Are You Struggling With Sleeplessness or Insomnia?

Introduction

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Few Unanswered Queries

Have you wondered why you are struggling to sleep at night? 

Do you feel irritated when you have a planned long day schedule, but you struggle with fatigue? 

Are you losing track at work?

Are you not able to perform well in your exams?

Is your sleep-deprived lifestyle adversely impacting your love life?

Do you feel the constant urge to rest during the daytime? If all these are your case, too, you might have Insomnia.

No, it’s not something too dangerous.

You just need to have changes in daily habits that can quickly cure it.

Without wasting any time, let’s dive into the topic, “Are You Struggling With Sleeplessness or Insomnia?“.

Two Inescapable Scenarios

Exam Next Morning! Imagine a scenario where you must appear in the Entrance Exam for admission to Engineering or Medical College the following day.

You have worked very hard and are hopeful of a good score and selection in a top-notch University with a good rank.

But you failed to sleep the night before the exam, even for one hour!!!!

How will you perform in the exam the following day?

Won’t you feel sleepy during exams?

First Night!!!!! Today is your marriage with your sweetheart, and your would-be spouse expects that First Night will be the best night of your life.

But again, you have struggled with sleep for the past few nights. And last night too, you didn’t even sleep for one hour!!!!

What do you expect will happen during your First Night?

Will you perform as per your spouse’s expectations to be, despite your fatigue due to sleeplessness?

Rosy’s Horror Story

Every Night’s Problem. Rosy, a 30-year-old medical intern doctor, saw a physician and discussed her problems with sleeplessness or inability to rest properly.

The problem started four months back, as she started to wake up at 3 a.m. every morning, irrespective of the time she went to sleep. After waking up, she found it very difficult to fall asleep again.

She would often find it difficult to fall asleep after she lay on her bed to sleep.

Sometimes, she used to remain awake the whole night.

Some mornings she lay awake in the dark, close to her fiancée, who enjoyed sound sleep, very peacefully.

On other mornings, she would go very early to her office at the University.

As a result, she felt “out of it” during the day while struggling to catch up with her workplace targets.

This made her feel more concerned about the problems she would face in completing her thesis when it was challenging for her to remain focused on her professional goals. All of this happened because of severe fatigue and sleeplessness every night.

Since the problem lasted, she found herself dreading a day later and wondering how exactly she would perform at the workplace the next day if she only managed a few hours or no sleep every night.

Popping Up Sleeping Pills

After a month of poor sleep, Rosy found the names of a few pills which help people suffering from sleeplessness to have a sound sleep.

Later, one pill stopped helping her ensure sound sleep and slowly increased to two tablets.

She hated how groggy the pills made her, but she was helpless and powerless to stop taking them.

If she tried avoiding consuming those pills, she would remain awake for the night.

Although she often relied on coffee throughout the day, she never consumed it after 2 p.m.

An avid tennis player, she decided to play in the early morning.

Negative Health Impact due to Sleeplessness

Nevertheless, she did have a cup or two of wine at supper with her fiancée each night.

“By dinner, I begin to bother about whether I’ll be able to sleep at all or not” she stated, “and in all honesty, the wine helps.”

She would be a complete wreck, falling apart and unable to live up to her responsibilities.

She knew that the lack of sleep would make her sick and die sooner or later.

That became an increasingly vicious cycle: sleep deprivation, exhaustion, insomnia, followed by even greater fatigue—and mounting terror.

She felt that she is on the verge of collapse.

New Medical and Health Complications

It wasn’t until she was rushed to the coronary care unit of her local hospital with a dangerously low heart rate that the problem got sorted out, and she was taken off Inderal.

But by then, her story about not being able to sleep without pharmaceuticals had crystallized.

Still, she was constantly worried about the long-term effects of the drugs on her mind and body.

She’d try the latest, supposedly less harmful, wonder drug.

When that didn’t work, the natural supplement and herbal sleep aid industry made a pile off her.

Rosy did not appear exhausted.

She didn’t look sad or on edge and became uncertain if she had previously been depressed. But she had been confident of nagging, low-level anxiety.

“This sleep issue has taken over,” she explained. “I’m stressed about my work, and my fiancée and I have been arguing. But it’s all because I’m so tired.”

Her fiancée would be fresh from the previous night’s sound sleep and expect an excellent physical intimate game the following evening.

But due to Rosy’s sleeplessness, she would feel exhausted the next full day and would start worrying about the excuses to avoid any physical intimacy the following evening.

Rosy relied on self-medicating with caffeine to remain alert during the day and getting addicted to wine to help her sleep during the night.

