What is Insomnia?
Insomnia is the disturbance of a normal sleep pattern - difficulty getting to sleep or staying asleep. If it occurs regularly or over a long period of time,
it is called chronic insomnia
Why do we need sleep?
Sleep is a state of consciousnesses, giving your body time to rest and build up your strength. While you are asleep, your body goes through different stages at approximately 90 minute cycles.
These include light sleep, deep sleep and dreaming, also known as rapid eye movement (REM) sleep. This is the time when most dreams occur.
The amount of sleep we need differs from person to person an adult can need between 7-8 hours, a baby up to 17 hours and a older child 9-10 hours. Most people over 70 need only 6 hours sleep a night
The stages of sleep occur in cycles
The first cycle, which ends after the completion of the first REM stage, usually lasts for 90 minutes. Each cycle after the first lasts longer because the REM stage lasts longer in each cycle. A person may have five cycles of sleep during a typical night.
Everyone has difficulty sleeping at some time in their life but this is usually only for a short time. It is estimated one in ten people suffer from chronic insomnia and is more common in older people and those under a lot of stress.
Sleeping problems appear in a variety of ways:
- Difficulty getting to sleep (sleep onset insomnia). This is most common in young people.
- Lying awake for a long time at night before getting to sleep
- Active Mind preventing you from sleeping
- Waking in the night frequently this is most common in older people.
- Waking early in the morning - the least common type of sleep disturbance.
- Not feeling refreshed after sleep. You may have trouble functioning normally during the day, feel irritable, tired, and find it difficult to concentrate.
- Waking when you have been disturbed from sleep by pain or noise.
Insomnia can last for days, months or even years and can be split into three categories:
- Transient insomnia lasts for 2-3 days.
- Short-term insomnia lasts for more than a few days but less than 3 weeks.
- Chronic insomnia can be defined as insomnia most nights for 3 weeks or longer.Chronic insomnia can lead to mental health problems such as depression, or misuse of alcohol or other drugs in order to gain sleep.
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Sleeping difficulties are most commonly caused by stress and worry. Other common causes include physical illness that causes pain, environmental noise, depression, shift work, caffeine or alcohol consumption, and medication side-effects.
Physical
Insomnia can be caused by an underlying physical condition causing involuntary movement, pain or discomfort. Examples include:
- restless leg syndrome,
- coughing,
- arthritis, headaches and back pain,
- hot flushes (due to the menopause),
- head injury,
- gastrointestinal disorders,
- pruritus (excessive itching),
- Parkinson's disease.
Physiological
Disruptions within the sleeping environment or to bedtime routines can cause insomnia.
- noise,
- light,
- snoring,
- partner moving about,
- jet lag,
- activities before bedtime, like reading or exercise
- If you are a night or shift worker, your job can disturb your ability to sleep properly as your natural body clock will be affected. This is because your body is designed to release awake chemicals when there is daylight and sleepy chemicals when it gets dark.
Diagnosis
Your GP will ask about your sleeping routines, how much alcohol and caffeine you drink each day and your general lifestyle habits, such as diet and exercise.
They will check your medical history for any illnesses or medications that may be contributing to the insomnia. Your GP will ask if you are taking any other substances. For example, drugs. In many cases, a cause of insomnia can be identified through these simple measures.
If the cause is not immediately obvious, your GP may suggest you keep a sleep diary to show when you went to sleep, how long for, and whether you were disturbed in the night.
A polysomnography is a physical test for identifying sleeping problems, although this is mainly used to diagnose sleep apnoea. Sensor leads (electrodes) are placed on various places on your body, including the torso and head. While you are asleep, the test will record:
- electrical activity in the brain,
- eye and jaw muscle movement,
- leg muscle movement,
- airflow,
- respiratory effort (chest and abdominal movement during breathing),
- heart activity (using an electrocardiogram or ECG), and
- oxygen saturation (amount of oxygen being absorbed by the lungs).
If carried out in a sleep research centre (rather than your home) you may also be videotaped during the test, to compare the electronic readings with what was happening in the room.
Self-help
There are a number of things that you can do to help overcome insomnia.
- Reduce your caffeine intake, especially late in the day.
- Try a Natural Sleep Aid that improves your Sleep Naturally
- Try keeping a Sleep Diary
- Drink alcohol in moderation. It may make you sleepy, but it will cause you to wake up early.
- If you smoke, try to stop. Night-time breathing problems are more likely in smokers.
- Take regular exercise, but don't do strenuous activity immediately before going to bed.
- Don't take naps during the day.
- Try taking a warm bath, having a milky drink or listening to soothing music to create a relaxed mood before going to bed.
- Meditation and exercise such as yoga can have a relaxing affect, helping prepare your body for sleep.
- Try to get into a daily routine to establish a sleep rhythm. Go to bed the same time each night and get up the same time each morning.
- Don't have heavy or rich meals, especially in the few hours before you go to bed.
- If you can't sleep, get up and read until you feel sleepy or do something you find relaxing. Don't watch television as this can stimulate the mind, and try not to lie in bed thinking about how much sleep you are missing.
- Mentally dealing with the day's unfinished business is also helpful. Write down any worries to deal with the next day before you go to bed. This may help to clear them from your mind and prevent them re-surfacing in the early hours.
- Make sure your room isn't too hot or too cold, and that your bed is comfortable with a good pillow.
- Don't watch the clock as this will only make you anxious. For example, 'it's 2.30 I've got to be up at 6.30'.
Try these methods for at least 3 - 4 weeks so that you break your usual sleep patterns.
Be aware that you may feel tired during this period so you must take extra care when you are driving or operating machinery etc.
When you are asleep for the majority of the time you are in bed, try going to bed 15 minutes earlier, but make sure you get up at the same time.
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