon as you have had enough sleep to feel rested.
Behavior therapy is a non-medicine treatment for insomnia that is actually as effective and sometimes even more effective than sleep medication. The goal of behavior therapy is to help you change behaviors that cause or worsen insomnia and replace them with new behaviors that contribute to quality sleep. Examples of behavior therapy include the following:

  • Relaxation techniques including biofeedback, breathing exercises, and muscle relaxation help reduce anxiety by controlling heart rate, muscle tension, breathing, and mood.
  • Stimulus control that limits the time you are awake in bed helps you associate the bed and the bedroom with sleep and sex only.
  • Cognitive behavioral therapy works to eliminate or at least control negative thoughts and anxieties that might be keeping you awake.
  • Sleep restriction causes partial sleep deprivation by decreasing your time in bed, thus making you more tired each night. An increase in time spent in bed occurs once your sleep improves.
  • Light therapy uses the evening’s natural light or a medical-grade light box to push back your internal sleep clock if you have a tendency to wake up too early because you fall asleep too early.
Over-the-counter and prescription medications have been developed to help you either fall asleep or stay asleep. They are generally not recommended for long-term use and should only be taken under the supervision of a board-certified sleep medicine physician.
Rather than try to deal with insomnia on your own, Dr. Nassar will find a treatment or combination of treatments that will work for you and your circumstances. If insomnia makes it hard to go about your normal daily tasks, contact Dr. Nassar and his sleep team at Jacksonville Sleep Center. They will work with you to diagnose and treat your insomnia.

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