What is Insomnia?
What is Insomnia? Insomnia is a condition in which the person has difficulty falling asleep or wakes up earlier than desired and has difficulty retuning to sleep. The person may also still feel tired after waking up. It is a common problem in the general population.
Short-term insomnia can occur for a few days or weeks and is often a result of stress. Insomnia is only deemed a “disorder” when difficulties with sleep occur at least three nights a week for more than a month, and it causes daytime distress and problems with day-to-day functioning. It is estimated that 10-15% of the adult population have chronic sleep problems, and it is more prevalent among the elderly and in those with medical or psychiatric conditions.
What Talk About Insomnia?
Persistent sleep problems can impact your day-to-day tasks and strain relationships as it makes you tired, unfocused and irritable.
It can also affect your quality of life, and in the long run, impact your mood and lead to psychiatric disorders. Furthermore, it is known to be linked to other health issues such as weight gain, high blood pressure and heart conditions.
Myths About Slep Patterns and Sleep Difficulties
Myth : Normal people have uninterrupted sleep every night for 7-8 hours.
Fact : It is common for people to have disturbed sleep 1-2 nights a week or even more during periods of stress, and wake up once or twice during the night. Pressurising ourselves with unrealistic sleep expectations can cause undue anxiety and worsen sleep.
Myth : Insomnia is caused entirely by chemical imbalance, and hence can only be treated with medication.
Fact : There are multiple causes for insomnia, such as poor sleep habits, lifestyle factors, excessive stress, and mood or anxiety disorders. Depending on the healthcare provider’s assessment, different behavioural or psychological strategies may be prescribed to address the condition, and medication may not always be necessary.
Myth : If I have poor sleep on a given night, I should try to catch up by napping the next day, or by sleeping longer hours the next night.
Fact : Sleeping during the day or at irregular hours on different nights can affect the quantity and quality of night time sleep. The best way to improve sleep is to train your body to go to bed and wake up at the same time every day. It is not helpful to try to catch up on sleep by napping, going to bed earlier, or sleeping-in later.
Risks Factors for Insomnia
Insomnia may be caused by a multitude of factors such as :
- An anxious and worrisome personality
- A weaker body clock (also called circadian rhythm)
- Family history of insomnia
- Stressful life events
- Use of substances such as alcohol, caffeine and nicotine
- Medical health conditions that cause discomfort and pain, and conditions like restless legs and sleep apnea
- Unhelpful habits such as day time napping, and worrying about the effects of sleep difficulties
Tips to Manage Insomnia
- Go to bed only when you feel sleepy
- Maintain a regular arising time in the morning, irrespective of what time you fell asleep or whether it is a work day or holiday
- Do not nap during the day
- Maintain bed time rituals, such as listening to soft music, praying, or doing something more relaxing before you sleep
- Avoid caffeine, nicotine and alcohol as they may interfere with sleep
- Do not have heavy meals close to your bedtime
- Regular exercise helps to deepen sleep, but do it earlier in the day and not too close to your bedtime
- Minimise noise and light in your bedroom, and keep the temperature comfortable
- Disengage from your computers, phones or tablets an hour before your bedtime if they interfere with your sleep
When to Seek Help?
If you feel that you are having little or no improvement in your sleep after trying the different methods, speak to your doctor about what you are experiencing, or consult a mental health professional.
How is an Assessment for Insomnia done?
Insomnia is a treatable condition. Your mental health professional will ask you a series of questions regarding your past and current life events to understand you and your difficulties better. You may also be asked to fill out a series of questions regarding your symptoms, behaviours and lifestyle. After this initial assessment, you may be advised to seek psychological therapy to learn skills to manage your insomnia better. If necessary, medication may also be prescribed.
Sleeping tablets traditionally refer to a class of medicines called benzodiazepines and a class called Z drugs. These medications are recommended only for short courses (or around a week or so). They should not be the first or main treatment for insomnia.
They have been shown to cause problems when used for longer periods of time such as:
- problems with memory (e.g. forgetfulness)
- falls
- reliance / addiction to these medications and difficulty stopping
- tolerance which means the usual dose loses its effect and you feel the need to take more
Other medicines that may be used to help sleep and are not addictive include melatonin and some antihistamines.
