Insomnia – Types, Treatments and Causes
Insomnia means you frequently have trouble sleeping. There are two main types of insomnia, short-term insomnia (sometimes known as acute insomnia) where it lasts for less than three months, and long-term insomnia (chronic insomnia) where it lasts for longer than three months.
The amount of sleep you need will depend on your age - you’re likely not getting enough sleep if you’re tired during the day. Many things cause insomnia, ranging from stress to shift work. Thankfully, in most cases, insomnia can be treated by changing your sleeping habits. However, you can also seek insomnia treatment from your GP or pharmacist, too.
The occasional night of poor sleep isn’t enough to diagnose insomnia. Most people lose sleep at some point, like if you have a newborn baby, for example. Rather, insomnia is when you’re regularly unable to sleep at night and stay asleep. The symptoms of insomnia include:
- Difficulty falling asleep
- Waking up multiple times during the night
- Lying awake in bed at night
- Waking up early and being unable to go back to sleep
- Still feeling tired after waking
- Struggling to nap during the day even though you’re tired
- Experiencing side effects of insomnia, like fatigue, irritability and difficulty concentrating
Sleep is just as important to your health as diet and exercise, with a lack of it impacting both your physical and mental health. In fact, people with insomnia often have a lower quality of life than those who are able to get enough sleep.
Insomnia can cause a number of complications, such as a low performance at school or work, slowed reaction times, which is particularly dangerous when driving, in addition to an increased risk of mental health disorders and long-term health conditions like high blood pressure and heart disease.
Types of insomnia
There are two main types of insomnia, acute (which lasts for a short time, less than three months) and chronic (which lasts for a longer time, surpassing three months).
Often, acute insomnia is caused by a stressful event, like losing a loved one or a job or relationship change, or even a bodily change like pregnancy or the menopause. These insomnia symptoms will likely disappear on their own as you cope with the event or the event passes. Nevertheless, acute insomnia is able to progress into chronic insomnia.
Chronic insomnia is when you have difficulty falling asleep for at least three nights per week for a period of three months or longer.
This type of insomnia is associated with irregular sleep patterns, poor sleep hygiene, sleep disorders, medications and health conditions. For example, you may frequently work night shifts or have a mental health condition like depression or anxiety that’s the cause of your sleep problems.
As we discussed briefly in the previous section, the two main types of insomnia can be caused by multiple things like grief, bodily changes such as pregnancy, or even certain health conditions that can prevent you from staying asleep. Some of the most common causes for insomnia include:
- Mental health conditions like depression and schizophrenia
- Alzherimer’s disease or Parkinson’s disease
- Sleep apnoea
- Certain medicines
- Long-term pain
- Sleep walking
- Restless leg syndrome
- Overactive thyroid
- The menopause
- Nightmares or night terrors
- Noise, like outside traffic
- A room that’s too hot or too cold
- Uncomfortable beds
- Alcohol, caffeine or nicotine
- Recreational drugs
- Jet lag
- Shift work
Who is at risk?
Women are more at risk of developing insomnia in comparison to men, possibly due to the hormonal changes during pregnancy and the menopause. Additionally, the older you are, the more likely you are to be an insomniac, too. This may be down to the natural bodily changes that come with ageing, and the higher likelihood of older people having health conditions and taking medications that negatively affect sleep.
Those who work shifts and frequently travel long-distance to different time zones are at an increased risk due to changes in your circadian rhythm, also known as your internal clock which tells your body when it’s time to sleep and when it’s time to be awake.
To diagnose insomnia, your doctor will look for things that could be the primary cause of your insomnia, like a health condition or even change your medication if it's causing your sleep disturbance.
They may also ask you a series of questions about your sleeping habits to determine not only if you have insomnia, but categorise it into the two main types: acute and chronic.
When to see your GP
Despite most cases of insomnia improving by altering your sleeping habits, sometimes, it’s important to visit your GP if this hasn’t worked, if you can’t get to sleep for months, or your insomnia is severely affecting your daily life.
Your GP may wish to send you for something known as a sleep study, otherwise known as a polysomnogram test. This test requires you to sleep overnight at the hospital with sensors attached to your scalp, face, eyelids, chest, limbs and fingers.
These sensors will monitor you while you’re sleeping, with dedicated sleep specialists using this data to diagnose any sleep disorders you may have that might be causing your insomnia.
To ensure that you’re getting the right treatment, your GP will try to determine the cause of your insomnia first. You may be referred for cognitive behavioural therapy (CBT) that works to change your thoughts and behaviours that are preventing you from getting a good night’s rest.
As we touched on before, you may be sent to a sleep clinic to have a sleep study performed, especially if you’re showing symptoms of a sleep disorder or sleep apnoea.
Of course, there are also medical treatments available to treat insomnia, ranging from medicines you can get over-the-counter (OTC) at the pharmacy, to prescription-strength medicines that a GP or a prescribing pharmacist can prescribe to you.
An example of an OTC sleep aid is diphenhydramine hydrochloride, a type of drowsy antihistamine that works by blocking the production of histamine in your body, encouraging you to feel drowsy and drift off to sleep.
If OTC medicines haven’t worked, your GP may suggest sleeping pills, such as melatonin, zopiclone or temazepam. However, these aren’t advised unless your insomnia is extreme and other treatments haven’t worked.
This is because sleeping pills can have serious side effects and it’s easy to become dependent on them. Typically, sleeping pills are only prescribed for a few days to weeks.
Valerian root extract is a popular herbal remedy that many people use to treat insomnia, in addition to reducing stress and anxiety. It acts as a natural sedative, helping you feel drowsy.
There’s limited evidence to support herbal remedies in the treatment of insomnia, and some may interact with certain medicines, so always double check with your doctor or pharmacist before taking them.
Practicing sleep hygiene is a good way to help prevent insomnia, and surprisingly, it has nothing to do with being clean. Instead, it’s about setting a sleep schedule so you’re going to bed at the same time every day, in addition to having a fixed wake-up time.
When you’re lying in bed, don’t toss and turn. If, after 30 minutes you haven’t gotten to sleep, get up and do a calming activity (keeping the lights low) such as stretching or reading before you try to go to sleep again.
Winding down before you go to bed is a useful way to relax your mind and body before sleep. Dimming the lights, unplugging yourself from electronics and even implementing relaxation techniques like meditation or breathing exercises can reinforce the message that it’s time for bed.
You may also wish to improve your sleeping environment by ensuring it’s not too hot or cold, your mattress, pillow and bedding is comfortable, and the room is dark and silent. Infusing the air with lightweight, calming scents such as lavender may cultivate a positive sleeping space.