Insomnia: Symptoms, Causes, Risks, Complications, Diagnosis, Treatment, Prevention and Prognosis

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A Men sleeping and next to him a women who have the sleep disorder insomnia.

1Overview

Many individuals across the globe may suffer from various sleeping problems.
The most common one is the difficulty in falling asleep. Insomnia is a common sleep disorder that can affect people from all walks of life.

Insomnia can make it difficult to fall asleep or hard to stay asleep. In other people,
the condition may wake them up too early and not able to get back to sleep. People with insomnia may also feel unrested even after waking up. Hence, this sleep disorder can lead to various energy and mood problems. In the long run, insomnia may take a toll on the person’s work, quality of life and health.

The number of hours of sleep depends from one person to another. However, in general, most adults need about seven to eight hours of sleep per night. Some people may experience acute insomnia, which can last for days to weeks. This type of insomnia is due to a traumatic event, stress or jet lag.

On the other hand, chronic insomnia lasts for a month or more. Some people may have insomnia as a result of an underlying health condition or it could be the primary problem itself. Chronic insomnia may happen at least three nights per week and lasts at least three months.

Insomnia is a common sleep disorder because it affects many individuals across the globe. People today sleep about 20 percent less than they did a century ago. More than 30 percent of the population suffers from insomnia. About 30 to 40 percent of Americans report having insomnia each year. Usually, the sleep disorder results from a secondary cause like lifestyle or illness.

2Symptoms

Insomnia can be a problem itself or a symptom of an underlying medical condition.
Here are the signs and symptoms associated with insomnia:

  • Having a hard time falling asleep at night
  • Waking earlier than usual or intended
  • Waking during the night
  • Daytime fatigue
  • Sleepiness
  • Still feeling tired even after a night’s sleep
  • Depression and anxiety
  • Irritability
  • Being uncoordinated
  • Poor concentration
  • Tension headaches
  • Worrying about sleeping
  • Hard time socializing
  • Gastrointestinal problems

3Causes

Insomnia can be caused by a wide variety of psychological and physical factors. Sometimes, there are underlying medical conditions that may lead to insomnia.

Causes of insomnia:

Altered Circadian Rhythm

When the body suddenly experiences disrupted circadian rhythms, these could lead to insomnia. Some examples include a change in work shifts, jet lags, high altitudes, extreme heat or cold and environmental noise.

Medical Conditions

Some medical conditions may cause insomnia including chronic pain, congestive heart failure, angina, acid reflux disease, sleep apnea, chronic fatigue syndrome, obstructive pulmonary disease, asthma, arthritis, tumors, stroke and Alzheimer’s disease, among others.

Psychological Problems

People who have psychological conditions like bipolar disorder, anxiety, depression and psychotic disorders may find it hard to sleep at night.

Stress

When a person has concerns about school, health, work, finances, and relationships, these can keep the mind active, making it hard to sleep.

Hormones

Some hormones like estrogen shifts during menstruation. As a result, this could cause insomnia.

Eating late in the evening

Eating too much may cause you to feel uncomfortable before sleeping.

Medications

Some medications can interfere with sleep like antidepressants and drugs for high blood pressure.

Caffeine, alcohol, and nicotine

Drinking caffeinated drinks like coffee, tea and cola can stimulate the brain and interfere with sleep. Drinking them late in the afternoon or at night may alter one’s sleep. Moreover, drinking alcohol and smoking cigarettes may affect one’s sleep too.

Other factors

Sleeping next to a snoring partner, genetic conditions, poor sleeping habits, overactive mind, and pregnancy are the other causes of insomnia.

4Risk Factors

Some factors may increase the risk of a person experiencing insomnia. These include:

Advanced age

Older people have more problems regarding falling asleep and staying asleep. This is because of the bodily changes brought about by aging.

Women

Women are more likely to suffer from insomnia than men. This is maybe because of the various hormonal changes women experience throughout their lives.

Pregnancy or menopausal

Women who are pregnant and those undergoing menopausal, are more likely to have insomnia. This is still due to the hormonal changes they experience.

