What is insomnia? – Causes, Symptoms, Types, Diagnosis and Treatment

The insomnia is difficulty falling asleep or staying asleep, even when he has the opportunity to do so, people with insomnia may feel dissatisfied with their sleep and generally experience one or more of the following symptoms: fatigue, low energy, difficulty concentrating , mood disturbances and decreased performance at work or school.

What is insomnia?

Insomnia is a sleep disorder in which people have trouble sleeping, they may have a hard time falling asleep or falling asleep for as long as they like, it is usually followed by daytime sleepiness, low energy, irritability, and a depressed mood. . It can be short-term, lasting days or weeks, or long-term, lasting more than a month.

Between 10% and 30% of adults suffer from this disorder at any given time and up to half of people have it in a given year, about 6% of people have it and it is not due to another problem and lasts more than a month, those over 65 are affected more often than younger people, women are often more affected than men. Descriptions of insomnia occur at least as far back as ancient Greece.

Types of insomnia

There are two types of insomnia: primary insomnia and secondary insomnia.

Primary insomnia

It means that a person has sleep problems that are not directly associated with any other health condition or problem. Read more about primary insomnia. (Required item)

Secondary insomnia

It means that a person has trouble sleeping because of something else, such as a health condition (such as asthma, depression , arthritis, cancer, or heartburn ); pain; medications they are taking; or a substance they are using (such as alcohol). Complete content of secondary insomnia. (Required item)

Causes of insomnia

It can be caused by physical and psychological factors, sometimes there is an underlying medical condition that causes chronic insomnia, while transient insomnia can be due to a recent event or occurrence. It is commonly caused by:

• Circadian Rhythm Disruptions – Work shift changes, high altitudes, ambient noise, extreme heat or cold.
• Psychological problems:  bipolar disorder, dementia , anxiety disorders or psychotic disorders .
• Medical conditions:  Chronic pain, chronic fatigue syndrome, congestive heart failure, angina, acid reflux disease, chronic obstructive pulmonary disease, asthma, sleep apnea, Parkinson’s and Alzheimer’s diseases , hyperthyroidism, arthritis, brain injury, tumors, stroke .
• Hormones:  Estrogen, hormonal changes during menstruation.
• Use of psychoactive drugs (such as stimulants), including certain medications, herbs, caffeine, nicotine, cocaine, amphetamines, methylphenidate, aripiprazole, among others.
• Pain, an injury, or condition that causes pain can prevent a person from finding a comfortable position in which to fall asleep, and can also cause awakening.
• Poor sleep hygiene, for example noise or excessive caffeine consumption.
• A rare genetic condition can cause a permanent and eventually fatal prion-based form of insomnia called fatal familial insomnia.
• Physical exercise. Exercise-induced insomnia is common in athletes in the form of prolonged sleep-onset latency.
• Other factors: sleeping next to a snoring partner, parasites, genetic conditions, overactive mind, pregnancy. (Required items)

Insomnia Signs and Symptoms

Insomnia itself can be a symptom of an underlying medical condition. However, there are many signs and symptoms that are associated with insomnia:

• Difficulty falling asleep, including difficulty finding a comfortable position to sleep.
• Waking up during the night and not being able to go back to sleep.
• Feeling not renewed upon waking.
• Daytime sleepiness, irritability, or anxiety .
• Little concentration and focus.
• Not being coordinated, an increase in errors or accidents.
• Tension headaches (feels like a tight band around the head).
• Difficulty socializing.
• Gastrointestinal symptoms.
• Worried about sleeping.

Lack of sleep can cause other symptoms, the affected person may wake up without feeling fully awake and refreshed, and may feel tired and sleepy throughout the day. Having trouble concentrating on tasks is common. According to the National Heart, Lung, and Blood Institute, 20 percent of non-alcohol-related car accident injuries are caused by driver drowsiness.

It is common for patients who have difficulty falling asleep to also have nocturnal awakenings with difficulty falling back to sleep, two-thirds of these patients wake up in the middle of the night, and more than half have trouble falling back to sleep after an awakening in the middle of the night.

Early morning awakening is an awakening that occurs earlier (more than 30 minutes) than desired with the inability to fall asleep again and before the total sleep time reaches 6.5 hours.

Poor quality of sleep

Poor quality of sleep can occur as a result of, for example, restless legs, sleep apnea or major depression, it is caused by the individual not reaching stage 3 or delta sleep which has restorative properties. Major depression leads to disturbances in the function of the hypothalamic-pituitary-adrenal axis, causing an excessive release of cortisol that can lead to poor quality of sleep.

Subjectivity

Some cases of insomnia are not really in the traditional sense, people who experience the misperception of the dream state often sleep for normal periods, however, they overestimate the time it takes to fall asleep and stay asleep.

Insomnia diagnosis

Your doctor will likely diagnose insomnia based on your medical and sleep history and a physical exam – he or she may also recommend a sleep study.

Medical history

To find out what is causing your insomnia, your doctor may ask if you:

• You have new or ongoing health problems.
• You have painful injuries or health problems, such as arthritis.
• Take any medication, either over the counter or prescription
• You have symptoms or a history of depression, anxiety, or psychosis
• You are dealing with highly stressful life events, such as divorce or death

Your doctor may also ask you questions about your work and leisure habits. For example, he or she may ask about your work and exercise routines; your use of caffeine, tobacco, and alcohol; and your long-distance travel history, your answers may provide clues as to what is causing your insomnia.

