Insomnia is a common sleep disorder which includes the following circumstance:
- Lie awake for a long time and have trouble falling asleep.
- Wake up a lot and have trouble returning to sleep.
- Wake up too early in the morning.
- Feel like you haven’t slept at all.
Definition: Insomnia is defined as short and poor quality sleep that affects your functioning during the day. Although the amount of sleep a person needs varies, most people need between 7 and 8 hours of sleep a night to feel refreshed.
Acute insomnia is a short-term sleep problem that is generally related to a stressful or traumatic life event and lasts from a few days to a few weeks. Acute insomnia might happen from time to time.
Chronic insomnia, sleep problems occur at least 3 nights a week for more than a month. Insomnia tends to increase as women and men age.
Different types of insomnia: There are 2 types of insomnia:
Primary insomnia is not a symptom or side-effect of another medical condition. It is its own disorder. It may be life-long or triggered by:
- Shift work,
- Stressful life events, emotional or physical discomfort
- Other factors that disrupt your sleep routine.
Primary insomnia may end once the issue is resolved, or can last for years. Some people tend to be prone to primary insomnia.
Secondary insomnia has an underlying cause, so it’s a symptom or side-effect of something else. It is the most common type. Secondary insomnia may have a medical cause, such as:
- Depression or anxiety
- Chronic pain such as from fibromyalgia, migraine, or arthritis
- Gastrointestinal problems such as heartburn, acidity.
- Sleep disorders, such as sleep apnea(Breathlessness) or restless leg syndrome(during sleep)
- Alzheimer’s disease
Secondary insomnia also can result from:
- Some medicines, such as those that treat asthma, heart problems, allergies, and colds
- Caffeine, tobacco, and alcohol
- Poor sleep environment (such as too much light or noise, or a bed partner who snores)
Women have more insomnia then men
Women are more likely to have insomnia than men. One important reason is that hormonal changes during the menstrual cycle and menopause can affect sleep. During peri-menopause, women may have trouble falling asleep and staying asleep. Hot flashes and night sweats often can disturb sleep.
During pregnancy, hormonal, physical, and emotional changes can disturb sleep. Pregnant women, especially in the third trimester (last 3 months), may wake up frequently due to discomfort, leg cramps (pain), or needing to use the bathroom.
How to get rid of it?
Acute insomnia may not require treatment. Mild insomnia often can be prevented or cured by practicing good sleep habits, which includes following tips:
- Try to go to sleep at the same time each night and get up at the same time each morning.
- Avoid prolonged use of phones or device at night.
- Avoid caffeine, nicotine, and alcohol late in the day. Caffeine and nicotine are stimulants and can keep you from falling asleep. Alcohol can cause walking in the night and interferes with sleep quality.
- Get regular exercise. Try not to exercise close to bedtime, because it may stimulate you and make it hard to fall asleep. Experts suggest not exercising for at least three to four hours before the time you go to sleep.
- Don’t eat a heavy meal late in the night. A light snack before bedtime, however, may help you sleep.
- Make your bedroom comfortable. Be sure that it is dark, quiet, and not too warm or too cold. If light is a problem, try a sleeping mask. If noise is a problem, try earplugs, a fan, or a “white noise” machine to cover up the sounds.
- Follow a routine to help you relax before sleep. Read a book, listen to music, or take a bath.
- Avoid using your bed for anything other than sleep or sex.
Chronic insomnia can be managed by:
- Finding and treating any medical or mental health problems
- Stopping or reducing behaviors that may lead to the insomnia or make it worse, like drinking moderate to large amounts of alcohol at night.
Other treatments are:
- Cognitive behavioral therapy (CBT)
Cognitive behavioral therapy (CBT)
Research shows that CBT is an effective and lasting treatment of insomnia. CBT helps you change thoughts and actions that get in the way of sleep. This type of therapy is also used to treat conditions such as depression, anxiety, and eating disorders.
CBT consists of one or more approaches. These are:
- Cognitive control and psychotherapy — Controlling or stopping negative thoughts and worries that keep you awake.
- Sleep hygiene — Taking steps to make quality sleep more likely, such as going to bed and waking up at the same time each day, not smoking, avoiding drinking too much coffee or alcohol late in the day, and getting regular exercise.
- Sleep restriction — Matching the time spent in bed with the amount of sleep you need. This is achieved by limiting the amount of time spent in your bed not sleeping. You go to bed later and get up earlier then you would normally, and then slowly increase the time in bed until you are able to sleep all night.
- Stimulus control — Conditioning a positive response with getting into bed. For example, using the bed only for sleep and sex.
- Relaxation training — Reducing stress and body tension. This can include meditation, hypnosis, or muscle relaxation.
Complications Prescription sleep medicines can help some people get much-needed rest. Most sleep medicines are used for short-term treatment, though some people with severe chronic insomnia may benefit from longer treatment.
It is important to understand the risks before using a sleep medicine such as:
- Grogginess or rebound insomnia.
- Interact with other medicines.
- Become habit-forming.
- Severe allergic reactions or facial swelling.
- High blood pressure, dizziness, weakness, nausea, confusion, or short-term memory loss.
Author: Captain Dr.Muhammad Rashedul Haque Gazi, MBBS, CMU