The first weeks and months after bringing a new baby into the family can be a trying time. The newborn's sleep patterns often play a major part in the difficulties faced by new parents, but after a few months, a newborn will usually settle into a more mature sleep pattern.…
Insomnia (sleep problems)
What is insomnia?
Insomnia is a term that describes a difficulty with falling or staying asleep. It can be caused by stress, changes in your sleeping environment, or as a result of other health problems. Some medications can also make it hard to sleep and lead to insomnia.
Insomnia is a very common condition and can lead to day-time sleepiness, which may result in poor performance at school or work and can also lead to depression or anxiety.
Many different factors can cause difficulty sleeping. Some that may cause short-term insomnia include stress, shift work or a change in your sleeping environment, such as noise, bright lights or temperature. The use of substances called stimulants can also make it hard to sleep. Common stimulants include caffeine, which is found in coffee, soft drink and energy drinks, alcohol, nicotine and some medications.
Insomnia that lasts for more than a few weeks is often associated with other health conditions including pain, menopause, depression and anxiety disorders.
Insomnia can be a symptom of a number of other sleep disorders that include:
Restless leg syndrome
This is characterised by the urge to move the legs and an uncomfortable burning or cramping feeling in the legs.
Periodic limb movement disorder
This involves involuntary movements of the lower legs during sleep and can lead to sleep interruptions.
Sleep apnoea is a condition that results in short pauses in breathing during sleep. Obstructive sleep apnoea is a result of the throat walls coming together briefly during sleep, causing temporary shortness of breath.
Circadian rhythm disorders
This is a group of conditions that affect the timing of sleep.
Some of the factors that can increase your chances of developing insomnia include:
- Being over the age of 60;
- Being female;
- Frequent international travel;
- Shift work, and;
- Having mental health disorders, such as depression or anxiety.
There are several different terms that are commonly used to describe insomnia. These are based on either the cause of the insomnia, or how long your sleep has been affected.
This term is used when the difficulty sleeping is not related to any other health problems.
Insomnia that is related to another health condition. For example, pain, depression and anxiety disorders can all cause sleep problems. Secondary insomnia also describes insomnia that is related to the use of medications and other substances, such as alcohol or caffeine.
Short-term and long-term insomnia
Insomnia can also be classified on the basis of how long sleeping has been affected. Short-term (acute) insomnia is used to describe the condition when sleep has been affected for less than one month. Long-term (chronic) insomnia describes the condition when it lasts longer than one month.
Signs and symptoms
The main signs that are associated with insomnia are difficulty falling asleep at night and difficulty staying asleep. If you have insomnia you may also experience:
Methods for diagnosis
To work out if you have insomnia, your doctor is likely to ask about your sleep patterns and habits, as taking a history is the main basis for diagnosing insomnia. They may also conduct a physical exam to see if you have any other conditions that may cause sleeping problems. You may be asked to keep a sleep diary, which involves recording the times when you go to bed, fall asleep, wake up, stay awake in bed and get up in the morning. In some cases your doctor may recommend more tests if there is concern that other medical conditions may be contributing to your sleep difficulties. These tests include:
A sleep study, or polysomnography, is usually done overnight in a sleep lab or can be done at home with mobile equipment. It measures your brain activity, eye movements, heart rate and blood pressure. This information can be used to work out if you have a sleep disorder that could be related to your insomnia, in particular sleep apnoea or a limb movement disorder.
Actigraphy is a test that is sometimes performed to diagnose conditions that affect your sleep cycle. It involves wearing a small device on your wrist that can measure movement and provide information on how you sleep and your activity levels during the day.
Types of treatment
The type of treatment you need depends on the cause of your insomnia. Trying to get sleep naturally by using self-care methods is usually the first line of treatment for insomnia. In some cases your doctor may prescribe medication to help you return to a normal sleep pattern. It is also important to treat any underlying health conditions, such as sleep apnoea or depression, that may be contributing to your insomnia.
