When you DON'T choose to Sleep Alone: Insomnia

Are you one of those people who either have trouble falling asleep at night OR wake up throughout the night; often struggling to fall back to sleep? Most probably this will sound common to a lot of you, with the ‘busy’ lives that we are leading in today’s times. 

For some people, it could just be a matter of a few disturbances that occur throughout the week, resulting in acute insomnia; and this can last for just a month. Our lifestyles have become extremely hectic and our work patterns become far more demanding.

However, most people fall under the other category, which is chronic insomnia- that happens for over 1 month. Insomnia is not just about finding it difficult to fall asleep; it actually has a lot to do with the ‘quality’ and ‘quantity’ of our sleep. It is an inability for individuals to get restorative sleep, eventually causing daytime sleepiness, drowsiness and fatigue.

Of course this is accompanied by feelings of irritability, anxiety and even depression. The end result being that our personal and even our professional lives get adversely affected. It can even make day-to-day tasks difficult to execute such as driving, etc.


Although insomnia can occur without any underlying cause, most often it can aggravate other health problems such as psychiatric conditions, pulmonary disease and many other conditions that may cause physical pain.

 Some of the underlying conditions that cause insomnia are: diabetes, cancer, Parkinson’s disease, Alzheimer’s Disease, gastro esophageal reflux disease (GERD), hyperthyroidism, an overactive thyroid, heart failure, chronic pain, sleep apnea, restless leg syndrome, use of or withdrawal from alcohol and other sedatives such as anti-anxiety and sleep drugs like benzodiazepines, mental disorders such as bipolar disorder, clinical depression, generalised anxiety disorder, post-traumatic stress disorder (PTSD), schizophrenia, obsessive compulsive disorder, ADHD and dementia.

Medications: Now, this is the tricky part, because many people already suffer from some or the other health problem and the medicine they take for that health problem may create a side effect of insomnia. Medications such as epilepsy medications, antidepressants, hormone replacement therapy, medication for high blood pressure (hypertension), such as beta-blockers, non steroidal anti-inflammatory drugs (NSAIDS), certain medications that are used for treating asthma such as salmeterol, salbutamol and theophylline.

Psychiatric problems such as mood disorders, depression, bipolar disorder, anxiety disorders anti-anxiety sedatives, panic attacks, or even post-traumatic stress disorders; all cause insomnia. Even psychotic disorders such as schizophrenia can cause insomnia.   

Insomnia is also a side effect to many stimulants such as caffeine and alcohol, which can disrupt the sleep cycle. Sleep therapist and a hypnotist, Tanusha Banerjee says, "Remember how you survived on cups of coffees during the nights when you crammed for your exam? Caffeine is a stimulant, and it can make us alert by temporarily blocking certain sleep-inducing chemicals in the brain. It also increases adrenaline production. So, avoid having anything caffeine in the night time." That is also to mention tea, cola and other caffeinated drinks which can keep you up in the night and prevent you from sleeping. 

It could even run in the family. According to a 2008 study teens with parents who had insomnia have an increased risk of using prescribed sleeping pills and having mental problems.

It could also be a result of the daily stresses that are experienced at work or even relationships, or even environmental factors (such as having to work at night shifts, having a new born baby, etc.). There are also biological factors that play a role in causing insomnia as well too; these include heightened levels of cortisol, reduced levels of estrogen and progesterone (typically common during menopause). Its easy to try to ‘self-medicate’ one-self’ by consuming alcohol and taking benzodiazepines.         

So, what about the diagnosis of insomnia? As per medical information, it has been found that insomnia lasts for periods of time because of Symptoms or a history of depression, anxiety, or psychosis, Any new or ongoing health problem, painful injuries or health conditions, such as arthritis, coping with highly stressful life events, such as divorce or death and taking any medicines taken- either over-the-counter or prescription


Good Sleep Hygiene:

It’s very important to have good sleep hygiene; i.e. sleeping and waking up at the same time everyday, including weekends.

It also includes getting exercise on a daily basis, reducing alcohol intake, avoiding daytime naps (ONE OF THE MAIN REASONS FOR INSOMNIA), avoiding caffeine and smoking (and in general) in the evening and NOT going to sleep on an empty stomach (i.e. hungry). To ensure good sleep, it's important that you tire your body out," says sleep specialist Mohammad Hasin, "Exercising four hours before your sleep time is advisable.