5Complications

The altered sleep and lack of sleep may lead to various complications. Sleep is as important to the health as regular exercise and eating a healthy diet. People with insomnia typically don’t get enough sleep or do not feel rested even after sleeping at night. These may lead to the following complications:

  • Poor performance at work and in school
  • Higher risks of accidents when handling machinery and driving
  • Mental health disorders like anxiety, substance abuse, and depression
  • Higher risk of developing long-term diseases such as high blood pressure and heart disease

6Diagnosis

The doctors may utilize numerous tools to measure insomnia symptoms. One of the most important ways to diagnose insomnia is a completely personal and medical history taking. The doctor will ask you questions about your sleeping habits and some factors that might be causing the sleeping problem.

Sleep Inventory

A sleep inventory is an extensive questionnaire that collects data and information about the patient’s health, sleeping patterns, and medical history.

Sleep Log

This is an important tool that determines the details about your sleep. In the sleep log, the patient records the time of sleeping, how sleepy they feel, wake up time, and how many times they woke up at night. This may also help the doctor determine what caused insomnia.

Sleep Study

The doctor may suggest that the patient perform a sleep study or polysomnography. This will help collect data about the person’s nighttime sleep. The test involves sleeping in a laboratory and being connected to an EEG machine, which monitors the stages of the sleep.

Blood Tests

These tests are used to identify possible underlying medical conditions.

7Treatment

People with insomnia should seek medical help if the sleeping disorder has become a pattern and has affected the daily activities, work, school, and health. If a person feels fatigued or unrefreshed during the day, medical attention is important.

The treatment options include behavior and lifestyle changes, complementary medicines and medical therapy.

Non-medical Treatments

Many behavioral and psychological techniques can be helpful for treating insomnia.

Relaxation Training

Also called progressive muscle relaxation, the technique guides the person to systematically relax and tense muscles in the various parts of the body. In the long run, this technique helps relax the muscles and induce sleep.

Other relaxation techniques include meditation techniques, guided imagery, mindfulness and breathing exercises.

Stimulus Control

This technique helps build an association between sleep and the bedroom. The person needs to limit the stimulus in the bedroom like activities that are allowed. For instance, one stimulus to avoid is going to bed only if you’re already sleepy.

Cognitive-Behavioral Therapy

Cognitive behavioral therapy includes behavioral changes that can help induce sleep. The technique works by challenging unhealthy lifestyle practices and boosts positive thinking.

Medical Treatments

Many medical treatments can help induce sleep and relax the body. Major classes of prescription medicines for insomnia include nonbenzodiazepine hypnotics, melatonin receptor antagonists, and benzodiazepine hypnotics. These medicines are only prescribed by a licensed doctor.

Alternative Medicine

Many individuals do not visit a doctor for sleeping problems. Though these alternative medicines may show safety and effectiveness, these have not been proven by science.

Valerian

Valerian dietary supplements are marketed as sleep aids. It has a mild sedating effect, but it has not been widely studied. Always ask your doctor before taking this alternative drug.

Melatonin

People can buy melatonin over-the-counter, and it has been marketed to help people with insomnia. However, doctors are warning individuals to always ask them first before taking any supplements.

Acupuncture

Some studies have shown that acupuncture may help those who have insomnia. However, more research is still needed. It is important to visit your doctor first.

The U.S. Food and Drug Administration does not mandate that manufacturers of medicines show the proof of effectiveness or safety dietary supplement sleep aids. Always talk with your doctor before taking any herbal supplements or over-the-counter medicines.

8Prevention

Insomnia can be prevented and people can have a healthy sleep through the following ways:

  • Establish a routine bedtime.
  • Eliminate stimulants like coffee, tea, and cola.
  • Create a comfortable environment.
  • Restrict overly-stimulating activities.
  • Eat well to sleep well.
  • Limit electronic device use at night to reduce the exposure to blue light.
  • Exercise regularly.
  • Avoid smoking and drinking too much alcohol.
  • Do not exercise close to bed time.
  • Get up the same time every day.
  • Don’t nap during the day.
  • Make a sleep diary.

9Prognosis

A study has shown that people who slept for about seven hours a night lived the longest. On the other hand, those who slept more than 8 hours or less than 6 hours had low survival rates. Insomnia is not life threatening, but it may lead to various health complications that can affect one’s quality of life.

People with insomnia are more likely to have:

  • Increased risk of accidents
  • Effect on mood and quality of life
  • Poor performance