Insomnia - dealing with your restless nights

Insomnia is the most common sleep disorder, affecting 10%-30% of adults on a chronic level. It affects your sleep schedule by making it hard to fall asleep, hard to stay asleep, or causing you to wake up early and not be able to go back to sleep. Often times, people who struggle from insomnia will wake up still feeling tired - which can then ruin your energy levels and mood, and affect your health, work performance, and overall quality of life.

During some point in time, many adults experience short-term (acute) insomnia, which can last for days or even weeks. Usually, it is the result of stress or a traumatic experience, which causes the brain to cycle in the negative mind-space and keep you up at night. There are, however, those who suffer from chronic (long-term) insomnia - which means it lasts a month or more. Chronic insomnia could be the main reason for the sleeplessness, or it may be tied with other medical conditions - or even medications prescribed for other conditions!

Symptoms of insomnia may include the following:

  • Difficulty falling asleep at night

  • Waking frequently during the night

  • Waking up too early

  • Irritability, depression, or anxiety

  • Difficulty paying attention, focusing or remembering

  • Ongoing worries about sleep

  • Increased errors or accidents

  • Daytime tiredness or sleepiness

  • Not feeling well-rested after a night's sleep

Insomnia can affect anyone. The most common external causes include:

  • Stress: Concerns about outside conditions in your life, such as work, family, school, finances, etc., can keep your mind active at night and make it difficult to sleep. Stressful life events or traumatic experiences, such as job loss, divorce, or death of a loved one can also lead to insomnia.

  • Travel/Work Schedule: The circadian rhythms in your body act as an internal clock, determining a multitude of things including your metabolism, body temperature, and sleep-wake cycle. Disrupting your body's natural rhythm can lead to insomnia issues. This can be as easy as jet-lag, working the early or late shift, or even frequently changing up your shifts, causing your body's rhythm to constantly be in flux.

  • Poor Sleep Habits: Insomnia caused by poor sleep habits can be seen in irregular bedtime schedules, naps, and stimulating activities before bed (TV, computer, cellphone). Other examples include uncomfortable sleep environments, and using your bed for work.

  • Eating too much, too late in the evening: Having something small before bed is okay - a light snack can't do much harm. However, eating too much before you lay down can cause physical discomfort, often times resulting in heartburn.

Chronic insomnia doesn't just come from sleeping on an uncomfortable bed every night and stressing out about your job. Sometimes, it's the use of prescription medications for OTHER ailments (for example, beta blockers to be used for high blood pressure). Treating the medical condition may end up improving sleep, but the insomnia may persist after the condition is treated.

The most common internal causes for chronic insomnia are:

  • Mental health disorders: Naturally, your mental health can absolute effect your sleep schedule. Anxiety disorders, such as PTSD, can disrupt your sleep. If your key insomnia symptom is waking up too early, you could also be depressed. Insomnia goes side by side with a lot of mental health disorders, due to the abnormal brain processing.

  • Medications: There are so many prescription medications on the market these days that interfere with sleep - antidepressants, medications for asthma, and for blood pressure. Numerous over-the-counter medications, like some options for pain medication, cold and allergy meds, and even weight-loss products contain a varying level of caffeine and other stimulants that can disrupt your sleep cycle.

  • Medical conditions: Some examples of medical conditions linked directly with insomnia are: chronic pain, diabetes, cancer, asthma, heart disease, gastroesophageal reflux disease (GERD), overactive thyroid, Alzheimer's disease and Parkinson's disease.

  • Sleep-related disorders: Sleep disorders, such as sleep-apnea, causes you to stop breathing periodically throughout the night, disrupting your sleep. Another common example is restless leg syndrome, which causes unpleasant sensations in your legs which leads to an almost irresistible desire to move them, adding more disruption.

  • Caffeine, nicotine, alcohol: Cola, coffee, tea, and other caffeinated drinks are classified as stimulants - meaning they spike the circulation of chemicals such as cortisol and adrenaline in your body. Normally, in small portions, they can provide a boost of energy - however, before bed, this is not what you want! Drinking them late in the afternoon can give you struggles while trying to sleep later in the day. Nicotine and tobacco products are similar stimulants, and can affect your sleep the same way. Alcohol, even as a depressant that could help you fall asleep, prevents deeper stages of sleep from occurring and therefore can cause you to wake up in the middle of the night.

Insomnia becomes more common as you age, with a lot of people experiencing changes in sleep schedule, changes in activity amount, changes in health (and the health of those around you), as well as often an increase in medication amount. All these factors can affect your sleep schedule! But insomnia doesn't just affect adults - it affects children and teens too! It's wise to address any sleep schedule difficulties regarding teenagers directly with the doctor - teenager circadian rhythms are more delayed as they grow, causing them to naturally want to stay up and wake up later.

Nearly everyone experiences the occasional sleepless night of tossing and turning trying to relax. However, there are higher risks associated with the following groups:

  • You're a woman - hormonal shifts during menstrual cycle and menopause can play a dramatic role. During menopause, night sweats and hot flashes often disrupt the sleep schedule. Insomnia is also increasingly common during pregnancy.

  • You're over 60 - the natural changes that come into play as you age, such as sleep schedule, additional stress levels, and increased medications can all cause insomnia.

  • You have a mental health disorder/physical health condition - many issues that impact both physical and mental health can directly affect sleep.

  • You're under a lot of stress - Stressful situations and periods of time in your life can bring on acute/temporary insomnia. Major, long-lasting stress can bring on chronic insomnia.

  • You don't have a regular schedule - The body needs to follow it's natural clock, circadian rhythm, to perform at peak capability. Changing shifts at work, or swapping around your sleep schedule can disrupt your sleep-wake cycle and throw the balance off.

So, before we see a professional, what ways can we change our behaviors to try and help our insomnia challenges? Good sleep habits, such as keeping a consistent bedtime throughout the week (even weekends), avoiding naps, staying active, and creating a relaxing bedtime ritual (reading, taking a bath, listening to music) will always benefit your sleep schedule. Remember to check any prescription medications you have to see if insomnia is a side effect, don't eat too much or drink caffeine/alcohol/consume nicotine anytime close to bedtime, and talk to a professional if insomnia starts to effect your day to day life!