Self-care treatments are simple things you can do at home that may help you settle down before going to bed. Some common natural ways to help sleep include:
- Establishing a routine before going to bed;
- Going to bed and getting up at the same time each day, regardless of how much sleep you have or have not had, including on weekends and holidays;
- Getting regular exercise during the day, but avoiding late-night exercise;
- Avoiding alcohol, caffeine, energy drinks and smoking before bedtime;
- Avoiding sleeping during the day;
- Avoiding lights and watching television in the bedroom, including light from tablet devices, computer screens and phones, and;
- Relaxing before bedtime.
In some cases, if natural ways to aid sleep have not worked, your doctor may prescribe medication to help you sleep and return to a normal sleeping pattern. These medications can become less effective the more they are used, meaning that they need to be taken in higher doses to achieve the same effect. If taken for more than two weeks, these medications can lead to difficulty sleeping when the medication is stopped. Some of the common medications prescribed for insomnia include temazepam, zopiclone and zolpidem. These are generally recommended to only be used at the lowest effective dose and for the shortest amount of time needed.
Melatonin is a hormone that is found naturally is the body. It is important in the control of your circadian rhythm - the variation of the level of alertness or sleepiness throughout the day. Melatonin in tablet form can be used as a short-term treatment for insomnia.
Not getting enough sleep at night can affect how you function during the day. Sometimes this can lead to problems such as poor performance and trouble concentrating at school or work. Long-term insomnia can also lead to poor immune system function and mental health issues such as depression and anxiety. In extreme cases, being very tired from lack of sleep could lead to serious accidents.
Insomnia itself is usually not a very serious condition, but if sleep is affected for a long time it can have serious complications. It is important to treat the underlying cause of the insomnia to try and restore a normal sleep pattern. With proper treatment and lifestyle changes, most people will be able to overcome their difficulty sleeping.
You may be able to prevent insomnia by identifying problems that could cause sleeping problems and dealing with them early. This might include managing any medical problems that could cause difficulty sleeping, such as depression, and reducing the amount of caffeine, alcohol and other stimulants you consume. Getting regular exercise and developing good sleeping habits, such as going to bed and getting up at the same time each day, may also help to prevent insomnia. Maintaining an environment that is conducive to sleep is also important, so reduce excess light, noise and temperature.
FAQ Frequently asked questions
How much sleep is normal?
The exact amount of sleep a person needs is difficult to gauge, as it can change with age and between one individual to another. On average, adults need between 7.5 and 9 hours sleep each day.
What is insomnia?
Insomnia is difficulty falling asleep or difficulty staying asleep. It is a symptom and not a disease. It is very common for people to experience insomnia at some point in their lives.
What causes insomnia?
Lots of different factors can cause you to have trouble sleeping. Short-term insomnia may be caused by stress or a change in your sleeping environment such as noise, bright lights or temperature. Insomnia can also be caused by substances called stimulants that can …
What are the symptoms of insomnia?
The main symptom of insomnia is experiencing trouble falling asleep at night and difficulty staying asleep. If you have insomnia you may also wake up many times during the night, or wake early in the morning. You may not feel well rested after a night’s …
How is insomnia treated?
The treatment for insomnia will depend what is causing the condition. It is important to treat any underlying condition, such as sleep apnoea or depression. Self-care strategies for insomnia include trying to get to sleep naturally by establishing a bedtime …
Who is at risk of insomnia?
Anyone can experience insomnia, but several factors can increase your risk of developing the condition. These include being over the age of 60, being female, being under a lot of stress, having a mental health disorder, or working night shifts.
Can insomnia be prevented?
You can prevent insomnia by identifying and treating, early on, problems that could cause difficulty sleeping. This might include managing any health problems, reducing the amount of caffeine, alcohol and other stimulants you consume, and developing good sleeping …
How is insomnia diagnosed?
Insomnia is a symptom and not a disease, so your doctor will focus on identifying the reason why you might be having difficulty sleeping. your doctor will usually want to perform a physical examination to look for related health conditions, and ask you about your …
Is insomnia serious?
Insomnia is not usually serious. However, lack of sleep can result in day-time sleepiness, which can lead to poor performance at school or work and can increase the risk of having accidents. If insomnia is experienced for a long time, it can also lead to mental health …