Recognizing & Treating Insomnia

INSOMNIA: Recognizing & Treating

The DefiniTIVe Guide (2018 Update)


Counting sheep without success? Or hours until the morning?

When you are lying in bed awake at 2 a.m. and staring at the ceiling wondering why can’t you fall aslee​​​​​​​​​p, it probably feels like you are the only person in the w​orld facing this problem.

But the truth is far from that.

More than 30 percent of the population is experiencing the same struggle to fall asleep, even though nothing seems to be physically preventing them from doing so.

Insomnia is a cruel enemy who leaves you exhausted and incapable of function normally during the day.

To defeat insomnia, first, you need to know everything about it.

Chapter 1: 

  Insomnia Fundamentals

There are a lot of misconceptions about insomnia – but we have the facts to make everything clearer, from symptoms, to types and treatment.

Here’s the thing:

Millions of people worldwide are affected by insomnia (it is believed to be one of the most prevalent health complaints), yet we know so little about this sleep disorder.

It is time to change that, and fight this problem with the most powerful weapon we have – knowledge. First and foremost, it’s important to define insomnia.

However, defining insomnia is not an easy task.

Especially if you’re suspecting you’re suffering from this disorder but you’re not sure.

''RAISE YOUR HAND IF YOU’VE BEEN THERE. I KNOW HOW YOU FEEl'


There are different concepts used to define this sleep disorder which can range from “unsatisfactory sleep” to “insufficient sleep almost every night.

Although there is no unity in defining insomnia, the thing we can all agree on is that insomnia is a widespread sleep disorder which is characterized by a difficulty in falling asleep or staying asleep for enough time to feel rested and refreshed in the morning.

Many people suffering from insomnia try to live with it, instead of asking for help or changing their lifestyle to cope with it easier.

However, that is a huge mistake, since the effects of this sleep disorder, especially if it is chronic, can be devastating.

People suffering from insomnia usually face daytime sleepiness, mood swings, lethargy, anxiety, irritability and a general feeling of being physically and mentally unwell.

Here are some interesting facts about insomnia:

  • It can be hereditary.
  • It is more likely to affect women than men.
  • Elderly people are more susceptible to insomnia
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    Adults with children are more prone to insomnia than those without.
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    Individuals who are naturally more alert and awake are more likely to suffer from this sleep disorder.
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    Individuals who use alcohol and stimulants are more likely to report insomnia.
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    People who frequently get less sleep have higher rates of missed work days, are more likely to get into traffic accidents, are more likely to get easily irritated, and are less satisfied with their jobs.
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    Following different sleep schedule on weekdays and weekends can lead to insomnia.
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    In very rare cases, people can actually die from insomnia.
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    Chronic insomnia increases the risk of alcohol abuse.
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    About 30 percent of the global population complains of sleep problems.
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    The risk of insomnia rises with age.
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    Individuals with high school education or lower have a higher prevalence of insomnia than more educated groups.

Chapter 2: 

Know the Main Reasons Why You Get Insomnia and How It Is Diagnosed

Reasons behind developing this disorder are many – let’s find all about them.

When faced with the issue of not sleeping at night and having trouble getting asleep, one could easily think that the way of life or stress might be the reason. This might be true, but in reality, there’s many more factors that can contribute to the state.

Factors like your diet, substances you’re consuming, pshychological states you’re going through and medical causes can induce insomnia and make your life miserable.

Let’s put everyday stress, medication, and substances aside, because those causes can’t actually induce more serious state.

Here’s the thing:
  • Chronic insomnia is usually a symptom of a medical condition, or that condition causes it.
  • By learning to understand the medical causes, you may find a solution faster.
  • Some of the medical conditions commonly associated with insomnia are:

Asthma

Nasal allergies

Arthritis

Endocrine problems

Gastrointestinal problems

Low back pain

Neurological conditions (e.g. Parkinson’s disease)

Chronic pain

  • In addition, insomnia may be linked to sleep apnea, which is another sleep disorder we will discuss later in this article.
  • Also, a neurological condition called restless leg syndrome characterized by uncomfortable sensation when a person needs to move his or her legs can be the cause. This makes falling and staying asleep very difficult for individuals suffering from this condition.
  • Furthermore, the medical states or issues that you might be facing can induce the usage of medications, and that’s what brings the problem out:
  • Certain medications, such as the ones taken for high blood pressure, thyroid disease, nasal allergies, depression, asthma, heart disease and birth control can cause insomnia.
  • Specific medications which are believed to cause insomnia are beta blockers, corticosteroids, cholinesterase inhibitors, ARBs (angiotensin II-receptor blockers), SSRI antidepressants, ACE inhibitors, second generation (non-sedating) H1 agonists, alpha blockers, and statins.
  • Insomnia plays a significant role in depression and anxiety as well, as a basic symptom correlated to these conditions.
  • If you are suffering chronic insomnia and struggle to fall asleep each night for at least three weeks, you should pay a visit to your general practitioner because your problems with sleeping may be actually your body telling you that there is some other condition behind it, or maybe you need to change your medications.