Final Diagnosis

Rosy had been identified as having an insomnia disorder.

Her problem of sleeplessness started due to her over-stressed life and impossible future goals.

Her worries about sleep deficiency may have made the specific situation worse.

Read further to know everything about Insomnia.

Here’s all you need to know about Insomnia.

Courtesy – YouTube

What is Insomnia or Sleeplessness?

Due to life’s never-ending array or challenges, just about everyone has trouble sleeping once in a while.

Insomnia is a sleep disorder in which a person has difficulty falling asleep or remaining asleep.

The people have trouble falling asleep or staying asleep, or they awaken after a few hours of sleep.

The condition of insomnia is identified whenever the patients have less than 6.5 hours of sleep, or a person requires half an hour or more to fall asleep, and signs persist for at least a month.

After six months, the diagnosis is classified as chronic sleeplessness or insomnia.

It is one of the most common sleep disorders, with an average of 35% of adults suffering from it.

What happens when you remain awake the whole night and need to get up in the early morning? Can you get back the lost sleep?

Unfortunately, this is one of the myths.

Sleep is not like a bank because you cannot accumulate debt with the hope of paying it off later.

Let us give you a piece of evidence to make that point very clear.

If I have to take an individual and deprive them of a whole night of sleep, like 8 hours of lost sleep, I give them all the recovery sleep they want, like the 2nd or 3rd night.

Yes, we see that they sleep longer.

But do they get back the lost 8 hours of sleep from the previous night?

Even if we keep measuring, they can’t recover their sleep.

Back to the example of the bank, you cannot accumulate sleep in the form of debt of lost 8 hours of sleep and then cover it up by sleeping longer the next night.

Many of us do this by short sleep during the week and long hours on weekends. This is what we call Social Jetlag.

What is the mortality rate of short sleep?

During one study, it was shocking to know that a person who sleeps for around 5 or 6 hours a night has got 65% higher likelihood of dying anytime. Increase in 65% of mortality rate.

Then we have a group of people sleeping for 5 hours a night on weekdays and longer sleep hours during weekends, and you can reduce some of that mortality rate.

But there is danger here. We know that the social jetlag of short sleeping during weekdays and binge or long sleep hours during weekends is associated, not necessarily with a shorter life span, but associated with a far less healthy lifestyle.

If you look into those studies for the group, who try to sleep longer at weekends, you will notice that they have impoverished health relative to the people, to what we generally recommend as people having 7 to 9 hours of sound sleep.

This group is far more likely to suffer from diabetes, obesity, and poor cardiovascular health.

So, it is recommended that everyone ensure an excellent sleep, irrespective of weekdays or weekends is very important.
Sleep does not follow the credit system.

Although insomnia may be related to disease or injury to the brain’s sleep centres, most often, it is the result of the below-mentioned reasons: –

• Physical illness
• Jet lagged
• Nervous about something like upcoming exams
• Loss of loved ones
• Excessive consumption of food, coffee, caffeine
• Excited about something new
• Chronic pain
• Stress
• Depression
• Anxiety
• Obsessive-compulsive rumination
• Panic attacks
• Post-traumatic stress disorder
• Drugs or alcohol abuse

Fortunately, most people tend to adjust to these circumstances, and their sleep rhythm returns to normal (for them) in a few days. However, a large percentage of Americans have problems with sleeping that last several weeks to years. The most common sleep problems are not sleeping enough (insomnia), sleeping during the day (excessive daytime sleeping), and unusual activities.

Symptoms of Insomnia

People having sleep difficulties might face these problems.

• Difficulty falling asleep at night.
• Awake at night.
• Difficulty in staying awake during the day. Not feeling well-rested during the day, leads to fatigue and an increased desire for a day nap.
• Difficulty in remembering basic tasks.
• Impaired ability to concentrate and focus.
• Headaches
• Irritability, anxiousness and nervousness.
• Lack of zest for life and resultant low motivation.
• No energy for work.
• Impaired judgement.
• Higher frequency of accidents.
• Sudden mood swings.

Types of Insomnia

Transient Acute Insomnia

Also known as short-term Insomnia, it usually lasts for less than three months.

A person might have acute Insomnia due to various reasons, including work pressure, family problems, personal issues and bad health conditions.

Acute Insomnia is common in both adults and children.

However, it is observed in women more than men. It gets cured on its own with time as the stressful event settles.

Chronic Insomnia (Insomnia Disorder)

It is a long-term sleeping disorder usually lasting for more than three months.

It might also be caused due to stress, as in the case of short-term Insomnia.

Still, other factors such as irregular sleep cycles, nightmares, anxiety and other physical and mental problems may affect a lot.

