Causes, Effects, and Solutions
It’s another night of staring at the ceiling. Unable to calm your mind, your thoughts go from yearning for sleep, to asking why it won’t happen, to wondering how long until sunrise, and back to the urge for rest. Again and again, you toss and turn pleading with your body to just drift into the slumber you so desperately need… to no avail.
This can be the typical night of someone suffering from Insomnia. According to the American Academy of Sleep Medicine, about 10% of the United States population suffers from chronic insomnia. That means 32 million people suffer this fate each night in the U.S., and if you are one of them it can be maddening.
Insomnia Causes, Effects, and Solutions
What is Insomnia?
Insomnia is a disorder in which the person affected has trouble sleeping, and can be characterized by difficulty falling or staying asleep. While this may sound like a somewhat subjective description, there are many identifying symptoms and causes surrounding the disorder that give it more specific traits.
In Dr. Thomas Roth’s article published in the August 2007 edition of the Journal of Clinical Sleep Medicine, he described insomnia as “… a disorder with the following diagnostic criteria: (1) difficulty falling asleep, staying asleep or nonrestorative sleep; (2) this difficulty is present despite adequate opportunity and circumstance to sleep; (3) this impairment in sleep is associated with daytime impairment or distress; and (4) this sleep difficulty occurs at least 3 times per week and has been a problem for at least 1 month.”
The following are some of the most common symptoms surrounding Insomnia:
- Difficulty falling asleep
- Difficulty finding a comfortable sleeping position
- Waking during the night and being unable to return to sleep
- Feeling unrefreshed upon waking
- Fatigue or daytime sleepiness
- Poor attention or concentration
- Reduced energy or motivation
- Behavioral problems (i.e., hyperactivity, impulsiveness, aggression)
- Anxiety, depression or irritability
- Headache and chronic pain
Insomnia vs. Sleep Deprivation
It’s important to note that in order for the sleeplessness to be labeled as Insomnia, these symptoms have to happen even though the person has had plenty of opportunity for sleep, otherwise it might just be a problem of sleep deprivation.
Also, if the cause of the sleeplessness is due to a poor sleep environment it can’t really be labeled Insomnia either.
Chronic vs. Acute
Often patients who are suddenly faced with difficulty falling or staying asleep may not have lasting Insomnia. When the problem lasts for at least 3 months and occurs regularly (at least 3 nights a week), most doctors classify it as Chronic Insomnia. Anything that has been going on for a shorter period of time is labeled as Acute (or short-term) Insomnia.
This is important because often the causes of this sleeplessness can be recognized more easily when identifying how long it has been occurring.
What Are the Dangers?
Obviously Insomnia produces some unpleasant symptoms as discussed above, but outside of the direct effects, this disorder can lead to some serious risks as well. Without treatment, Insomnia can develop in ways that may not be outwardly apparent.
Lack of sleep can weaken the immune system, worsening any pre-existing conditions, and it can actually affect your genetic predisposition towards certain health problems. There is an increased Mortality Rate among those who get less than the needed amount of sleep and increased risk of other Chronic conditions such as heart-disease, stroke, and cancer.
The graphic to the right, created by CogniTune, contains some very interesting data about Insomnia gathered from the American Academy of Sleep Medicine, Sleep Research Society, National Sleep Foundation, Center for Disease Control and Prevention, and National Highway Traffic Safety Administration.
Why Does It Occur?
Insomnia can occur for a number of different reasons, and sometimes it’s related to more than one. In order to effectively treat patients who are suffering from Chronic Insomnia, doctors will often attempt to identify specific physiological, psychological, and environmental causes related to the problem.
Labels are often very helpful for medical doctors to quickly choose a course of treatment for a disorder such as Insomnia. That is where subtypes of Insomnia come in.
“Ultimately, the sub-types of insomnia may help to label the underlying cause,” Dr. Brandon Peters said. “By properly identifying the cause, the most effective treatment can be selected. For example, sleep apnea or anxiety may contribute to difficulty sleeping, and each would require unique therapies. There may be overlap, and sorting out the contributions may require an expert evaluation.”
Peters, who is a double board-certified neurologist and sleep medicine specialist practicing at Virginia Mason Medical Center in Seattle, identifies these subtypes in an article he published with VeryWell.com:
- Psychophysiological insomnia: heightened arousal with excessive worry and focus on sleep.
- Idiopathic insomnia: longstanding and genetically based, often beginning in infancy or childhood.
- Paradoxical insomnia: sleep state misperception resulting in mistaken belief that sleep has not occurred.
- Inadequate sleep hygiene: habits that disturb sleep including naps, caffeine intake, a variable sleep schedule, and using the bedroom for non-sleep activities.
- Behavioral insomnia of childhood: usually either sleep-onset type in infants or limit-setting type in toddlers.
- Insomnia due to a mental disorder: most often anxiety or depression.
- Insomnia due to a medical condition: most often chronic pain or sleep apnea.
- Insomnia due to drug or substance: may be due to intoxication or withdrawal from over-the-counter, prescription, or illicit substances.
