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A Comprehensive Overview of Insomnia


What regulates sleep?

Sleep is generally regulated by sleep pressure, and the circadian rhythm, or our body clock, which is a 24 hour cycle that controls all our biological and physiological systems. It predicts environmental changes around us so that we can adapt to those changes. A natural hormone cycle keeps healthy people awake and alert during the day and sleepy at night.

In the ideal scenario, the circadian rhythm will rise in the early hours of the morning, promoting wakefulness and alertness, and will reach it’s pinnacle in the evening. After a waking time of approximately 15 hours, sleep pressure becomes stronger. In other words, we tire. When darkness arrives, the circadian beat drops to the lowest level and helps to manage rest.

Cortisol, the “stress hormone”, peaks in the morning to wake you up and continue to rise into the early morning and early waking hours. The peak in production of cortisol is about 9am, and over the course of the day, levels decline at a steady rate. Melatonin, the “sleep hormone”, peaks in the evening to calm you down. With the onset of sleep, cortisol levels continue to decline.

As long as this system is working, you’ll feel awake in the morning and sleepy in the evening, and stay asleep through the night without any disruption to your sleep. However, if you are stressed, this can keep cortisol levels high which can throw off many people’s circadian rhythms and sleeping patterns. This is how insomnia generally begins.

There are various ways in which our body clocks may be disrupted. For instance, when you go to different time zone, your body clock will not be in sync for some time as it experiences an alternate time for sunlight and sundown to what it’s used to – also known as ‘jet lag’. Likewise, doing shift work and travelling frequently across different time zones throws your body clock out of whack and can adversely affect your health, and has been linked to obesity, type 2 diabetes, depression, peptic ulcers, heart disease and cancer.

How widespread is insomnia?

Here are the stats:

  • 30 to 35% have minor symptoms of insomnia.
  • 15 to 20% have acute insomnia disorder, which lasts less than three months.
  • 10% have a chronic insomnia disorder, which occurs at least three times per week for a period of at least three months.

The effects of insomnia can impact nearly every aspect of your life because how you sleep affects how well you function as an individual. The quality of your sleep affects how you think, react, work, learn and interact with others.

If you suffer from insomnia, you likely have one or more of the following symptoms:

  • Difficulty falling asleep no matter how tired you are.
  • Waking up frequently during the night
  • Having trouble going back to sleep after waking up
  • Not feeling well-rested after a night’s sleep.
  • Getting up too early in the morning.
  • You start every day tired and irritable.
  • Feeling drowsy, fatigued or unenergetic all day.
  • Having to rely on alcohol or medication to fall asleep.
  • Difficulty paying attention, focusing on tasks or remembering.
  • You dread bedtime.

You will know that you have insomnia if you are not happy with the amount of sleep you’ve been getting. Lack of a good night’s rest tends to take a severe toll on your energy, mood and ability to function during the day.

Effects of insomnia include:

  • Mood swings.
  • Poor productivity at school or work.
  • Difficulty staying focused on tasks
  • Low energy levels throughout the day

A good night’s rest is critically important and plays a key role in your mental and physical health throughout your life. It is key to a good quality of life. The fact of the matter is that we need to get enough sleep in order to rejuvenate our body and soul. The consequence of not getting enough sleep can result in all type of illnesses.

In a recent study that involved more than 54,000 adults, it was discovered that individuals that get less than six hours of sleep per night (or more than nine) were significantly more at risk of heart disease, diabetes, stroke, dementia and obesity.

Now and again, we all experience nights of poor sleep. In a lot of cases this is due to keeping late nights or having our sleep interrupted, causing us to wake up too early. This does not mean you have insomnia, it just means you did not get enough sleep.

There are two main types of insomnia; acute and chronic:

Acute Insomnia

Also known as primary insomnia, acute insomnia is the most common type of insomnia, and it is known to occur in 20% of people. It can last from one day to three months. Acute insomnia is typically brought on as a result of core levels of stress that an individual is experiencing, and is often related in time to an identifiable cause.

For instance, if you have gone through a significant life stressor such as losing your job, failing an exam, breaking up with a partner, losing a loved one or some other personal loss, these events can wreak havoc on your mind and lead to a period of sleeplessness. Disruptive work schedules, jet lag, lack of exercise, a poor diet and many commonly used substances such as caffeine, alcohol, tobacco and other nicotine products all have a profound effect on a person’s sleep-cycle.

Acute insomnia tends to be a short-term condition that generally lasts for as long as the underlying cause remains in the forefront of your mind. This could be a day or a number of weeks. During this time, you may find it difficult to fall asleep due to the circumstances that you’re having to deal with.

Since this form of insomnia is caused by an underlying event and only lasts for a temporary period, there’s usually no urgent or compelling reason to seek any type of medical treatment for the condition.

Chronic Insomnia

Chronic insomnia (also known as secondary insomnia) on the other hand, is a prolonged kind of insomnia where you’re unable to get a good night’s rest for a few nights every week for a period of 2-3 months or more. Chronic insomnia is usually linked to an underlying medical or psychological issue such as an emotional disorder.

This means that the reason why you might be experiencing chronic insomnia is down to the stress of something else on your mind. Anxiety, stress and depression are some of the most common causes of chronic insomnia, and not getting enough rest often exacerbates these conditions.

Typically, this occurs when you’re facing a significant change in your personal circumstances. With chronic insomnia, the underlying cause is something else other than insomnia. Being unable to sleep is simply a symptom of a deeper problem, and the right solution is to treat that problem, rather than focusing on the insomnia itself.

Other situations where an individual may suffer from this type of insomnia is when they have an unhealthy level of sleep habits where they sleep whenever they feel like it. If you wake up whenever you want to or stay up as late as you want, then your mind will get used to staying awake whenever it wants to without having a specific schedule.

Other common medical, emotional and psychological causes of chronic insomnia include the following:

  • Chronic (ongoing) pain such as arthritis, back pain and headache disorders
  • Nasal allergies
  • Sinus allergies
  • Overall chronic pain
  • Asthma
  • Menopause and hot flashes
  • Gastrointestinal problems
  • Grief
  • Deep worry
  • Anger
  • Traumatic experiences such as being assaulted, robbed or burgled.
  • Other neurological problems

These conditions can stress the body and cause the mind to remain awake for a longer period of time, leading to a major lack of proper sleep and rest mainly because the body cannot get into a comfortable position to get adequate rest.

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