In addition to the two types of insomnia mentioned above, we also have 11 types of insomnia, as shown in the video posted below:-

Courtesy – YouTube

Causes of Insomnia

Insomnia may be caused due to a variety of reasons. Some of them are as enumerated below:

Stress

As humans, it is natural for us to be stressed about so many things in our life.

Stress about studies, work, family, money, and relationships all affect our health, resulting in sleep problems.

Sometimes, sudden or unexpected events such as the death of a loved one, losing a job, failing an exam might increase our stress level, thus making us insomniac.

Courtesy – YouTube

Unhealthy Lifestyle

We often neglect the importance of a healthy lifestyle.

Long naps in the afternoon, overeating at night may hamper your sleep.

Before bedtime, it is always advisable to have light food, resulting in unconscious feelings, heartburns, etc.

Poor Sleep Schedules

Irregular bedtime schedules, uncomfortable bed or sleeping environment, inappropriate sleeping habits such as using mobiles, laptops or any other gadgets before sleeping hampers our sleep a lot. 

Mental Health Issues

Anxiety, depression, trauma are also responsible for acute and chronic Insomnia.

These problems often let a person remain awake late at night or might result in awakening the person too early.

Food Habits, Caffeine, Nicotine

Tea, coffee, and other caffeinated drinks are stimulants. If consumed late in the evening or at night, it may interfere with your sleep.

The nicotine contained in tobacco is another stimulant that hampers sleep.

Courtesy – YouTube

Smartphone Usage before Sleep

Mobile use at bedtime (after the lights have been turned off) can cause Poor Sleep Quality (PSQ).

Due to the technology revolution, most mobile phone users now have smartphones that enable them to access the internet and social networks, watch videos, online chatting and play games. This results in exposure to stimulating content, mobile phone overuse and phone addiction, thus contributing to hyperarousal in pre-bedtime and poor sleep quality.

A significant factor that can contribute to PSQ is the blue light emitted by the screens of mobile phones.

This blue light can decrease melatonin production, the hormone that controls the sleep/wake cycle or circadian rhythm.

Reduction in melatonin makes it challenging to fall and stay asleep.

Courtesy – YouTube

Some studies have found that overexposure to blue light 1 hour before sleep, or while attempting to sleep on the bed, increases brain alertness and can stimulate cognitive functions, leading to PSQ.

“Using the mobile for a minimum of half an hour (without blue light filter) after the lights have been switched off” results in poor sleep quality, daytime sleepiness, sleep disturbances and increased sleep latency.

“Keeping the mobile nearby the pillow while sleeping” definitely correlates with daytime sleepiness, rest disturbances and increased sleep latency.

Mobile-Related Sleep Risk Factors (MRSRF) were highly prevalent among the mobile people who use a smartphone, right before sleep or while attempting to sleep, after the lights have now been switched off, without using the blue light filter or aeroplane mode or placing the smartphone near your pillow while sleeping.

Courtesy – YouTube

Role of Alcohol or Marijuana

Alcohol is the classic drug we call sedatives.

And sedative doesn’t help in sleep.

What you are doing while consuming alcohol is that you are just knocking down your cortex and entering into a sedation like state, and you are not going into actual sleep.

Alcohol litter your sleep with many more awakenings throughout the night.

You will feel rested when you wake up the following day.

You will feel refreshed.

The problem in this scenario is that people don’t remember waking up throughout the night if they drank in the previous evening.

They don’t realise that it was the alcohol disrupting the sleep.

The final thing about alcohol is that it is a good blocker for your “Dream Sleep” or “Rapid Eye Movement (REM) Sleep”.

REM sleep is essential for various functions, including emotional and mental health.

So, alcohol removes the dream sleep or decrease it significantly, blocking that necessary and critical part of sleep.

What is the significance of REM sleep? Studies done in the 1980s came up with shocking results. In that study, rats were deprived of REM sleep, and they all died as if they were deprived of food.

That’s how essential Dream Sleep or REM sleep is, which you ned up blocking with alcohol.

What happens when you consume Marijuana?

Many people consume Marijuana to escape from anxiety, which prevents them from falling asleep.

Certainly, Marijuana improves the speed with which you will fall asleep.

But Marijuana, with different biological mechanisms, like alcohol, will also block your Dream Sleep or REM Sleep.

With REM sleep deprivation, you will become more anxious, even more, depressed than the following day.

So, people will start seeking out more Marijuana to medicate the symptoms that Marijuana is causing sleep disruption.

So, it is advised not to seek the help of alcohol or Marijuana as a sleep aid.

