DEFINITION OF INSOMNIA
Insomnia is a common problem characterized by a persistent difficulty falling asleep and/or staying asleep, despite having ample time to do so. This can range from mild to severe, depending on how often and long it happens for. A patient with insomnia may be tired and grumpy during the day, have trouble concentrating, and be prone to falling asleep.
Many people are sleepy during the day just because they went to bed too late the night before – in this case, they don’t have a sleep disorder, they just simply didn’t get enough sleep for when they have to get up the next day.
Everyone has occasional nights of bad sleep, and for most people insomnia lasts only a few days and then goes away. Sometimes, however, the insomnia may last for several weeks or even longer. It especially becomes a problem when the insomnia starts interfering with the day-to-day waking activities of the person.
Insomnia may be caused by a variety of events and problems, as outlined below. Anyone who thinks their insomnia is due to vampirism should go through the list to be sure the problem they’re having is not due to a more mundane – and potentially fixable – cause. Get medical diagnostic help if necessary – there’s no harm in getting things checked out, and you’re not required to get treatment if you don’t want it. Understanding WHY you can’t sleep can help you deal with other things.
TYPICAL NIGHTTIME EFFECTS OF INSOMNIA
Difficulty falling asleep despite being tired
Relying on sleeping pills, alcohol, or antihistamines to fall asleep (common among people trying to sleep against their natural body clock)
Awakening frequently or lying awake in the middle of the night
Awakening too early in the morning and not feeling refreshed
TYPICAL DAYTIME EFFECTS OF INSOMNIA
Daytime drowsiness, fatigue and/or irritability
Difficulty concentrating; poor job/school performance
Lower reaction times and diminished mental alertness; increased likelihood of accidents or mistakes
Weakened immune system (from the stress caused by sleep deprivation)
Increased risk of depression, anxiety and substance abuse
Duration (time definition varies depending on medstaff):
* Transient (typically lasts days to weeks)
* Acute (typically lasts weeks to months)
* Chronic (typically lasts months to years)
* Onset (Trouble getting TO sleep, often due to things like anxiety)
* Middle (can’t maintain sleep – due to pain, illness, bathroom trips, etc.)
* Terminal/Late (Waking up too early; often due to things like depression)
EXAMPLE CAUSES OF INSOMNIA
Medications / Drugs
Psychoactive drugs or stimulants such as caffeine, amphetamines, modafinil (sometimes prescribed for fibromyalgia patients), etc. Side effects of some drugs such as the flouroquinolone class of antibiotics (typically these will have a “-floxacin” suffix to the chemical name, such as “Levofloxacin” for the brand Levaquin and “Ciprofloxacin” for the brand Cipro. There are exceptions to this naming convention, but to my knowlege, the exceptions are all currently unavailable in the USA or off the market completely.)
Glucosamine/Chondroitin has been reported by some people (and I have experienced this myself) as causing insomnia. If you take this, try taking this first thing when you get up as a means of waking up, rather than taking it close to your bedtime.
Sleep apnea (semi-wakes about every two hours or so throughout the night. Sleep is interrupted, so patient never gets quality sleep.), depression, excessive urination (such as with some kidney problems), restless legs syndrome (patient can’t get comfortable), pain (especially pain that is not managed well!), sometimes hormonal changes for the ladies (hot sweats, PMS, etc.), anxiety, stress or post traumatic stress disorder, schizophrenia, obsessive compulsive disorder, bipolar disorder, brain lesions or injury (affecting the regions that control the ability to fall or stay asleep), high blood pressure (either from hyperthyroidism or other things), rheumatoid arthritis (likely due to the pain or the medications used to control the pain) and others.
Delayed Sleep Phase Syndrome (DSPS), shift work and jet lag. DSPS is where the body’s wake/sleep cycle is naturally a bit off from what is considered “normal”. This is really only a problem if you’re required to go against your body clock. 🙂
Shift work often sets off insomnia – especially rotating shifts – because the body falls asleep at a different time from what it expects. Some people can handle shift work (or someone with DSPS gets a shift that matches their body clock), and some people can’t. Shift work is required in 24/7 workplaces such as computer data centers, factories, hospitals, and so on. Some have rotating shifts, some have fixed shifts. Day shift is often in demand, which leaves the nights more available for people who WANT to work nights. (It is a tradeoff, though – if you want promotions, especially promotions into management, you want to be noticed BY management, which is almost exclusively a day shift crowd.)