DIAGNOSING INSOMNIA

There is no definitive test to check whether you are suffering from insomnia.

Doctors use different methods to diagnose it because each person has unique symptoms.

Some of the methods include filling out logs, sleep diaries, and questionnaires, while others include blood tests and sleep study.

Sleep specialists usually conduct sleep evaluation and clinical assessment to discover the sleep disorder a patient may be facing with. Making diagnose usually requires reviewing entire family and personal medical history, and performing a set of laboratory tests and physical examination.

A sleep study most commonly includes an overnight stay in the clinic (sleep center) so that the specialists could evaluate the time the patient needs to fall asleep, as well as the wake-up cycles.

There are several types of sleep studies, including maintenance of wakefulness test (MWT), polysomnography, actigraphy, and multiple sleep latency test (MSLT).

Chapter 3:

INSOMNIA: LEARN TO RECOGNIZE
THE SIGNS AND SYMPTOMS

If you learn to recognize the signs of insomnia early on, you may start with treatment (natural or medical) as soon as possible.

Although insomnia itself can appear as a symptom of some disease, many signs and symptoms are suggesting that you may have problems with this condition:

  • Difficulty falling asleep at night although nothing is physically preventing you from doing so (e.g. noise).
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    Having irregular sleep patterns or waking up during the night.
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    Waking up earlier than you would want or need to.
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    Daytime sleepiness or fatigue
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    Still feeling tired even after you have slept enough.
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    Mood swings and irritability.
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    Anxiety or depression.
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    Poor focus.
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    Poor hand-eye coordination.
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    Gastrointestinal problems.
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    Tension headaches.
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    Being concerned about sleeping.
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    Having trouble socializing.

Some of these problems can have a serious effect on your daytime activities and even cause further health issues, which will require treatment.

If you notice any of these signs and if they become persistent, it might be the time to visit your doctor.

Chapter 4: 

Distinguish Different Types of Insomnia Easily

One of the reasons why insomnia is so hard to be defined is because there are different types of the condition.

All of these affect different individuals in various ways, and happen as a result of several situations or medical conditions.

Transient insomnia is the lightest form of this sleep disorder because it lasts up to three nights. Although it affects people for a short period, it still has some serious effects, such as the inability to focus, poor eye-hand coordination, bad mood, etc.

This type is often caused by immediate problems, such as travel, jet lag or sudden stress (e.g., death of a loved one).

Acute insomnia is more serious than transient, and its symptoms persist for a couple of weeks, which can cause a person who is experiencing it severe difficulties in daytime functioning.

Similar like transient, short-term insomnia can be associated with an identifiable cause, such as changes at work and moving to another home, or any other situation which causes prolonged stress.

Depending on the individual’s mental and physical health, the same cause can lead to either transient or acute insomnia.

Chronic insomnia can last for months and even years.

It is a very complex condition, which can range from inability to sleep properly for a prolonged period of time or a total lack of sleep during that period.

According to National Heart Lung and Blood Institute, chronic insomnia rarely occurs as a response to a sudden stress, and it more frequently happens as a side-effect or symptom of another problem, such as medical conditions, substances, and medicines.

Although all of these circumstances may be a reason to ask for professional help, or at least try to use natural remedies, chronic insomnia is by far the most dangerous one, as it can severely compromise your health, energy level, mood, work performance and ability to think clearly.

The mentioned three types of insomnia cover almost every aspect of this condition, but The International Classification of Sleep Disorders provided a more advanced and thorough listing of specific subtypes of insomnia:

1. Adjustment insomnia

Reaction to identifiable stressor commonly related to individual’s social life, physical health or environmental changes.

 2. Behavioral insomnia of childhood

It affects children after the period of parental nurturing is replaced with independence.

3. Idiopathic Insomnia

It happens with no logical reasons, starts early in life and never ends.

 4. Insomnia Due To Medical Condition

Inability to sleep due to medical factors.

5. Insomnia due to mental disorder:

Lack of sleep caused by a psychiatric disorder.

6. Nonorganic

When a doctor can give diagnose of the origin.

 7. Organic:

There is a cause contributing the onset of insomnia, but it can’t be specified.

8. Paradoxical Insomnia:

A patient is complaining about insomnia, but there is no evidence pointing out to this condition (no daytime impairment).