Your doctor may also ask if you have new or ongoing personal or work problems or other stresses in your life. Also, he or she may ask if you have other family members who have trouble sleeping.

Dream story

To get a better idea of ​​your sleep problem, your doctor will ask you for details about your sleeping habits. Before your visit, think about how to describe your problems, including:

• How often do you have trouble sleeping and how long have you had the problem?
• When do you go to bed and get up on weekdays and days off?
• How long does it take you to sleep, how often do you get up at night, and how long does it take you to sleep?
• How refreshed do you feel when you wake up and how tired do you feel during the day?
• How often do you fall asleep or have trouble staying awake during routine tasks?

To find out what is causing or making your insomnia worse, your doctor may also ask:

• If you are concerned about falling asleep, falling asleep, or getting enough sleep.
• What you eat or drink, and whether you take medicine before bed.
• What routine do you follow before going to bed.
• How are the noise level, lighting and temperature where you sleep.
• What distractions, such as a television or a computer, are in your bedroom.

To help your doctor, consider keeping a sleep diary for 1 or 2 weeks, note when you go to sleep, wake up, and take naps, also note how much you sleep each night, and how sleepy you feel during the day.

Physical exam

Your doctor will perform a physical exam to rule out other medical problems that can cause insomnia, you may also need blood tests to check for thyroid problems or other conditions that can cause sleep problems.

Treatment

Acute insomnia may not require treatment, mild insomnia can often be prevented or cured by practicing good sleep habits. If your insomnia makes it difficult for you to function during the day because you are sleepy and tired, your doctor may prescribe sleeping pills for a limited time, avoid using over-the-counter sleeping pills as they can have unwanted side effects and tend to lose your effectiveness over time.

Treatment for chronic insomnia includes first treating any underlying conditions or health problems that are causing it. If it continues, your healthcare provider may suggest behavior therapy, behavioral approaches help you change behaviors that can make insomnia worse and learn new behaviors to promote sleep, techniques such as relaxation exercises, sleep restriction therapy, and Reconditioning can be helpful.

Good sleep habits

Good sleep habits, also called sleep hygiene habits, can help you sleep well and beat insomnia. Here are some tips:

• Try to go to sleep at the same time every night and get up at the same time every morning, try not to take naps during the day, because naps can make you less sleepy at night.
• Avoid prolonged use of telephones or  light-emitting reading devices before bedtime, this can make it more difficult to fall asleep.
• Avoid caffeine, nicotine, and alcohol late in the day as they are stimulants and can prevent you from falling asleep. Alcohol can cause wakefulness at night and interfere with the quality of sleep.
• Get regular exercise. Try not to exercise near bedtime, because it can stimulate you and make it difficult for you to fall asleep, experts suggest not exercising for at least three to four hours before going to sleep.
• Do not eat heavy in the day. However, a light snack before bed can help you sleep.
• Make your room comfortable. Make sure it’s dark, quiet, and not too warm or too cold, if light is a problem, try a sleep mask, if noise is a problem, try earplugs.
• Follow a routine to help you relax before bed. Read a book, listen to music, or take a bath.
• Avoid using your bed for anything other than sleeping or having sex.
• If you can’t fall asleep and you don’t feel sleepy, get up and read or do something not too stimulating until you feel sleepy.
• If you find yourself awake worrying about things, try making a to-do list before going to bed, this can help you not focus on those worries at night.

Cognitive behavioral therapy

There is some evidence that cognitive behavioral therapy for insomnia is superior in the long term to benzodiazepines and non-benzodiazepines. In this therapy, patients are taught improved sleep habits and counterproductive assumptions about sleep, misconceptions, and common expectations that can be modified include:

• Unrealistic sleep expectations (for example, I need 8 hours of sleep each night).
• Misconceptions about the causes of insomnia (for example, I have a chemical imbalance that causes my insomnia).
• Amplifying the consequences of insomnia (for example, I can’t do anything after a bad night’s sleep).
• Performance anxiety after trying for so long to get a good night’s sleep by controlling the sleep process.

Read more information about: Cognitive behavioral therapy.

Medicines

Many people with insomnia use sleeping pills and other sedatives. In some places, medications are prescribed in more than 95% of cases, however they are a second-line treatment.

The percentage of adults who use a prescription sleep aid increases with age. During 2005-2010, approximately 4% of American adults ages 20 and older reported taking prescription sleep aids in the past 30 days, usage rates were lowest among the youngest age group (ages 20-39). years) by about 2%, increased to 6% among people 50 to 59 years old and reached 7% among people 80 years and older.

Frequent questions

• How long does insomnia last?  It can last all the time or it can last only a few nights or it can last for months or more.
• Do children have insomnia? People of all ages can develop it, including children, for many of the same reasons as adults, including medical conditions, medication side effects, and even stress .
• Can insomnia affect general health? Sleep is essential to function, when you don’t get enough rest it can affect your health and your overall quality of life. The good news is that insomnia can be successfully treated in most cases.
• What should I do if I have insomnia?  The first step is to talk with your doctor, if you have tried self-help strategies and they haven’t worked, a treatment is available that can help you get the restful sleep you need.