Insomnia: an overview and more

Insomnia is characterized by the inability to get enough sleep to feel rested. This may be due to difficulty falling asleep or sleeping. You can also make her wake up earlier than you would like. Sleep is often reported to be chronically poor quality, light, and unrefreshing. As a result, people with insomnia suffer from daytime symptoms such as poor concentration, irritability, and low energy.

Fortunately, there are effective treatment options for insomnia, from temporary sleeping pills to cognitive behavioral therapy.

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Insomnia symptoms

For insomnia, sleep problems occur at least three nights a week for more than three months .

Insomnia interferes with daytime activity and causes one or more of the following symptoms :

  • Daytime fatigue or drowsiness
  • Malaise (malaise)
  • Little attention or concentration
  • Performance interruption (errors, accidents)
  • Decreased energy or motivation.
  • Behavioral problems (eg, hyperactivity, impulsivity, aggression)
  • Inability to take a nap
  • Headache, indigestion, and chronic pain

In addition to the above daytime symptoms, mood disorders such as anxiety or depression are often associated with insomnia. Depression can be associated with waking up early in the morning and having trouble getting back to sleep. Anxiety can cause anxiety at night, and anxiety overwhelms you when you try to sleep. When it becomes difficult to fall asleep, it can rekindle the fire of anxiety, exacerbate the situation, and rekindle a vicious cycle.

Additionally, insomnia can affect serotonin levels and frontal brain function. The frontal lobe is responsible for several executive functions that play a key role in rational decision-making and proper social interactions. The impairment can be so severe that the ability to suppress suicidal thoughts or even the direct urge to commit suicide may be lost.

Research shows that the risk of suicide can double among people with insomnia. Anyone with these thoughts should seek help by calling the toll-free number for the National Suicide Prevention Service (800) 273-8255 or by going to the nearest emergency room.

Causes

Experts' understanding of the cause of insomnia is based on three factors: predisposition, provocation, and persistence.

Predisposition

Anyone can develop sleep problems similar to insomnia. This is called predisposition or threshold. The threshold for the development of insomnia depends on the individual.

Believe it or not, there are people who rarely or never have trouble sleeping at night. On the other hand, some people may be unlucky and are simply prone to insomnia. This is likely due to genetic factors (insomnia often runs in the family), age, gender (insomnia is more common in women), substance use, and other medical and psychiatric conditions (for example , depression, anxiety or chronic pain). disorders such as migraines or fibromyalgia ).

Insomnia can also be associated with increased alarm. This refers to the sympathetic nervous system, which is responsible for the fight or flight response. Some people may be more attracted to sympathy, which means that they are in the mood to respond to external threats. This signal can keep you awake during the day, but it also prevents people with insomnia from falling asleep at night. Some describe him as "tired but lethargic".

Provocation

Even if you may have a predisposition to insomnia, you should provoke it. These triggers are called triggers.

Examples of such factors include:

  • Drink alcohol, caffeine, or smoke a cigarette before bed.
  • TV or pets in the bedroom
  • Travel (causing jet lag)
  • Shift work
  • Stress due to job loss, financial problems, divorce, or the death of a close friend or family member
  • Nightly responsibilities like feeding babies

Keep in mind that insomnia usually goes away after the cause is removed. However, it can also be immortalized due to the changes it made.

Immortalization

The final ingredients that turn transient sleep difficulties into chronic insomnia are called persistent factors. These factors can be better understood with an example.

Let's say you stay awake for several hours in the middle of the night, which is common with insomnia. You realize that you need eight hours of sleep and being awake is reducing that time. Decide to go to bed two hours early to make up for this. This may help some, but now that you go to bed very early, you need more time to fall asleep. Since you no longer sleep at night, your frustration intensifies and exacerbates your initial insomnia.

After all, there are many options that can perpetuate your insomnia. Some people choose to limit their daytime activities due to drowsiness. This avoidance can reduce your physical activity. Because you are not exercising, you may feel less tired and cannot sleep.

Alternatively, you can start working on your computer in bed to make the most of your time awake. Your computer light and activity can affect your ability to sleep. You can also start sleeping during the day to get some rest, which can undermine your desire to sleep and your ability to sleep at night.

The existence of persistent factors prolongs your fight against insomnia.

Diagnostics

Insomnia is usually diagnosed only on the basis of a complete history. In some cases , a sleep log , multiple sleep latency test , sleep-wake actigraphy , or sleep study (polysomnogram) can provide supporting evidence or be used to rule out other sleep conditions, such as circadian rhythm disturbances or sleep apnea .

Watch out

If insomnia leads to impaired daytime function, especially if it persists chronically, treatment may be required.

Here are some key interventions that healthcare professionals, especially sleep specialists , use to treat insomnia .

Referring to your triggers

For many people, insomnia triggers go away on their own. For example, a bad dream before a school exam will disappear as soon as it is over.

Other triggers can be removed after they are properly identified and removed. For example, stopping caffeine in the afternoon, ditching alcohol as a late night drink, and eliminating tech gadgets or disturbances in the sleep environment may be enough to get you a quality prankster.

If you suffer from chronic insomnia, you may need professional help. It can be very helpful to get rid of the beliefs, thoughts, and feelings surrounding your insomnia with a treatment called cognitive behavioral therapy for insomnia (CBTI) .

With CBTI, a specially trained psychologist can help you identify your unique triggers and then help you get rid of them. For instance:

  • If you cannot sleep because you have rescheduled bedtime, restricting sleep , in which you limit time in bed and avoid daily sleep, may be a recommendation.
  • If you are awake at night and cannot sleep, controlling your stimuli can help.
  • If your mind is racing when you lie down, it may help to keep an eye on your buffer zone before bed, or to schedule moments of anxiety throughout the day.

Finally, if your insomnia is caused by a longer-term trigger (such as shift work or jet lag due to frequent travel), talk to your doctor about interventions that specifically target this trigger.

Taking medication

There are many medications that can be effective in the short term for treating insomnia. The two main classes include benzodiazepine and non-benzodiazepine drugs.

Some of these prescription and over-the-counter medications include:

The reason the above medications should only be used short term rather than long term is because sleeping pills can cause what is called tachyphylaxis. With this phenomenon, the drug becomes less effective, so higher doses are needed to achieve the same effect. Ultimately, the drug stops working and insomnia rebounds when you stop taking it.

Coexistence management

It is also very important to address any chronic problems that may be contributing to or related to your insomnia, such as an underlying mood disorder (such as depression, anxiety, or post-traumatic stress disorder) or another sleep disorder (such as sleep apnea or sleep syndrome). restless legs) . ) …

Talk to your healthcare provider about any symptoms you may be experiencing that cannot be explained by your diagnosis, and work with your healthcare provider to adjust your treatment plans that need fine tuning to help you feel better.

Consider complementary therapy

Some people also find that various complementary therapies are helpful in treating insomnia, such as:

Get the word of drug information

Insomnia is a common medical condition that can cause a significant deterioration in quality of life and daily functioning. The good news is that there are many therapy options available, although your personalized treatment plan will require careful consideration of your unique triggers and health profile. After all, if you are struggling with insomnia, talk to your doctor. Our discussion guide for healthcare providers below will help you start a conversation and find the most appropriate treatment options.

A Discussion Guide for a Healthcare Provider for Insomnia

Get our printable guide to your next doctor's appointment to help you ask the right questions.

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