- 04 May 2023
- Psy. Neha Sahu
Sleep Disorder (Insomnia)
Insomnia Disorder: -
Insomnia is a common sleep disorder that can make it hard to fall asleep, hard to stay asleep or cause you to wake up too early and not be able to get back to sleep. You may still feel tired when you wake up. Insomnia can sap not only your energy level and mood but also your health, work performance and quality of life.
How much sleep is enough varies from person to person, but most adults need seven to eight hours a night.
At some point, many adults experience short-term (acute) insomnia, which lasts for days or weeks. It's usually the result of stress or a traumatic event. But some people have long-term (chronic) insomnia that lasts for a month or more. Insomnia may be the primary problem, or it may be associated with other medical conditions or medications.
You don't have to put up with sleepless nights. Simple changes in your daily habits can often help.
Insomnia symptoms may include:
- Difficulty falling asleep at night
- Waking up during the night
- Waking up too early
- Not feeling well-rested after a night's sleep
- Daytime tiredness or sleepiness
- Irritability, depression or anxiety
- Difficulty paying attention, focusing on tasks or remembering
- Increased errors or accidents
- Ongoing worries about sleep
Diagnosis criteria: -
- A predominant complaint of dissatisfaction with sleep quantity or quality is associated with one (or more) of the following symptoms:
- Difficulty initiating sleep. (In children, this may manifest as difficulty initiating sleep without caregiver intervention.
- Difficulty maintaining sleep, characterized by frequent awakenings or problems returning to sleep after awakenings. (In children, this may manifest as difficulty returning to sleep without caregiver intervention).
- Early-morning awakening with inability to return to sleep.
- Sleep disturbance causes clinically significant distress or impairment in social, occupational, educational, academic, behavioral, or other important areas of functioning.
- The sleep difficulty occurs for at least 3 months.
- The sleep difficulty is present for at least 3 months.
- The sleep difficulty occurs despite adequate opportunity for sleep.
- Insomnia is not better explained by and does not occur exclusively during the course of another sleep-awake disorder (e.g., narcolepsy, a breathing-related sleep disorder, a circadian rhythm sleep-wake disorder, a parasomnia).
- Insomnia is not attributable to the physiological effects of a substance (e.g., a drug of abuse, or a medication).
- Coexisting mental disorders, a medical condition does not adequately explain the predominant complaint of insomnia.
Insomnia may be the primary problem, or it may be associated with other conditions. Chronic insomnia is usually a result of stress, life events or habits that disrupt sleep. Treating the underlying cause can resolve insomnia, but sometimes it can last for years.
Common causes of chronic insomnia include:
- Stress. Concerns about work, school, health, finances or family can keep your mind active at night, making it difficult to sleep. Stressful life events or trauma — such as the death or illness of a loved one, divorce, or a job loss — also may lead to insomnia.
- Travel or work schedule. Your circadian rhythms act as an internal clock, guiding such things as your sleep-wake cycle, metabolism and body temperature. Disrupting your body's circadian rhythms can lead to insomnia. Causes include jet lag from travelling across multiple time zones, working a late or early shift, or frequently changing shifts.
- Poor sleep habits. Poor sleep habits include an irregular bedtime schedule, naps, stimulating activities before bed, an uncomfortable sleep environment, and using your bed for work, eating or watching TV. Computers, TVs, video games, smartphones or other screens just before bed can interfere with your sleep cycle.
- Eating too much late in the evening. Having a light snack before bedtime is OK, but eating too much may cause you to feel physically uncomfortable while lying down. Many people also experience heartburn, a backflow of acid and food from the stomach into the oesophagus after eating, which may keep you awake.
Chronic insomnia may also be associated with medical conditions or the use of certain drugs. Treating the medical condition may help improve sleep, but insomnia may persist after the medical condition improves.
Additional common causes of insomnia include:
- Mental health disorders. Anxiety disorders, such as post-traumatic stress disorder, may disrupt your sleep. Awakening too early can be a sign of depression. Insomnia often occurs with other mental health disorders as well.
- Medications. Many prescription drugs can interfere with sleep, such as certain antidepressants and medications for asthma or blood pressure. Many over-the-counter medications — such as some pain medications, allergy and cold medications, and weight-loss products — contain caffeine and other stimulants that can disrupt sleep.
- Medical conditions. Examples of conditions linked with insomnia include chronic pain, cancer, diabetes, heart disease, asthma, gastroesophageal reflux disease (GERD), overactive thyroid, Parkinson's disease and Alzheimer's disease.
- Sleep-related disorders. Sleep apnea causes you to stop breathing periodically throughout the night, interrupting your sleep. Restless legs syndrome causes unpleasant sensations in your legs and an almost irresistible desire to move them, which may prevent you from falling asleep.
- Caffeine, nicotine and alcohol. Coffee, tea, cola and other caffeinated drinks are stimulants. Drinking them in the late afternoon or evening can keep you from falling asleep at night. Nicotine in tobacco products is another stimulant that can interfere with sleep. Alcohol may help you fall asleep, but it prevents deeper stages of sleep and often causes awakening in the middle of the night.
Good sleep habits can help prevent insomnia and promote sound sleep:
- Keep your bedtime and wake time consistent from day to day, including weekends.
- Stay active — regular activity helps promote a good night's sleep.
- Check your medications to see if they may contribute to insomnia.
- Avoid or limit naps.
- Avoid or limit caffeine and alcohol, and don't use nicotine.
- Avoid large meals and beverages before bedtime.
- Make your bedroom comfortable for sleep and only use it for sex or sleep.
- Create a relaxing bedtime ritual, such as taking a warm bath, reading or listening to soft music.