Shift work can also – long term or even permanently – alter a person’s normal body clock, if they’re on the late shifts long enough, or the body is more prone to “sleeping in” to begin with.
Jet lag happens when the body crosses multiple time zones and can’t quite get the hang of what time it is at the destination. Jet lag usually just takes a day or two to recover from, provided the patient takes proper steps to adjust.
Ambient noise (too much, not enough, or just the wrong type), too much light, temperature, exercise (the increased adrenalin makes the patient take longer to fall asleep.) Ambient noise could be anything from the “hum” of electronic equipment, radios, and so on. Sometimes there isn’t enough noise (if the patient moved to a quiet sleeping environment from a noisy one) and it’ll take time to adjust, or there’s the wrong kind of noise. (I fall asleep quite well listening to the sounds of the beach surf….but it’s not easy to get that in the middle of the city. 🙂 )
Too much light is a common problem for many people – the body’s triggers for production of certain waking/sleeping chemicals is controlled by light – or lack thereof. Shiftwork people especially have this problem, as they often have to sleep during the day. Light blocking curtains are available for situations like this, and are available even in most discount stores now.
Insomnia is more common in older people, 50-60 on up. Sometimes the older person genuinely needs less sleep, sometimes it’s actually due to insomnia. If you’re an older person reading this, it’s worth getting a sleep study done to determine which is which.
GETTING RID OF INSOMNIA
Avoid Artificial Sweeteners
if you’re eating/drinking anything with an artificial sweetener (Splenda/sucralose, Equal/aspartame, Acesulfame/Acesulfame-K/Acesulfame-Potassium, Neotame, Saccharin, etc.) try NOT eating/drinking those items before bed – you may have insomnia caused by any or all of them (and some foods/drinks have multiple artificial sweeteners PLUS high fructose corn syrup PLUS sugar…yegods, the overkill!)
If it’s too bright, cover the windows, turn lights off, turn noisy things off or on, set up a tape or CD of whatever helps you fall asleep. Alternately, you can get foam earplugs from most grocery or drug stores and sleep with those in your ears instead to cut down on noise levels.
Health – Diabetic/Borderline
if you are diabetic, hypoglycemic, or “borderline” for either of those, make sure you eat properly – too little blood sugar can make you tired all the time, just as too much sugars can keep you up at night.
Melatonin / Niacin
Both have sedative effects that help you drop off to sleep. Melatonin generally should be in dosages of .5mg or less a night (I’ve seen pills with dosages up to 5mg and that’s WAY too much for most people!) Niacin (vitamin B3) in some forms may cause a warm flush that can last up to an hour – this is NORMAL! – and may feel like a sunburn on the areas that flush. If you don’t like the flush, get the Inositol Hexicontinate form instead – it’s more expensive, but you won’t flush without taking huge amounts. You’re safe on niacin doses until you get to the point of nausea or vomiting. I take 1,500mg nightly of the Inositol Hexicontinate form, and haven’t had any kind of negative reaction. I have taken as much as 4,500mg on occasion (also the inositol form), also with zero negative reaction.
No Sugars/Sweets Before Bed
Don’t eat sugary / sweet things before bed. Ideally, not less than 4 hours before bed – give your system time to work the sugars out. Actually, if you’re in the habit of eating before bed, stop that altogether, stick to water (get a pitcher filter if you need to) for a couple hours before bed.
If the room is too hot, cool it down somehow. If the room is too cold, turn on the heat, or set up a portable heater to warm the place up.
Some people have trouble sleeping if their legs are cold, especially if they have poor circulation – so try wearing long socks to bed, or a pair of sweat pants.
Stress / Depression
Isolate the causes for stress and/or depression so you can deal with it better – sometimes knowing WHY you’re stressed can help. Learn to relax. Try listening to relaxing music before going to bed – not anything with a fast beat, as that will get your adrenalin going. It may not be easy to deal with stress/depression, you may need to ride it out, or get medical help to get over the hump.
Timing of Sleep
A fixed schedule works better for most people especially on night shifts, if they get up and go to bed at the same time, even on days off, then it’s easier to fall alseep when they need to.
One thought on “Insomnia Basics”
[…] Improving sleep hygieneVarious sleep hygiene improvements will be suggested such as maintaining a regular sleep schedule – even on weekends, limiting activities for a few hours before bed that would keep the patient awake, making the sleep environment more comfortable, and avoiding caffeine and other chemical stimulants before bedtime.(You can see some additional tips in my Insomnia article.) […]