NHS choices defines insomnia as “difficulty getting to sleep or staying asleep for long enough to feel refreshed the next morning”. It’s a really common problem with about one in three people being affected. Insomnia isn’t just being unable to fall asleep, sufferers may wake up repeatedly in the night, wake up very early and be unable to go back to sleep, feel sleepy in the day but be unable to nap, or not feel refreshed on waking in the morning. Most of us experience some of these symptoms every now and again, and occasional periods of difficulty sleeping (also called transient insomnia) aren’t too much of a problem. Problems occur when insomnia becomes persistent - lasting months, or even years. In these cases, extreme tiredness can affect your mood, work and even personal relationships. The National Institute of Health states that the majority of chronic insomnia cases are secondary, meaning they occur as a side effect of another problem.
What’s so bad about insomnia? Well, apart from the obvious problem of being over-tired, lack of sleep can undermine performance at work, and cause problems such as obesity, anxiety, depression, irritability, poor concentration and memory, reduced immune function, and even reduced reaction time. It’s easy for acute short term insomnia to develop into a long term problem, if it is not recognised and managed effectively. For example: a person can’t sleep for two nights, so they give up and get up to do some work. They then have a couple of glasses of wine to get them back off to sleep. The next night they worry that they won’t be able to sleep again, and the worry prevents them from sleeping, so they get up to do some more work. Now, instead of just having the initial problem, there is an anxiety element, an expectation of not being able to sleep, and a habit of waking up to work. To manage both short and long term insomnia, we first need to understand what causes it.
The most common causes of insomnia are:
* Disruption to the circadian rhythm – the natural day/night cycle in the body. Things like shift work, jet lag, high altitudes, noisiness or being too hot or cold can trick your body into thinking it’s not night time yet, making it hard to sleep.
* Psychological issues – mood disorders such as depression, anxiety or bipolar disease are common causes of insomnia. This can be a vicious circle because lack of sleep predisposes to mood disorders, which in turn cause lack of sleep. The good news is that both are treatable, no matter which came first!
* Hormones –hormonal changes around menstruation can cause problems with sleep.
* Medical conditions such as strokes, heart disease, acid reflux, chronic obstructive pulmonary disease (COPD), asthma, sleep apnoea, arthritis etc can all cause insomnia
* External factors – sleeping next to a snoring partner can be a real nightmare! Try and encourage them to address the problem by going to a snoring clinic. If not, ear plugs or noise cancelling earphones can be a real life saver. I take my noise cancelling earphones everywhere I go and credit them with saving my relationship!
* Technology in the bedroom – researchers from Helsinki University found that media technology in the bedroom disrupts sleep patterns in children. A second study has shown that backlit screens also affect sleep patterns.
Can insomnia be treated?
Simple answer, yes. The first step is to go to your doctor, and get checked out for any underlying conditions that could be causing you to have difficulty sleeping. Your GP may refer you to sleep clinic, where you spend a night in a special sleep unit and are monitored. It isn’t as daunting as it sounds! There are also some easy ways to improve your sleep at home:
1. Relaxation exercises
Relaxing and switching off are essential for good sleep. Everyone relaxes in a different way and there is no one size fits all program
a. Breathing exercises such as inhaling for five seconds, holding your breath for five, then breathing out for five can instantly relax you
b. Guided imagery can really help some people-there are lots of available CDs and recordings!
d. Progressive muscle relaxation, where you start at the toes and consciously relax each muscle in your body up to your head
2. Lifestyle changes
Being unable to switch off is often a consequence of being unable to switch your body and mind off. Relaxation exercises are a good tool for calming your mind, but lifestyle changes can do wonders for calming your body.
a. Be conscious of what you eat and drink around bed time. Whatever happens, do not rely on alcohol to get you to sleep. Alcohol may be a sedative, but once it wears off you usually wake up, and have to do the whole process of going to sleep again. Caffeine is another no no. Research shows that caffeine can last in your system for up to 8 hours, so don’t consume food or drinks with caffeine after lunch.
b. Routine is a powerful tool to help you sleep. Following a pattern in the evenings trains the brain to start switching off when it is close to bed time.