Insomnia

Insomnia, a sleep disorder, can cause difficulty falling asleep, staying asleep, or waking up too early. When you awaken, you may still be tired. Sleeplessness can affect your mood, energy levels, and work performance, as well as your health.

The amount of sleep required varies depending on the person. However, most adults require seven to eight hours per night.

Many adults will experience acute (short-term) insomnia lasting for days or weeks. Stress or a traumatic experience is usually to blame. Some people have chronic insomnia, which can last for up to a month. Insomnia can be the main problem or be caused by other medical conditions.

Sleepless nights are not inevitable. Simple changes to your daily routine can help.

Symptoms

Insomnia can manifest as:

• Sleeping problems at night
• Wake up too early
• Feeling tired after a good night’s rest
• Tiredness or sleepiness during the day
• Anxiety, depression, or irritability
• Attention problems, difficulty concentrating on tasks, and forgetfulness
• Accidents or errors are increasing.
• Sleeping problems: a persistent concern

When to visit a doctor

Consult your doctor if insomnia affects your ability to function in the daytime. Your doctor can help you identify the source of the problem and determine the best treatment. You may be sent to a sleep clinic for testing if your doctor suspects you have a sleeping disorder.

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Causes

Insomnia may be the main problem or be associated with another condition.

Chronic insomnia can be caused by stress, events in life, or bad habits. The underlying cause of insomnia can be treated, but it may last for many years.

Chronic insomnia is caused by:

• Stress. Worries about work, school, finances and health and safety matters may keep you awake at night. Traumatic life events such as death of a loved one, divorce or job loss may also contribute to insomnia.
• Work or travel schedule. Circadian rhythms are your internal clock. They control things like sleep-wake cycles, metabolism, and body temperature. Insomnia can be caused by disrupting your circadian rhythms. Jet lag can be caused by traveling through multiple time zones or working late or early.
• Bad sleep habits. Bad sleep habits are irregular bedtimes, naps, stimulating activity before bed, and using the bed to work, eat, or watch TV. Poor sleep habits include using your bed for work, eating, or watching TV.
• Too much eating late at night. A light snack is fine, but too much can make you uncomfortable when lying down. Heartburn is another common problem that can keep you up at night. It’s caused by stomach acid and food reflux into the esophagus.

Medical conditions or certain drugs can also cause chronic insomnia. The medical condition can be treated to improve sleep, but insomnia may still persist even after the condition is resolved.

Other common causes of insomnia include

• Mental disorders. Sleep disorders such as posttraumatic stress disorder can disrupt sleep. Early morning awakenings can be an indication of depression. Other mental disorders can also cause insomnia.
• Medicines. Some prescription drugs, like certain antidepressants or medications for blood pressure and asthma, can disrupt sleep. Some over-the-counter medicines, such as pain relievers, allergy and cold medication, and weight loss products, contain caffeine or other stimulants which can disturb sleep.
• Medical conditions. Conditions linked to insomnia include cancer, diabetes, and heart disease.
• Sleep disorders. Sleep Apnea is a condition that causes you to stop your breathing at random intervals during the night. This disrupts your sleep. Restless legs syndrome is characterized by unpleasant sensations and an almost insatiable desire to move your legs. 
• Alcohol, caffeine, and nicotine are stimulants: tea, coffee, and other caffeinated beverages. You can’t fall asleep if you drink them late afternoon or evening. The nicotine in tobacco products can also interfere with sleep. Alcohol can help you fall asleep but also prevents deeper stages and causes you to wake up at night.

Insomnia, aging, and sleep disorders

As you age, insomnia becomes more common. 

• Changes to sleep patterns. As you age, your sleep becomes less restful, and you are more likely to be woken up by environmental noises or changes. Your internal clock advances with age. You become tired earlier at night and awake earlier in the morning. Older people still require the same amount of sleep as younger ones.
• Changes to your activity. Your social or physical activities may have decreased. Lack of exercise can affect your sleep. The less active you become, the more likely it is that you will take a nap every day, which can affect your sleep at night.
• Health changes. Chronic back pain, depression, or anxiety, as well as conditions like arthritis, can cause chronic pain. Sleep can be disrupted by issues that cause you to need to urinate more often at night, such as bladder or prostate problems. As we age, sleep apnea and restless leg syndrome become more prevalent.
• More medication. Older adults tend to use more medications than younger ones, increasing the risk of insomnia.

Insomnia among children and teenagers

Children and teens may also have sleep problems. Some children and teenagers have difficulty falling asleep or will not go to bed at a set time because their internal clocks run slower. They want to sleep in later and go to bed earlier.

Risk factors

Almost everyone experiences a sleepless night. You are more likely to suffer from insomnia if you:

• You are a woman. The hormonal shifts that occur during menstruation and menopause can play a part. Pregnancy is another common cause of insomnia.
• You are over 60 years old. As you age, your sleep problems will increase.
• A physical or mental illness disrupts your sleep.
• You are under a great deal of stress. Events and situations that cause you to be stressed can lead to temporary insomnia. Chronic insomnia can be caused by chronic stress or major, long-lasting stresses.
• A change in shifts or travel disrupts your sleep-wake pattern.

Complications

Sleep is as important for your health as eating a balanced diet and exercising regularly. Sleep loss can have a negative impact on your mental and physical health. People with insomnia have a lower quality of life than those who sleep well.

Insomnia can lead to:

• Low performance at work or school
• Slower reaction time and increased risk of accident
• Mental disorders such as depression, anxiety disorders, or substance abuse
• High blood pressure, heart disease, and other long-term conditions are more likely to cause or worsen.