​9. Psychophysiological insomnia

Result of sleep-related anxiety or worry, which worsens the existing insomnia.

10. Sleep hygiene insomnia:

It occurs as a result of poor sleeping habits (e.g. staying up too late to watch TV).

11. Substance Induced Insomnia:

The person’s ability to sleep is disrupted by alcohol, drugs, caffeine or medicines.

Knowing the info from this list, you’ll  be (almost certainly) able to distinguish different types of insomnia and help yourself or someone who suffers.

Chapter 5: 

Protect Yourself Up Front by Knowing Who Is Prone to Insomnia

Some people are at greater risk of having insomnia.

Find out are you one of them in this chapter.

So, you have had problems falling asleep or remaining asleep a few times in your life, but is that really something you should worry about?

Not necessarily.

Although insomnia can affect anyone anytime, depending on the circumstances, there are some groups which are at greater risk than others.

Some people are more susceptible to suffering insomnia and those are:

  • people who suffer from mental disorders
  • the elderly
  • menopausal  women
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     Pregnant women (and women in general)
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     adolescents
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    drug or alcohol users,
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    workers with frequent shift changes at work (e.g., day vs. night),
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     travelers who are frequently changing time zones
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      young adult students

You might not fit into any of the categories above, and still have insomnia.

Wondering why?

Poor sleeping habits put you at high risk of developing insomnia.

Would you describe yourself as a night owl who has no regular sleep or wake time? In that case, you might be leading yourself straight into this sleep disorder.

Also, inactive lifestyle (sedentary behavior, no physical activity…) can jeopardize your sleep quality.

Here’s an interesting fact:

Research shows that young and middle-aged African Americans can be at risk of insomnia more than Caucasian Americans.

According to research, it takes them longer to fall asleep, they take more naps and have a lighter sleep.

Those are the categories that are prone to sleep disorders and insomnia in general. If you can clasify yourself in some (or in several) of those, you can consider a higher risk of insomnia.

Chapter 6:

How does insomnia affect health?

Insomnia affects your day-to-day activities, but it can also contribute to the onset of various severe health conditions.

According to the National Institute of Health, insomnia can raise some serious health concerns and increased risk of diseases such as:

Asthma

   Stroke

Heart disease

High blood pressure


Obesity

Anxiety

However, besides being a contributor to some severe health issues, insomnia can also disrupt your life each day, making your otherwise normal activities much more challenging.

Here’s how:

  • Sleep deprivation can lead to energy slump in the afternoon, making you feeling fuzzy and making it difficult to stay awake.
  • On the other hand, lack of sleep can also make you unnaturally alert during the day, increasing your adrenaline levels and preventing your body to wind down sufficiently before you go to bed.
  • Insomnia makes you feel more angry and frustrated.
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    It leads to puffy eyes and dark circles around your eyes.
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    It affects your skin by preventing tissue repair and cell stimulation.
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    Missing out on sleep makes you crave for carbs, which in return can lead to gaining more weight.
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    Insomnia slows down your mental processing, and sometimes even affects long-term memory and reasoning skills.

Finally, a thorough analysis of the correlation between sleep and mortality showed that people suffering from insomnia have shorter life expectancy.

Chapter 7: 

How does insomnia affect health?

Insomniac use various medicines to treat their condition. In this chapter we’ll review their effectiveness.

Often times, people resort to natural remedies, and home treatments to ease the situation. Sometimes, this might work, but it’s not guaranteed to. On the other hand, there are medical approaches and actions that can be used.

If you’re struggling with insomnia or suspect of having one, the situation can be made easier with some natural treatments or home remedies:

Have a before-bed snack that contains tryptophan (e.g., banana, a slice of chicken or turkey).

Have a cup of herbal tea (e.g., valerian or passion flower).

Dub lavender oil onto your forehead and temples.

Take an aromatic bath before bed.

 Practice meditation and yoga.

Create optimal sleep environment (not too hot, not too warm, without electronic devices, quiet, etc.).

Calming yourself down and setting your sleeping area into dark, without any screens or sources of light will help as well.

Next, here are some interesting techniques you can perform at your own home:

Cognitive behavioral therapy (CBT) showed some very good results in treating insomnia, yet it’s straightforward to implement and use.

This therapeutic approach includes behavioral changes (e.g., eliminating afternoon naps and keeping a regular bedtime), with the addition of a cognitive component, which means that it encourages you to eliminate unhealthy beliefs around sleep and embrace positive and rational thinking.

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Stimulus control also helps inducing sleep by creating an association between the bedroom and sleep. For example, one form of stimulus control is going to bed only when you are sleepy and being awake in bed for about 20 minutes before you get up.

