Insomnia
Summary
Adequate sleep is a vital contributor to positive mental and physical health. When you have trouble falling or staying asleep, or you wake too early and can’t get back to sleep, you are suffering from a condition called insomnia. Insomnia can be short-term, lasting from one night to a few weeks in duration, or chronic in nature, occurring several nights a week for a month or more.
Insomnia can have a profound effect on quality of life. Poor sleep can contribute to irritability and frustration, as well as feelings of anxiety, sadness and fatigue. Poor sleep can make it difficult to focus and concentrate and to engage in interpersonal relationships in a healthy and productive manner. Chronic sleep problems can impact physical health by weakening the immune system and slowing reaction time, thereby making one more susceptible to illness and injury.
The vast majority of people in the United States do not get enough sleep, either by choice or because of difficulty falling and staying sleeping. There are many causes of insomnia, including poor sleep habits/hygiene, inactive lifestyles, and too much caffeine or alcohol consumption in the latter half of the day. Insomnia can arise in response to heightened stress, worry or depression, which can keep our minds active at bedtime. Medical conditions, such as hormonal imbalances and sleep disorders such as sleep apnea and restless leg syndrome, can also impact sleep quality and quantity. Certain medications can contribute to insomnia, such as cold and asthma medications and blood pressure medications. The blue light from phones and computer screens in the evening, a common activity for many, can delay melatonin production, making falling asleep and deep sleep more challenging.
Certain factors make one more susceptible to insomnia. Women are more likely than men to experience insomnia, as are older adults, and young and middle-age African Americans. Also, those managing long term illnesses, suffering from mental health conditions, and working night- or swing-shifts are at greater risk for developing insomnia.
Whatever the cause, not sleeping long enough or well enough on a regular basis can result in daytime sleepiness, an overall sense of fatigue, irritability, problems with memory and concentration, and slowed reaction times, all of which can result in negative consequences and poor health outcomes. Those suffering from insomnia experience lower job or school performance, are at greater risk for motor vehicle accidents due to slowed reaction time, are more likely to develop a mental health condition such as depression and anxiety, and are at increased risk for long-term health issues, such as high blood pressure and heart disease.
For those experiencing short term sleep issues with few daytime symptoms, treatment may not be necessary. However, if insomnia becomes chronic in nature, or produces negative daytime symptoms and makes it difficult to engage in day to day activities, intervention is helpful. After seeing a physician to ensure there are no underlying medical conditions or medications contributing to insomnia, many people report that working with a therapist can assist in both practical and emotional changes, thereby allowing for a better night’s rest. Behavioral therapy can help to identify individual factors contributing to insomnia and to develop positive coping resources that may promote better sleep. Therapy can also assist in working through deeper emotional issues that may be affecting sleep.
Some common behavioral practices that serve to promote good sleep include going to sleep and waking up at the same time each day, avoiding phone, computer, and television screens before bed, avoiding nicotine, caffeine, and alcohol late in the day, avoiding a big meal just before bed, and getting regular exercise. In addition, a light snack before bed might help with sleep, as well as a comfortable bedroom environment and a relaxing bedtime routine.