Insomnia: Causes, Symptoms, and Treatments

July 13, 2020

Insomnia

It is a type of sleeping disorder that affects millions of people throughout the world. People with insomnia may find it hard to fall asleep or stay asleep. People having insomnia also feel fatigued, and they do not feel refreshed even after having a good night’s sleep.

According to the APA (American Psychiatric Association), insomnia is the most common sleep disorder. It estimates that around one-third of all the adults in the US experience some symptoms of insomnia. About 6 to 10 percent of adults have severe enough symptoms to get diagnosed with insomnia disorder.

For some people, this condition can be hereditary. A type of insomnia known as fatal familial insomnia runs in families. It can affect brain structure responsible for controlling many essential functions, including emotional expression and sleep.

In the international classification of diseases, the WHO assigned ICD 10 code for insomnia, and It lists the approximate symptoms, clinical information, and other things related to the condition in under ICD 10 insomnia, on its website.

While insomnia is the most common reason people are unable to get proper sleep, a doctor usually makes a diagnosis of insomnia if a person meets the following conditions:

Sleeping problems occur for a minimum of three nights in a week for at least three months.

Problems in sleeping are causing significant distress or presenting functional difficulties in life.

Causes of insomnia

Like many other disorders, there is not a single cause for insomnia. It can be the primary problem, but it can also be a result of any other underlying medical issue.

Some of the common factors that contribute to the development of insomnia include:

Stress: it is the leading cause of insomnia in the majority of people. Worrying about health, work, finances, school, or family can keep the mind active at night, making it hard to fall asleep. A stressful or traumatizing life event, such as loss of job, divorce, or death of a loved one, can also result in insomnia.

Excessive eating late in the evening: eating something light before bed is okay, but overeating can cause physical discomfort. People can experience heartburn, backflow of acid & food to the esophagus, which can keep them awake at night.

Work or travel schedule: everyone has a circadian rhythm that ac as an internal clock controlling functions like the sleep-wake cycle, body temperature, and metabolism. Working long hours, or frequently rotating between shifts, traveling across time zones, can disrupt the circadian rhythm and increase the risk of insomnia.

Poor sleep habits: going to bed at odd times, taking naps throughout the day, doing stimulating activities before bed, watching TV or using a cell phone before bed, sleeping in an uncomfortable environment, and doing other works from the bed, are all the activities that constitute as poor sleep habits. These activities degrade sleep quality and worsen the symptoms of insomnia.

Medical conditions: problems like chronic pain, acid-reflux disease (GERD), asthma Parkinson’s and Alzheimer’s disease, sleep apnea, chronic fatigue syndrome, arthritis, tumors, chronic obstructive pulmonary disease, hyperthyroidism, etc. have symptoms that can worsen insomnia.

Psychological issues: depression, psychotic disorder, bipolar disorder, and anxiety disorders also contribute to the development of insomnia symptoms.

Medications: certain medicines, like SSRI antidepressants, corticosteroids, alpha-blockers, beta-blockers, statins, ACE inhibitors, etc. can cause insomnia as a side effect.

Symptoms of insomnia

The severity of insomnia symptoms can vary from person to person. Some people experience mild symptoms, while others can feel severe effects of this condition. Though it is common to share insomnia memes on social media to make fun of the disorder, it is not a fun experience for those who have insomnia.

People with insomnia can experience the following symptoms:

Trouble falling asleep at night
Difficulty staying asleep
Waking up early
Inability to go back to sleep
Fatigue and sleepiness at daytime
Feeling tired after a night’s sleep
Depression, anxiety, or irritability
Unable to concentrate
Lack of coordination and increase in accidents or errors
Headache
Gastrointestinal problems
Worrying about sleep
Stress or tension

Treatments for insomnia

A doctor might recommend either medication, or therapy, or both. Which method a doctor is more likely to prescribe vary from person to person. Treatment procedure also varies according to the severity of the symptoms a person is experiencing.

Medications

Prescription medications

These drugs help a person go to sleep and stay asleep. These medicines are usually helpful in short term use, and doctors do not prescribe them for more than a few weeks. Some medications are useful in long-term use, including:

Lunesta (Eszopiclone)
Rozerem (Ramelteon)
Sonata (Zaleplon)
Ambien, Edluar, Intermezzo, Zolpimist (Zolpidem)

The primary reason doctors don’t prescribe these drugs for an extended period because long-term use of these medications can build dependency and might result in addiction.

Over-the-counter drugs

Non-prescription medicines for sleep disorder contain antihistamines, which can make a person sleepy, but regular use of these drugs can have severe side effects. OTC drugs' adverse effects include dizziness, cognitive decline, confusion, daytime sleepiness, and difficulty urinating. It is vital to talk to a doctor before taking these medicines for extended periods.

Therapy

Doctors often recommend various therapies in conjunction with medications. Cognitive-behavioral therapy for insomnia can help people control or get rid of their negative thoughts and actions that might be responsible for keeping them awake at night.

Some of the behavioral therapies that can help with insomnia symptoms include:

Stimulus control therapy: under this therapy, the therapist will teach you how to form a bedtime routine, use the bed only for sleeping, avoid naps, and leave the bed if you are unable to sleep within 20 minutes. These things can drastically improve the quality of sleep.

Relaxation techniques: breathing exercise, biofeedback, and progressive muscle relaxation can help reduce anxiety and makes it easier for the brain and body to relax. Doing these exercises before bedtime can result in less stress and better sleep.

Sleep restriction: this therapy focuses on decreasing the time a person spends in bed. It also restricts daytime naps, which cause partial sleep deprivation and makes you more tired. Once the quality of sleep improved, the therapist will gradually increase your time in bed.

Light therapy: if a person wakes up and falls asleep too early, they can use light to push back their internal clock. The therapist can recommend that the person go outside more to sync their internal clock with nature or expose them to pulses of white light, which can help reset their sleeping schedule.