When Addicted to Sleeping Pills or Insomnia Medication?

My friend’s concern was prompted by new research reported by French and Canadian scientists showing that addiction to benzodiazepine or sleeping pills (consumed to help in sleep) is linked to raised rates of Alzheimer’s condition.

Therefore, the risk increases with higher consumption of sleep-enhancing medications.

“The more the cumulative times of usage, the greater the possibility of later diagnosis of dementia,” Antoine Pariente, a pharmacoepidemiologist during the University of Bordeaux as well as a co-author of this research, informed This New York Times.

The researchers found during their study that older adults who took daily doses for 91-180 days had an increased risk of diagnosis to more health-related complications by 32%; people who popped benzos sleeping pills (consumed to help in sleep) daily for more than 180 days had an increased chance of 84%.

It didn’t matter whether or not the number of days people consumed the sleep-enhancing medications happened over a duration of half a year or five years.

Adverse Impacts of Insomnia

Insomnia affects everyone both physically and mentally, irrespective of age or gender. Here we will dive deeper to see its impact on children, adults, and aged people.

Children

These days, there are many reasons that might create trouble in sleeping in children.

Unhealthy family environment, bad routine, nightmares, anxiety or stress about studies, personal or social factors might resist their sleep.

In this case, parents play a significant role in understanding their child’s behaviour by talking to them and supporting them.

Also, before consulting a doctor, parents should try to form good habits for their children like proper bedtime, no video games or phone before sleeping, light food before bed and a suitable sleeping environment.

Adults

Insomnia is most common in adults. Many studies worldwide have shown the prevalence of Insomnia in 10%–30% of the population, some even as high as 50%–60%.

It is common in older adults, females, and people with other medical issues. Workload, career tension, relationship issues, financial problems are primary reasons linked to Insomnia.

Insomnia adversely affects young adults and working professionals.

Daytime tiredness or irritability affects their performance in the workspace.

It often leads to other health issues like headaches, severe stress and also hampers our relationship with other people. 

A lifestyle change can help us overcome this issue.

Setting proper bedtime and a comfortable sleeping environment, avoiding naps during the daytime, inculcating good habits before sleep like reading a book, and avoiding phones are factors that might help us have proper sleep.

Aged People

Current studies suggest that People over 60 years are more susceptible to Insomnia, which can be due to various factors.

Old aged people are more prone to multiple mental and physical illnesses, leading to insomnia symptoms.

Certain medications prescribed to cure medical conditions might also contribute to sleep issues.

With age, the quality of sleep decreases and people often find it difficult to remain asleep.

Natural changes in the circadian rhythm and sleep-wake cycle cause a lot of trouble sleeping.

However, it can easily be cured with specific habitual changes and proper medications. Study on Insomnia or Sleeplessness

New Health Epidemic Called “Insomnia”. According to the United States Academy of Sleep Medicine, as many as 30-35% of adults complain of insomnia.

The percentages further increased to 40-60% in case people of the age group of 60+ years.

Women tend to experience twice the chances of sleeplessness compared to men.

Only a third of Americans (and few of them we know ourselves) get the standard recommended eight hours of sleep every night.

The Centers for Disorder Control (CDC) has labelled sleeplessness or insomnia as a “public health epidemic” and estimated that 50-70 million adults in the USA suffer from a “sleep or wakefulness disorder”.

As per the report issued in 2014, the CDC warned that people who suffer from insomnia or sleeplessness have a risk for increased mortality and persistent medical ailments like cancer, diabetes, high blood pressure, heart problems, obesity, and depression.

Sleeplessness can be directly linked to reduced immune function.

It’s no wonder. In 2013, researchers at UC Berkeley found that sleep starvation fires up the brain’s amygdala and insular cortex, areas associated with emotional processing.

The resultant pattern imitates the abnormal neural activity seen in anxiety disorders.

“These findings help us realize that those who are anxious by nature are the same people who will suffer the maximum damage from sleeplessness,” said Matthew Walker, a professor of psychology and neuroscience at UC Berkeley and senior composer of the paper, which was published into the Journal of Neuroscience.

Another 2013 study, published because of the CDC’s National Center for Health Statistics, unveiled that nearly nine million United States adults take prescription sleep aids, called hypnotics—a number that is on the rise—with women leading the pack.

And disaster room visits because of inadequate responses to the drugs—especially zolpidem, the ingredient in Ambien—are also on a steep uptick, having nearly doubled between 2005 and 2010.

Study on Impact of Smartphone on Sleeplessness.

A detailed study was conducted by (National Centre for Biotechnology Information, USA) NCBI and the results of that study on the impact of the usage of smartphones on our sleep cycle.