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Since most of the times when a person is experiencing difficulty to fall asleep it is because of inability to relax, relaxation therapies are used to induce sleep by systematically tensing and relaxing muscles in different parts of the body.

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Finally, there are plenty alternative therapies, such as herbal supplements and acupuncture, used to treat insomnia.

Some of the herbal supplements believed to be helpful are valerian root, chamomile, lemon balm and passionflower. You can consume them as teas, or use aromatic oils in your pre-sleep bath routine.

4

MEDICAL APPROACH

Although insomnia, as many sleep disorders, can be solved by making simple changes in your sleep routine and lifestyle, sometimes that is not enough. In some cases, lifestyle changes and natural remedies aren’t helping with insomnia. That could be the right time to visit your doctor.

You should probably make an appointment with your GP if your problems with sleeping are affecting your daily life, particularly if those problems are present for more than one month, and you haven’t been able to deal with them in any recommended natural way.

Visiting a sleep specialist can also be useful, because they have completed additional education in the field of sleep medicine, and they have a vast knowledge in psychology, internal medicine, neurology, and psychiatry, all of which can be useful in determining the cause and the effects of your sleeping disorder.

Sleep specialists are trained in the prevention, diagnosis, treatment, and management of sleep problems.

If the health center you are usually visiting doesn’t have a sleep specialist, you can find one in sleep centers, also called sleep labs or sleep clinics.

After you get your diagnosis, your doctor or sleep specialist can recommend various methods and medications for treatment.

Some types of insomnia just wear off, and some are gone when the cause behind them is gone.

To deal with most persistent types, therapy can include:

  • Determining the cause and treating it
  •  Using relaxation techniques
  • Improving sleep hygiene
  • Counseling
  • Sleep restriction
  • Stimulus control therapy
  • Prescription sleeping pills
  • Over-the-counter sleep aids
  • antidepressants​
  • melatonin
  • The most commonly used over-the-counter medications for insomnia are antihistamines, and some clinical trials proved that they’re efficient improving sleep.
  • However, they can lead to many side effects, such as blurred vision, weight gain, psychomotor impairment, dizziness and daytime sedation.
  • There is a common misconception that anti-depressants can be used to treat insomnia, but the fact that most of them (except low-dose doxepin) isn’t recommended by the FDA, should speak enough.
  • Not only they are not effective in improving sleep, but they also have some severe side effects.

Bottom line:

Don’t ever take these medications without the doctor’s perscription, no matter for how long you can’t fall asleep. These can only make things worse.

Taking prescription sleep pills, on the other hand, can be a good short-term solution, while behavioral changes can help you over the long run.

It is recommended to take sleep pills only now and then, and never for a long period, because anyone can become dependent on them.

Chapter 8:

Prevent insomnia through ​​​​Lifestyle Changes

The only long-term solution for insomnia might be changing your habits. In this chapter, see which the most jeopardizing ones are, and what to do about them.

Problematic lifestyle can cause insomnia, so it only makes sense that some lifestyle changes can aid in fighting this disorder.

Before you begin to introduce changes in your lifestyle, it is imperative to ask yourself what you are doing wrong now, how is that affecting your sleep quality, and how can you change it.

Here are some of the best modifications you can use to get a good night sleep – every night:

Set a sleep schedule: If you are constantly changing your bedtime, getting up time and the amount of sleep you are getting, your body gets confused about the time it should actually fall asleep. If you set a regular go-to-bed and wake-up time your body will probably stay on track.

 Cut back on caffeine: Caffeine stays in your system for about 12 hours, which means that noon is the last call for a cup of coffee if you are planning to get some sleep.

Get rid of bad habits: smoking and drinking alcohol can increase the risk of insomnia.

Improve your diet: Stay clear of processed food, and avoid heavy and spicy food before bedtime.

Have a bedtime routine ​and make your bedroom clear: If you love watching an episode of your favorite TV show just before you go to bed or texting with friends on Facebook, you should probably switch that routine for light reading or meditation.

Conclusion

Sleeping is essential for good health and well-being. Insomnia is getting in the way of that.

The damage that happens from sleep deprivation is severe. It raises the risk of serious health problems, but it can also cause instant consequences (e.g. car crash due to loss of focus and poor reflexes).

If you are having any of the mentioned symptoms of insomnia, you are probably not getting enough sleep, and therefore, you should practice the lifestyle changes that will help in easing the symptoms, use the available treatments and consult your doctor for further actions.

Sleep well, my friend!

Did you like the article? There’s always place for more useful info, and anyone battling insomnia should have this guide. If you agree, share it with your friends; you might end helping someone!

Also, would you add something to it? Let me know in the comment section below!