Insomnia is repeated difficulty in getting to sleep, staying asleep or getting enough good quality sleep, despite adequate opportunity, which leads to some form of impairment of performance or wellbeing during the daytime. If it occurs regularly or over a long period of time, it’s called chronic insomnia.
About one in three adults will have had some sort of problem with insomnia within the past 12 months. For most the problem is fairly short-lived, but for as many as one in ten it becomes a chronic problem which significantly affects their life.
There are many different patterns of insomnia. For example, one in three people with insomnia have no problem getting off to sleep but then wake in the early hours and cannot get back to sleep.
Causes of insomnia
A common trigger for sleeping difficulties is stress and worry. Some people are particularly vulnerable because they are more likely to show a more extreme response to stress, such as people who are depressed, chronically ill or struggling with other difficult issues such as relationship problems.
Other common causes include physical illness that causes pain, environmental noise, depression, shift work, caffeine or alcohol consumption, and medication side-effects. Other illnesses can disrupt sleep, such as menopausal hot flushes and urinary problems from infection or prostate disease causing night-time waking. Insomnia is much more common in older people.
Once triggered, sleep problems may then be perpetuated by the individuals beliefs and behaviours – they often worry excessively about the effect that inadequate sleep will have on them and so strive excessively hard to get to sleep, take daytime naps or sleep in late which can disrupt the natural rhythm, or turn to medicines or alcohol in the belief that this will help (most just induce unnatural patterns of sleep). A vicious cycle of poor sleep and stress is quickly set up and persists after the initial trigger has passed.
Insomnia contributes to excessive daytime tiredness, which in turn may be responsible for accidents, recurrent infections (inadequate sleep has been show to suppress the immune system), poor concentration, irritability, work and relationship problems and a general inability to cope. In children it may be linked to poor growth.
Treatment of insomnia
Sleeping tablets may be prescribed for short-term use only, when the cause of insomnia has been identified as bereavement or jet lag, for example.
However, it’s usually more important to address any underlying cause of the insomnia and attempt to restore a normal sleep pattern through changes in behaviour and lifestyle.
Deal with issues and anxieties which may keep you awake worrying. Make sure your bedroom is dark, cool and unstimulating Make sure your bed is comfortable and not too hot. Try to follow a set routine, going to sleep and getting up at the same time and avoiding daytime naps, and don’t work or watch TV in your bedroom. Recent research has shown that the effect of cooling on the body, and particularly the brain, such as following a bath, shower or hairwashing, can induce sleep.
You should also try avoiding stimulants such as caffeine, nicotine and alcohol. Getting more exercise during the day, having a warm milky drink before bed, and herbs such as valerian and camomile can also help.