Data were collected by convenience sampling technique, and the response rate was 38.5%, as 1925 out of 5000 students volunteered and completed the questionnaire.

A five minutes briefing session was given in the class to explain the rationale of study and terminologies used in the questionnaire (Average strength of students/class was 50).

The online questionnaire was shared with each class on their WhatsApp groups, and a time of 8 minutes was provided to the students to fill the questionnaire.

The students were assured about the confidentiality of their personal information.

The detailed results of the study are enumerated in the table below:-

Prevention

Many ways can help you prevent Insomnia or cure it.

Both acute and chronic Insomnia can be treated without doctors’ help, but if you don’t see any improvement after following any methods, you must visit a doctor.

Establish Regular Sleep Timings

Give your natural sleep cycle a chance to be in synchrony with the day-night cycle, by going to bed at the same time each night (within an hour more or less) and arsing without being awakened by an alarm clock.

This will mean going to bed early enough to give yourself enough time to sleep.

Try to maintain regular sleep timings during weekends or holidays.

Getting up early during the weekdays and sleeping late on weekends (Saturdays/ Sundays) may upset the rhythm of your sleep cycle.

Create a Proper Sleep Environment

Sleep occurs best when the sleeping environment is dark, quiet, free of distractions, and not too warm.

If you use radio, TV, smartphones to help you fall to sleep, use an auto timer to shut off the noise after falling asleep.

Avoid taking long naps during the day.

Wind Down Before Going to Bed

About 20 to 30 minutes before bedtime, stop any activities that can cause physical and mental arousal, such as work or exercise, and take up a “quiet” activity that can create a transition to sleep.

Transitional activities could include reading, watching “mindless” TV, meditation taking a warm bath/ shower or making love.

Make the Bedroom for Sleeping Only

Make your bedroom the most desired place for getting a good night’s sleep. Try not to use it for work or for discussing problems with your partner at all. Keep your bedroom clean and organized.

Don’t Worry While in Bed

If you are unable to sleep after 30 minutes or so in bed, because of the worry about the next day’s activities, get up and do some limited activities such as reading a magazine article, doing the dishes, or meditating.

Go to bed when you feel drowsy.

If you cannot sleep because of thinking about all that you have to do, then write down what all issues are troubling your mind and let that paper hold onto the thoughts while you sleep.

You can retrieve them in the morning.

Avoid or Limit Consumption of Alcohol, Caffeinated Drinks

Some people have a glass of wine or beer before bed in order to relax.

A large amount of alcohol, although sedating, block normal sleep and dreaming patterns.

Why?

Because caffeine remains in the body for several hours, people sensitive to caffeine should not ingest any afternoon.

Exercise Regularly and Remain Active

Exercising 20 to 30 minutes three to four times a week enhances the ability to sleep.

You should not exercise vigorously within three hours of bedtime, however, because of the possibility of becoming too aroused to sleep.

Avoid eating heavy foods before bed.

Keep a check on your medications to see if they interfere with your sleep.

Smart Usage of Smartphones.

You need to be very smart in using smartphones in your daily life.

Avoid at least one hour before you go to sleep.

In case of any emergency, if you have to use a smartphone, then use the blue light filter feature of your smartphone.

Courtesy – YouTube

Avoid keeping smartphones near the bed.

If possible, put your smartphone in airplane mode while you sleep.

Should we use the snooze feature of the alarm to wake in the morning every day?

No, it’s not a good idea to wake up in the morning with a sudden ringing of the alarm.

As per many studies done, when you are having a sound sleep, the alarm suddenly rings up, the cardiovascular response of alarm is a very stressful event.

When the alarm rings, there is a sudden spike in heart rate and the release of stress chemicals increases.

It’s fine to use the alarm only one time in the morning or only during emergencies where you have some time-specific event, like catching a flight at 2:00 AM.

But if you make this a habit of using snooze to feature your alarm every day and every small event, you are overstressing or assaulting your cardiovascular system.

So, try to avoid multiple uses of alarm snooze or use it once.

Conclusion

Insomnia is a common problem among everyone. A person might suffer from it for various reasons, both physically and mentally.

Anyone who is experiencing it might suffer from other health issues as well. Lack of proper sleep gives rise to many problems that can be harmful to a person. 

Chronic Insomnia is dangerous and may affect your daily life. A person suffering from it must consult a doctor to know the root cause and solution.

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Courtesy :

mayoclinic.org

mindful.org

NCBI

Health and Wellness (Eight Edition) by Gordon Edlin and Eric Golanty

Why Sleep Matter? by Matthew Walker

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