Insomnia

Insomnia refers to the condition of having difficulty in falling asleep or remaining asleep. Intensity and frequency may vary from one case to another, and can often be improved with the introduction of certain lifestyle changes.

Symptoms

The most straight-forward symptoms of insomnia are:

  • difficulty falling asleep at night (delayed sleep onset)
  • waking up intermittently during the night (poor sleep maintenance)
  • waking up much earlier than required and not falling asleep thereafter

Insomnia may be categorised as acute if it occurs briefly due to some sort of ongoing circumstances (such as a stressful life event), or as chronic if it occurs at least three nights a week and has lasted at least three months.

Complications

Several other ‘symptoms’ may be observed as a result of the body not getting a sufficient amount of sleep. These include:

  • feeling tired after waking up
  • tiredness, irritability, lethargy during the day
  • difficulty concentrating, recalling, focusing
  • anxiety or depression

Causes

Chronic insomnia may be associated with one or more of the following situations:

  • stressful life events, trauma or on-going concerns
  • irregular sleep schedules (bed time, wake time) or napping during the day
  • jetlag or changing work shifts that interfere with the body’s circadian rhythm
  • stimulating activities or screen time before bed
  • eating too much in the late evening, particularly for people with GERD, indigestion
  • mental health disorders such as PTSD, anxiety or depression
  • medical conditions such as asthma, chronic pain, GERD, dementia, sleep apnoea, etc.
  • consuming stimulants such as caffeine, alcohol, nicotine before bed time
  • prescribed medications that may have side effects as stimulants
  • uncomfortable sleeping conditions (such as room temperature, lighting, bedding)

Females and older individuals are believed to be at a higher risk of insomnia – related to the changing menstrual and menopausal hormonal patterns in females, and changes in lifestyle and sleeping patterns in older people.

Diagnosis

The observation of any of the mentioned symptoms and complications usually accounts for a straightforward diagnosis of insomnia. This may be confirmed and further looked into with a consultation with your GP.

Prevention

The bottom line for preventing insomnia is to create a suitable mood and environment for a good night’s sleep. This mostly involves the practice of good habits and avoidance of others:

  • maintain a consistent wake-sleep cycle throughout the week and weekend by going to bed and waking up at the same times everyday
  • avoid or limit day-time naps
  • maintain a physically active lifestyle
  • maintain a work-life balance which allows downtime for your brain to slow down and relax
  • avoid heavy meals close to bedtime
  • avoid stimulants such as caffeine and alcohol before bedtime
  • do not use nicotine
  • avoid screen time and stimulating activity such as exercise before bedtime
  • avoid using your bedroom as a work space
  • make sure your room’s arrangement, lighting and temperature are comfortable for you to sleep in
  • try the likes of meditation to help combat stress
  • try other methods of relaxation such as easy reading, a warm shower, soft music, aromatherapy (effectiveness varies among individuals) before bedtime
  • consult your doctor to replace any medication that might be contributing to insomnia

Treatment

If a change in lifestyle and habits seems to have no impact on insomnia and it still persists for months, the next step would be to consult your GP. Sleeping pills are NOT usually recommended or prescribed due to their addictive nature and dangerous side effects, and are only used in extreme cases as a form of short-term treatment (for not more than a few days).

Depending on the outcome of your consultation, your GP might recommend cognitive behavioural therapy (CBT) that may help change one’s ways of thinking and behaviour to help manage the source of insomnia.

Cover illustration from iStock.

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