Insomnia is a sleep disorder that millions of people worldwide have to live with. Individuals with insomnia find it difficult to either fall asleep and/or stay asleep.
Insomnia commonly leads to daytime sleepiness, lethargy and a general feeling of being unwell both mentally and physically.
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What is insomnia?
According to a survey by the National Sleep Association, 22% of US people say they experience insomnia every or almost every night.
Insomnia includes a wide range of sleeping disorders, from lack of quality of sleep to lack of quantity of sleep.
Insomnia is commonly separated into three types:
- Transient insomnia - occurs when symptoms lasts from a few days to some weeks.
- Acute insomnia - also called short-term insomnia. Symptoms persist for several weeks.
- Chronic insomnia - this type lasts for at least months, and sometimes years. According to the National Institutes of Health1, the majority of chronic insomnia cases are secondary, meaning they are side effects or symptoms of some other problem.
Although insomnia can affect people at any age, it is more common in adult females than adult males. The sleeping disorder can undermine school and work performance, as well as being a cause of obesity, anxiety, depression, irritability, concentration problems, memory problems, poor immune system function, and reduced reaction time. Insomnia has also been associated with a higher risk of developing chronic diseases.
The National Sleep Foundation2 informs that between 30% and 40% of American adults say they have had some symptoms of insomnia within the previous 12 months, and 10% to 15% of adults claim to have chronic insomnia.
This video from NHS Choices gives expert information about insomnia, including what causes it and different ways to deal with it.
What causes insomnia?
Insomnia can be caused by physical factors as well as psychological factors. There is often an underlying medical condition that causes chronic insomnia, while transient insomnia may be due to a recent event or occurrence.
Insomnia can commonly be caused by:
Studies have suggested that electronic devices with self-luminous "backlit" displays can affect evening melatonin, which might result in delayed sleep.
- Disruptions in circadian rhythm: jet lag, job shift changes, high altitudes, noisiness, hotness or coldness
- Psychological issues: people with mood disorders, such as bipolar disorder or depression, as well as anxiety disorders or psychotic disorders are more likely to have insomnia.
- Medical conditions: brain lesions and tumors, stroke, chronic pain, chronic fatigue syndrome, congestive heart failure, angina, acid-reflux disease (GERD), chronic obstructive pulmonary disease, asthma, sleep apnea, Parkinson's and Alzheimer's diseases, hyperthyroidism, arthritis
- Hormones: estrogen, hormone shifts during menstruation
- Other factors: sleeping next to a snoring partner, parasites, genetic conditions, overactive mind, preganancy
- Media technology in the bedroom - researchers from the University of Helsinki, Finland, reported in the journal BMC Public Health that media technology in the bedroom disrupts sleep patterns in children. They found that children with TVs, computers, video games, DVD players and mobile phones in their bedrooms slept considerably less than kids without these devices in their bedrooms. In addition, a study conducted by Rensselaer Polytechnic Institute found that back-lit tablet computers can affect sleep patterns.
Medications - according to the American Association of Retired Persons3 (AARP), the following medications are known to cause insomnia in some patients:
- Corticosteroids - used for treating patients with allergic reactions, gout, Sjögren's syndrome, lupus, rheumatoid arthritis, and inflammation of the muscles and blood vessels. Examples include: prednisone, triamcinolone, methylprednisolone and cortisone.
- Statins - medications used for treating high cholesterol levels. Examples include: simvastatin, rosuvastatin, lovastatin and atorvastatin.
- Alpha blockers - used for treating hypertension (high blood pressure, Raynaud's disease and BPH (benign prostatic hyperplasia). Examples include: terazosin, silodosin, alfuzosin, prazosin, doxazosin and tamsulosin.
- Beta blockers - used for treating hypertension and irregular heartbeat (arrhythmias). Examples include: timolol, carvedilol, propranolol, atenolol, metoprolol and sotalol.
- SSRI antidepressants - used for treating depression. Examples include: fluoxetine, citalopram, paroxetine, escitalopram, sertraline and fluvoxamine.
- ACE inhibitors - used for the treatment of hypertension, and other heart conditions. Examples include: ramipril, fosinopril, trandolapril, quinapril, benazepril, enalapril, lisinopril, moexipril, perindopril and captopril.
- ARBs (Angiotensin II-receptor blockers) - used when the patient cannot tolerate ACE inhibitors or has type 2 diabetes or kidney disease from diabetes. Examples include: candesartan, valsartan, telmisartan, losartan and irbesartan.
- Cholinesterase inhibitors - used for treating memory loss and other symptoms for patients with dementia, including Alzheimer's disease. Examples include: rivastigmine, donepezil and galantamine.
- 2nd generation (non-sedating) H1 agonists - used for treating allergic reactions. Examples include: loratadine, levocetirizine, fexofenadine, desloratadine, cetirizine and azelastine.
- Glucosamine/chondroitin - dietary supplements used for relieving the symptoms of joint pain and to reduce inflammation.
Who gets insomnia?
Shift workers commonly suffer with insomnia because of inconsistent sleep routines.
Some people are more likely to suffer from insomnia than others. These include:
- Shift workers with frequent changes in shifts
- The elderly
- Drug users
- Adolescent or young adult students
- Pregnant women
- Menopausal women
- Those with mental health disorders
On the next page we look at the signs and symptoms of insomnia, how it is diagnosed and the possible treatment options for insomnia.