Circadian Rhythm Disorders
Circadian Rhythm Disorders occur when your internal biological clock gets thrown off from external time cues. Most often this means that the person’s body doesn’t recognize things like “night time” as being “sleep time” and lead to irregular sleep patterns, or wanting to sleep at an atypical time.
Those who are affected by a Circadian Rhythm Disorder frequently suffer from Insomnia, and treating their sleeplessness can take a different course of action than is necessary with other types of Insomnia.
What Are the Treatment Options?
Most often, a diagnosis of Insomnia from a medical doctor is the first step in obtaining proper treatment of Insomnia. This usually includes a daily/nightly self evaluation of sleep called a sleep log. This kind of self reporting can help a doctor see the disorder in action without having to be there and lead to identification of the root of the problem.
But there are many other methods of evaluation that a doctor can employ to reach a solution for a patient suffering from Insomnia.
“Insomnia patients may benefit from a comprehensive consultation, as this will help to identify contributing causes,” said Peters. “Sleep logs may identify poor sleep habits or a circadian rhythm disorder. A diagnostic sleep study is often reserved for patients who have other symptoms or signs suggestive of Sleep Apnea. Sleep Apnea commonly causes chronic insomnia. Therefore, many patients may benefit from a study to identify this condition.”
These days the public has access to a variety of over-the-counter sleep aid medications and remedies. Many safe natural supplements can help those who suffer from sleeplessness, but some over-the-counter medications contain ingredients that doctors tend to avoid prolonged usage of. They are often a safe solution to Acute Insomnia, but Peters warns that they shouldn’t be used for long.
“Melatonin may be weakly effective as a sleep aid, but many over-the-counter sleep aids contain antihistamines like diphenhydramine to enhance sleepiness,” Peters cautions. “If used over the short term, infrequently or for fewer than 2 weeks, these medicines may have a role, but if insomnia persists, or the medicines are not helping, professional help may be needed.”
While many doctors recognize that prescription medications do have a place in treating Insomnia, it is often their goal to get to the root of the problem.
“Insomnia has effective treatments,” Peters said. “It often depends on identifying the potential contributors and working gradually to resolve these issues. It’s important that you seek help if symptoms persist or if sleeping pills become a chronic crutch to sleep.”
Cognitive Behavioral Therapy for Insomnia
Cognitive Behavioral Therapy for Insomnia (CBTI) has become a widely accepted method of treatment for Insomnia. This form of therapy usually includes regular visits with a doctor to evaluate and discuss the patient’s sleep habits that they keep in a regular log. CBTI often works through patient education, targeted changes, and relaxation training.
“CBTI is highly effective for chronic insomnia,” Peters said of the treatment. “Many are able to discontinue use of sleeping pills, and it teaches a set of skills to improve sleep for a lifetime.”
In fact the rise of this therapy and its use online has become fairly prevalent. Peters himself has developed an online program, Insomnia Solved that includes an eBook and associated audiovisual files.
A Continuous Positive Airway Pressure (CPAP) machine is the preferred method of treatment if the cause of Insomnia is Sleep Apnea. Sleep Apnea is a very common sleeping disorder in which a person involuntarily stops breathing while they sleep. Often, those affected experience this many times throughout the night.
“Sleep Apnea goes undiagnosed in thousands of patients,” Family Medicine Physician, Dr. Ankrehah Johnson, said. “The symptoms are so vague that people fail to realize there is a problem.”
CPAP machines help a person breathe normally, allowing Oxygen to reach their lungs and bloodstream more effectively, resulting in a deeper, more restful sleep. They work by gently increasing the air pressure in your breathing passages through a face or nasal mask. This works by keeping the collapsing soft tissue from obstructing the airway as the extra pressure slightly pushes open that area of the throat and increases airflow.
Those who suffer from Circadian Rhythm Disorders may want to consider Lightbox Therapy. A lightbox, which is exactly what it sounds like, produces a specific wavelength of light that helps your body essentially reset your biological clock.
This sort of therapy is most useful in the morning to help those who are suffering from these problems wake up, and to help those suffering from Seasonal Affective Disorder. Quite a bit of recent research has shown that this form of therapy is beneficial for a number of different disorders and struggles.
Intensive Sleep Retraining
Intensive Sleep Retraining (ISR) is an interesting new form of treatment for Insomnia. After researchers in Australia looked into alternative forms of treatment they came up with ISR. This therapy takes a lot less time to complete compared to CBTI and works by essentially producing what they refer to as Sleep Pressure.
During a 24 hour period, doctors will allow you to sleep for only short periods of time (about 3 minutes), waking you up for half an hour, then letting you fall back asleep again. This is supposed to help your body learn to recognize when you tired and how to fall asleep more quickly and naturally.
If you are suffering from sleeplessness, consult a medical professional to discover the best course of action for your specific problems. It can take time to find the root of sleep issues and the right solutions for those issues, but there is hope. New research and treatment options are being produced to help those suffering from sleeplessness all the time, and with so many people in the world suffering from Insomnia and other Sleep Disorders these solutions are needed more and more each day.
Is Insomnia affecting you? What methods do you use to fall asleep? Reply in the comments section below.