In this article, we’ll take a look at insomnia. What it is and what causes it; as well as what it can cause. We’ll also explore some treatment options.
You’ve had a sleep study, but they say you don’t have sleep apnea. And yet, you’re still not sleeping. Laying in bed, the thought keeps rolling over in your head “What’s wrong with me?”
What is Insomnia?
Simply put, insomnia is defined as difficulty falling asleep and remaining asleep. It also includes some form of impairment during the day. And even though it’s the most common sleep disorder, insomnia is also the most underdiagnosed, and undertreated. Actually, according to some statistics, approximately 10% of the general population suffers from chronic insomnia, while 30% do so occasionally.
Actually, according to some statistics, approximately 10% of the general population suffers from chronic insomnia, while 30% do so occasionally. Additionally, there are different degrees of insomnia, from mild to moderate to severe. It can also briefly appear from time to time, or come and stay awhile.
But just what causes insomnia? Let’s take a look.
The typical person with insomnia is an elderly white female. There’s also some evidence that it might run in your family.
Some other factors include:
- Chronic pain
- Restless Legs Syndrome
Although the #1 cause of insomnia is long term Stress.
However, the most common disorders associated with insomnia are anxiety and depression.
Furthermore, if you have insomnia, you’re more likely to be involved in a fatal car accident . You’re also more likely to miss work. And when you are working, you’ll tend to make more mistakes.
In addition to this, insomnia itself is a risk factor for other diseases. Which in itself can make it difficult to properly diagnose.
Let’s look more closely at that.
Insomnia can be difficult to properly diagnose. This is because it’s hard to determine if it’s a symptom of another disorder or a disorder all by itself. It’s important to find out what caused what so that proper treatment can be made.
For instance, depression can cause insomnia. However, insomnia can also cause depression. But which came first? If insomnia caused the depression, then treating the depression won’t entirely solve the problem.
Another reason for its difficulty involves something known as sleep state misperception. In other words, you can be in a very light stage of sleep, and feel as though you were lying awake the whole time.
Also, there are beliefs about sleep. In reality, some people need more sleep, some need less. The average is around 8 hours. So, if you believe you need 8 hours, but really only need 7, you could lay awake for an hour wondering why you can’t sleep.
Moreover, a diagnosis is made based mainly on what the patient describes, and includes reports of:
- Attention, concentration and/or memory problems
- Daytime Sleepiness
- Difficulty with social interaction
- Poor school performance
- Tension headaches
Your Doctor will make a diagnosis based on your sleep patterns. Also the use of some sleep questionnaires. Such as something called an Epworth Sleepiness Scale
A sleep study could also be ordered if the cause of your insomnia is unclear. Additionally, your Doctor might order some blood work, if (s)he suspects some other medical condition that might be the underlying cause. Such as thyroid disease or iron deficiency anemia.
Once a diagnosis has been made, it’s time to look at some treatment options. We’ll start with changing the way you think and act.
Self Perpetuating Insomnia
Insomnia can be started by something that causes you concern. but continue long after the initial problem is solved. Here’s how.
Some life event causes some concern. In fact, you lay awake in bed worrying about this. Your concern is now making it difficult to fall asleep. After awhile, the initial cause of worry is taken care of. However, you’ve now been in a pattern of not being able to sleep so long that you now have concerns about your inability to sleep.
So now your worry about not being able to fall asleep is causing difficulty falling asleep. And so the cycle continues, long after the initial event that caused it. To further complicate this, now your lack of sleep can lead to depression.
Next, we’ll take a look at some treatment options.
Cognitive Behavior Therapy
Insomnia responds better to behavioral changes then to the use of medicine. However, a combination of treatments can be even more effective. Let’s start with something called Cognitive Behavior Therapy or CBT. This basically involves changing the way you think and behave. There are different forms of CBT, depending on your specific needs. These include:
- Improve your sleep space- This includes not having a tv, clock, or other electronic devices in your sleep area.
- Mindfulness meditation
- Relaxation training
- Remaining passively awake-Simply try not to fall asleep It’s basically letting go of the worry that you can’t sleep. As mentioned earlier, it can sometimes be the worry of not being able to sleep that keeps you awake. Let go of that worry.
- Sleep hygiene-Establishing good sleep habits
- Sleep restriction-You builds up a ‘sleep debt’ while awake. When that ‘debt’ reaches a certain point, your brain tells you it’s time to go to sleep. However, any nap will ‘pay off’ some of that debt, leaving you more awake at bed time.
Also, keep in mind that body position is really important. For example, laying on your back is actually the best sleep position. This is because it properly aligns your spine and neck. As well as puts the least amount of strain on your body. Again, and I can’t stress this enough, there really should be no t.v. or other electronic devices in your bed room. And if noise is a factor, the use of a fan or other white noise machine can be helpful.
Next, we’ll take a look at some of the more common medications your Doctor might prescribe.
The 3 main medications are:
- Allergies make it hard to breathe, which can be at least some of the cause of your insomnia. So if you have allergies, your Doctor might prescribe something like Diphenhydramine (Benadryl), or an over the counter med such as Doxylamine (Unisom).
- Sedatives-Zolpidem (Ambien). Temazepam Lorazepam (Ativan)
- Antidepressants-Trazadone. Mirtazapine (Remeron)
There are some herbal supplements that have shown positive results. They include Melatonin, Valerian Root, and Chamomile.
And while medicine just relieves your symptoms, Cognitive Behavior Therapy will actually get at the cause of your sleeplessness. However, it will take time and effort on your part to get results.
As you can see, there are many good treatment options available. Talk with your Doctor, as you probably would benefit most from using a combination of treatments together.
We’ve looked at insomnia, and discovered some of the reasons it can be hard to properly diagnose. If you suffer from insomnia, I hope this article helps you understand it a little better. Also, if you know anyone suffering from this debilitating disorder, please share this article with them.
Till next time…Blessings.