What is Insomnia?

 
Medically reviewed by
Dacelin St Martin, MD
Triple board-certified in Sleep Medicine,
Internal Medicine, and Pediatrics.

 
 
Symptoms  |  When to Seek Help  |  What to Avoid  | Sleep Hygiene  |  About Sleeping Pills | CBT-I

Overview

These days, more than ever before, society is constantly connected, always thinking of what to do next, and stress has become the mainstay of life.

According to an article posted in the US National Library of Medicine, insomnia affects around 30 percent of adult samples drawn from different countries.^[1]

All of this adds up to an unhealthy picture over time. Of course, when one feels stressed or overwhelmed, one of the first things to be affected is sleep.

It’s almost impossible to get enough rest when one can’t switch off. 

What is Insomnia?

Insomnia is a medical condition that affects sleeping patterns and quality. Symptoms include difficulty falling asleep (onset insomnia), problems staying asleep (maintenance insomnia), a combination of both onset and maintenance insomnia, or waking up too early.

A person who has insomnia will feel extremely tired during the day; therefore, finding it difficult to concentrate on daily tasks.

The body releases a hormone called melatonin when it’s time to wind down for the night and get some sleep. However, when one is stressed, the body releases hormones called adrenalin and cortisol, preventing relaxation and sleep because one is physiologically in fight-or-flight mode.

Sleeplessness is a vicious cycle, as the more stressed one feels, the harder it is to sleep. Different factors cause insomnia, whether chronic or acute and sometimes it’s hard to identify the specific cause or reason.

Restful Sleep is a Process

Forming consistent sleep habits and regimens are essential for laying the foundation for a restorative night’s sleep, called sleep hygiene.

Certain factors may lead to sleeplessness, including an uncomfortable or unsuitable sleeping environment, noise, anxiety, or too much mental stimulation before bed, including drinking caffeine. As a result, insomnia may arise due to poor habits that prevent one from unwinding for a night of restful sleep.

The longer one has insomnia, the more of a problem it becomes. One only needs to miss a few nights of good quality sleep before feeling sleep-deprived, which can cause long-term health problems, including weight gain, depression, high blood pressure, and diabetes.

Symptoms

• Regularly Experiencing Problems Falling Asleep (Onset Insomnia)
• Struggling to Stay Asleep (Maintenance Insomnia)
• Waking Up too Early
• Irritability and Low Mood
• Daytime Fatigue
• Difficulty Concentrating
• Chronic Headaches caused by tiredness

Insomnia causes problems falling asleep and the inability to stay asleep; however, some people experience both, while others only experience one aspect of the disorder.

A diagnosis of chronic insomnia occurs if one experiences sleeplessness for more than three months, for more than three nights a week.

When to Seek Help?

Insomnia is not something one has to live with or tolerate as help is available. When experienced over a length of time, sleep problems to this degree can affect the quality of life and overall health and well-being.

One should seek medical help from a doctor in the following situations:

• Struggling with insomnia symptoms that have been ongoing for three months
• Tried self-help methods that do not offer relief
• Always tired
• Insomnia associated with severe snoring or even sleep apnea (a condition that causes one to temporarily stop breathing while sleeping)

Many people avoid visiting the doctor with sleep problems, assuming them to be nothing serious. However, sleep is vital to overall health and well-being, and without consistent quality sleep each night, one quickly becomes sleep deprived.

The amount of sleep needed for optimal health and well-being varies from person to person, but an average number is roughly 7 hours of uninterrupted sleep.

What to Avoid

The good news is that one can improve sleep issues by avoiding certain stimulants:

1. Caffeine & Alcohol

Avoid caffeinated drinks two hours before bed and avoid alcohol too. There’s a misconception that alcohol aids with sleep. 

According to a 2013 study, moderate to heavy alcohol consumption may lead to one falling asleep faster, but it interferes with REM sleep, which is the most restorative sleep phase.^[2]

2. Hard-to-Digest Foods

One should avoid eating anything too heavy or greasy for a few hours before planning to sleep. These types of food can lead to indigestion or heartburn, making it difficult for the body to relax and fall asleep.

3. Mental Stimulation

Avoid anything too stimulating before going to bed, like loud music or action movies. 

4. Electronic Gadgets

The blue light emitted by digital devices, like cell phones, is known to suppress the sleep hormone melatonin, leading to a night of sleeplessness.

Harvard researchers conducted a study that compared the effects of blue light vs. green light on subjects. They found blue light suppressed melatonin for about twice as long as a green light and shifted circadian rhythms by twice as much (3 hours vs. 1.5 hours).^[3]

Sleep Hygiene

Sleep Hygiene is when one adjusts bedtime habits and the sleep environment for the best sleep possible, like establishing a regimented bedtime routine. One should go to bed at the same time every night and wake up at the same time every day, regardless of the situation. An inconsistent sleep-wake schedule is one of the main causes of sleep disruption because it desynchronizes the sleep-wake cycle.

One should try having a warm bath before sleep. Some people find a few drops of lavender essential oil in their bath helps them to relax and wind down before bed.

The bedroom should be set at an ambient temperature, not too hot and not too cold. Make sure that pillows are comfortable, and one may even like to try a weighted blanket, which many people find useful for insomnia.

About Sleeping Pills

It’s been proven that sleeping pills are only effective for up to 3 months, and only add (on average) an additional hour of sleep per night.

The worst part is that they’re not addressing the primary cause of sleeplessness. It may also be that a medication one is currently taking for another problem is affecting sleep.

CBT-I

Cognitive Behavioral Therapy (CBT-I) is an approach recommended by the American College of Physicians to help combat and treat chronic insomnia.

Research studies show that CBT-I is more effective than sleeping pills and is a lifelong solution for sleeplessness. It addresses behavioral and psychological factors that lead to the disruption of sleep.

There are comprehensive programs online that use CBT-I to treat insomnia. One should talk to a doctor about options.

See a Doctor

In some situations, insomnia is caused by an undiagnosed sleep disorder. A doctor may refer the patient for sleep studies to identify the cause of the sleep problems.

Insomnia does not have to be a life sentence, and there are many ways to improve the situation, either by oneself or through the guidance of a doctor.

References:

1. Roth T. (2007). Insomnia: definition, prevalence, etiology, and consequences. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 3(5 Suppl), S7–S10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1978319/
2. Ebrahim, I.O., Shapiro, C.M., Williams, A.J. and Fenwick, P.B. (2013), Alcohol and Sleep I: Effects on Normal Sleep. Alcohol Clin Exp Res, 37: 539`-549. doi:10.1111/acer.12006 https://onlinelibrary.wiley.com/doi/abs/10.1111/acer.12006
3. Harvard Health Publishing, Harvard Medical School (July 2020). Blue Light Has a Dark Side. Retrieved from https://www.health.harvard.edu/staying-healthy/blue-light-has-a-dark-side