Another method of treatment is Stimulus Control: This is a term used to describe situations in which a behavior is triggered by the presence or absence of some stimulus. Therefore we associate the bed only with sleeping and for no other activity. It should not be used as a place for watching TV or even reading or sending a text or talking on the phone. 

Sometimes it is necessaary to make use of eye covers and plug ears in case there is bright lights and noise in the surrounding area. It is VERY, VERY important to NOT FORCE sleep. If you just cant sleep after twenty minutes of time, it is better to leave the bed, do something and come back when ready.

Another technique of treatment is known as behaviour therapy, which includes relaxation techniques and cognitive behviour techniques. This therapy helps a person to manage the problems and life stressors in their lives in a better manner.

However, despite all of these techniques there are medication which can help such as melatonin agonists, non-benzodiazpine sedatives and occassionally benzodiazepines. However, with every medication there is always a side-effect and these too have side effects.         
Tips for a Good Night of Sleep:

1) Create a Routine & Stick to it: Ensure that you wake up at a fixed time (suppose 8 AM) and sleep at a fixed time (10 PM). As far as possible avoid the afternoon snoozes.
Make sure your room is noise-free: Sleep in a room that is dark, with a comfortable temperature and does not have any surrounding noise.
2) Create a relaxing bedtime ritual: Have a relaxing, warm bath 30 minutes before bedtime: This will refresh you and create a mood to sleep. You can also listen to soft music or even use this time to read a book.
Have a glass of warm water/milk – whatever you prefer.
3) Avoid having heavy meals at dinner time.

In addition to all of this, some of the other cognitive and behavioural treatments include:

1) Sleep-restriction therapy: This is a therapy that is used to restrict the amount of time that is actually spent in bed versus   the actual amount of time spent asleep. The sleep time is gradually increased as and when the sleep improves.
2) Relaxation training: This method is also known as relation technique and is a method/process/activity/procedure to help a person basically relax. In order to do this, he/she has to attain a state of increased calmness or reduced levels of anxiety, pain, anger and stress. It helps to reduce the number of intrusive thoughts that may be interfering with the quality of sleep.
3) Bio-feedback: It is a method by which a person learns to control their body’s functions, such as say their heart rate. In this method, the person gets connected to electrical sensors, which help to receive information (feedback) about your body (bio).

Risk Factors: Who Should be on the lookout?

Although, everyone should pay attention to their health the risk of insomnia is higher for certain people. These people include:

A woman: Hormonal shifts that take place during the menstrual cycle and even in menopause. During menopause, hot flashes and night sweats are common and disrupt the sleep. In fact, insomnia is particularly common during pregnancy as well.

You’ve crossed the Age of 60: With changes in health and sleep patterns, so does the chance of getting insomnia increase.

No Fixed Schedule to Follow: A schedule brings about a sense of discipline in our lives. Without one, it could just bring about a lot of chaos and disruptions to our sleep-wake cycle.

A Mental health disorder or physical health condition:  Are you one of those suffering from anxiety or depression or physical health problems such as obesity, gastrointestinal problems, asthma, diabetes or heart disease?

In addition to psychological and physical health problems there is the constant nagging of your number one enemy, that being stress! "Stress doesn't only make us feel awful emotionally," says Jay Winner, MD, author of Take the Stress Out of Your Life and director of the stress management  Program for Sansum Clinic in Santa Barbara, Calif.
"It can also exacerbate just about any health condition you can think of." Its important to remember that stress is not JUST a feeling or JUST IN YOUR HEAD! According to Jay Winner, MD, author of Take the Stress Out of Your Life,  It's a built-in physiologic response to a threat. When you're stressed, your body responds.
Your blood vessels constrict. Your blood pressure and pulse rise. You breathe faster. Your bloodstream is flooded with hormones such as cortisol and adrenaline. "When you're chronically stressed, those physiologic changes, over time, can lead to health problems," 

Its high time you STOP the sleepless nights, take control of your life and daily habits and push INSOMNIA out the back door!