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What Is Insomnia?

Insomnia is characterized by an inability to obtain a sufficient amount of sleep to feel rested. It can be due to either difficulty falling or staying asleep. It may also result in waking earlier than desired. The sleep is often reported to be of chronically poor quality, light, and unrefreshing. As a result of this, people with insomnia suffer from daytime symptoms like poor attention, irritability, and reduced energy.

Fortunately, there are effective treatment options for insomnia, ranging from the temporary use of sleeping pills to cognitive behavioral therapy (CBT).

insomnia
Verywell / JR Bee

Insomnia Symptoms

With insomnia, sleeping difficulties occur at least three nights per week for more than three months.1

Insomnia negatively affects daytime functioning, leading to one or more of the following :

  • Fatigue or daytime sleepiness
  • Malaise (feeling unwell)
  • Poor attention or concentration
  • Impaired performance (errors, accidents)
  • Reduced energy or motivation
  • Behavioral problems (i.e., hyperactivity, impulsiveness, aggression)
  • Inability to nap
  • Headache, upset stomach, and chronic pain complaints

In addition to the above daytime symptoms, mood disorders, like anxiety or depression, are commonly associated with insomnia. Depression may be associated with  difficulty returning to sleep.  may leave your mind buzzing at night, worries washing over you as you try to get to sleep. When sleep becomes difficult to obtain, this may fuel the fires of anxiety, making matters worse and fueling a vicious cycle.

Moreover, insomnia may affect serotonin levels and the function of the  of the brain. The frontal lobe is responsible for various executive functions, which are key in making rational choices and appropriate social interactions. Impairment can be so significant that the ability to suppress suicidal thoughts, or even the outright impulse to kill oneself, may be lost.

Studies suggest that the risk of suicide may double among those with insomnia. Anyone with such thoughts should seek help by contacting the toll-free at (800) 273-8255.

Causes

Experts’ understanding of the  is rooted in three factors: predisposition, provocation, and perpetuation.

Predisposition

Everyone has the potential to develop the kind of difficulty sleeping that characterizes insomnia. This is referred to as a predisposition or threshold. The threshold for developing insomnia will vary for each person.

Believe it or not, there are people who rarely or never develop trouble sleeping at night. On the other hand, some people may be unlucky and are simply predisposed to have insomnia. This likely relates to genetic factors (insomnia often runs in families), age, sex (more often women), substance use, and other medical and psychiatric conditions (e.g., depression, anxiety, or chronic pain disorders.

Insomnia may also be attributed to an increased alerting signal. This relates to the sympathetic nervous system, which is responsible for the so-called “fight or flight” response. Some people may have an increased sympathetic drive, meaning they are primed to respond to an external threat. This signal can keep you awake during the day, but it also keeps people with insomnia up at night. Some have described this as being “tired but wired”.

Provocation

Even though you might have a predisposition to insomnia, it has to be triggered. These triggers are called precipitating or provocative factors.

Examples of such factors include:

  • Drinking alcohol, caffeine, or smoking a cigarette before bed
  • Television or pets in the bedroom
  • Travel (causing jet lag)
  • Stress from a lost job, financial problems, a divorce, or the death of a close friend or family member
  • Nighttime responsibilities, such as infant feedings

Keep in mind, typically when the cause is removed, insomnia abates. However, it can also become perpetuated by changes you make.

Perpetuation

The final components that transform a passing difficulty sleeping into are called perpetuating factors. These factors can best be understood by considering an example.

Let’s imagine that you lie awake several hours in the middle of the night, a common occurrence in insomnia. You recognize that you need eight hours of sleep, and by lying awake you are cutting into this time. You decide to start going to bed two hours earlier to compensate. This may help some, but now that you are going to bed extra early it is taking you more time to fall asleep. As you lie awake more of the night, your frustration increases and you compound your initial insomnia.

In the end, there are a variety of choices that might perpetuate your insomnia. Some people choose to limit their daytime activities because of sleepiness. This avoidance may reduce your physical activity. Since you aren’t exercising, you may be less tired and unable to sleep.

Alternatively, you may start working on your computer in bed to make the most of your time spent awake. The and the activity may worsen your ability to sleep. Or, you may start napping during the day to get some rest, which could undermine your sleep drive and ability to sleep at night.

The existence of perpetuating factors prolongs your battle with insomnia.

Treatment

If insomnia results in disrupted daytime function, especially if it persists chronically, it may require treatment.

Addressing Your Triggers

Many people’s insomnia triggers resolve on their own. For example, a bad night of sleep before a school exam will go away as soon as the test is over.

Other triggers can be alleviated once they are properly identified and addressed. For instance, eliminating afternoon avoiding alcohol as a “nightcap,” and removing technology devices or disturbances within your sleep environment may be enough for you to get some quality shuteye.

If you are suffering from chronic insomnia, you may need to seek professional help. It can be very beneficial to address the beliefs, thoughts, and feelings that surround your insomnia with a treatment called

With CBTI, a specially trained psychologist will help you identify your unique triggers and then help you defuse them. For instance:

  • If you cannot fall asleep because you moved your bedtime up, —where you limit your time in bed and avoid daily naps—may be the recommendation.
  • If you lie awake at night and cannot get to sleep, may be helpful.
  • If your mind races when you lie down, you may benefit from observing a  before bedtime or scheduling worry time during the day.

Lastly, if your insomnia is due to a more long-term trigger (e.g., shift work or jet lag from frequent travel), talk with your doctor about interventions that specifically target that trigger.

Taking Medication

There are many medications that can be effective in the short-term for treating insomnia.3 Two major classes include nonbenzodiazepine medications.

Some of these prescription and over-the-counter medications include:

 

  • ProSom (estazolam)
  • Restoril (temazepam)

The reason why the above medications should only be used short-term and not long-term is that sleeping pills may cause something called tachyphylaxis. With this phenomenon, the medication becomes less effective, so higher doses are needed for the same effect. Ultimately, the medication stops working, and when discontinued, rebound insomnia occurs.

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8 Comments

  1. Reply

    Cool

  2. Reply

    Interesting

  3. Reply

    And it’s not good for the body

  4. Reply

    Yup

  5. Reply

    Amazing

  6. Reply

    This is really good to know

  7. Profile photo ofExcel01

    Reply

    Interesting

  8. Reply

    Good article

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