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What is insomnia?

Insomnia is a sleep disorder where the sufferer finds it difficult to fall and/or stay asleep. People with insomnia have one or more of the following symptoms:

  • Difficulty falling asleep
  • Waking up often during the night and having trouble getting back to sleep
  • Waking up too early in the morning
  • Feeling tired upon waking

Types of insomnia

There are two types of insomnia: primary insomnia and secondary insomnia.

  • Primary insomnia: This is when the sufferer has sleep problems that are not directly associated with any other health condition or problem.
  • Secondary insomnia: This is when the sufferer has sleep problems because of something else, such as a health condition like asthma, depression, arthritis, cancer or heartburn; pain; medicine being taken; or a substance being used, like alcohol.

 

Acute vs. chronic insomnia

Insomnia also varies in how long it lasts and how often it occurs. It can be short-term (acute insomnia) or it can last a long time (chronic insomnia). It can also come and go, with periods of time when a person has no sleep problems. Acute insomnia can last from one night to a few weeks. Insomnia is called “chronic” when a person has insomnia at least three nights a week for a month or longer.

Causes of insomnia

Causes of acute insomnia can include:

  • Significant life stress (such as losing or changing your job, death of a loved one, divorce, moving home).
  • Illness.
  • Emotional or physical discomfort.
  • Environmental factors like noise, light or extreme temperatures (hot or cold) that interfere with sleep.
  • Some medicines (for example those used to treat colds, allergies, depression, high blood pressure and asthma) may interfere with sleep.
  • Interferences in your normal sleep routine (such as jet lag or switching from a day to night shift).

 Causes of chronic insomnia include:

  • Depression and/or anxiety.
  • Chronic stress.
  • Pain or discomfort at night.

Symptoms of insomnia

Symptoms of insomnia can include:

  • Sleepiness during the day.
  • General tiredness.
  • Irritability.
  • Problems with concentration or memory.

Diagnosing insomnia

If you think you have insomnia, talk to your doctor. He or she may carry out an evaluation which may include a medical history, sleep history, and physical examination. You may be asked to keep a sleep diary for a week or two, keeping track of your sleep patterns and how you feel during the day. Your doctor may want to interview your bed partner about the quantity and quality of your sleep. In some cases, you may be referred to a sleep centre for special tests.

Treatment for insomnia

Acute insomnia may not require treatment. Mild insomnia can often be prevented or cured by practising good sleep habits (see below). If your insomnia makes it hard for you to function during the day because you are sleepy and tired, your doctor may prescribe sleeping pills for a limited time. Rapid onset, short-acting medications can help you avoid side effects such as drowsiness the following day.

Treatment for chronic insomnia includes first treating any underlying conditions or health problems that are causing the insomnia. If insomnia continues, your doctor may suggest behavioural therapy. Behavioural approaches help you to change behaviour that may worsen insomnia and to learn new behaviour to promote sleep. Techniques such as relaxation exercises, sleep restriction therapy and reconditioning may be useful.

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