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Everything You Need to Know About Sleep Disorder – Insomnia

What is Insomnia?

Insomnia is a common sleep disorder in people in which they have trouble in sleeping or to remain
asleep. This is the health condition in which you will have difficulty falling asleep, or remain asleep as
long as you desired, or wake up during the night or too early in the morning.
Insomnia can affect your energy level, mood, health, attention level, work performance, and quality of
life. Healthy sleep duration varies from person to person, however most of the people need 7-8 hours
every day to sleep.
Millions of people across the countries suffer from insomnia which impact their lives. Some reports say
30% of world population is suffering with insomnia. More than 50% people reported at least one
symptom of insomnia. As per report more than 45% chance of insomnia in women than men. According
to a report on insomnia 68-70% of adults ages 18-29 years complaining symptoms of insomnia, in
comparison to 57-60% of adults ages 30-64 years, and only 42-46% of people over the age of 65 years.
Treatment is available for all people suffering from insomnia. There are several kinds of medical therapy,
behavioral and psychological therapy are available to treat insomnia relying upon the condition of the
individual.

What are Different Types of Insomnia?

Insomnia is a common sleep disorder that makes difficult to fall asleep or stay asleep. It results in
daytime sleepiness and not feeling rested or refreshed once you awaken.
There are a few different types of insomnia. Each type is differentiated by how long it lasts, how it
affects your sleep, and its cause. These are as below:

Acute insomnia
Acute insomnia is short-term insomnia which will last from a couple of days to a couple of weeks. It’s the
most common type of insomnia. Acute insomnia is usually caused by a life circumstances, such as a
stressful change in a person's job, receiving bad news, or travel. Acute insomnia can be resolve without
any treatment.
Common causes of acute insomnia include:

  • any stressful event, such as the death of any family member or loved one or starting a new job
  • environmental factors that disrupt your sleep, such as noise or light or any other disturbances
  • sleeping in an unfamiliar bed or surroundings, such as a hotel or new home or somewhere else
  • illness or any certain medications

Chronic insomnia
It is a long-term difficulty of sleeping. Insomnia is considered chronic if you have trouble sleeping at least
three days per week for at least one-two months. Some people with chronic insomnia have a longer
history of difficulty in sleeping.
Chronic insomnia can be primary or secondary. Primary chronic insomnia, which is also called idiopathic
insomnia, doesn’t have an obvious cause or medical condition.

Secondary insomnia is called comorbid insomnia and is more common in people. Its chronic insomnia
that occurs with another conditions like:

  • chronic medical conditions like diabetes, Parkinson’s disease, hyperthyroidism etc..
  • mental health conditions like depression, anxiety
  • use of medications like antidepressants, antianxiety and beta blockers
  • consumption of caffeine and other stimulants like alcohol, nicotine, and other steroid/drugs
  • lifestyle factors, including frequent travel, jet lag, rotational work shift, and napping.

Behavioral insomnia of childhood
Behavioral insomnia of childhood (BIC) affects approximately 25% of children. It’s divided into three
subtypes:

  • BIC sleep-onset. This type results from wrong habits with sleep. These children usually need a
    parent, comfort item, or being rocked or nursed by their parent to sleep.
  • BIC limit-setting. In this type of BIC children usually refuse and repeating their attempts to avoid
    to go to bed and sleep. Examples of this behavior are asking for a drink, to go to the bathroom,
    or listening story from their parent.
  • BIC combined type. This form is a combination of above two subtypes of BIC. This occurs when a
    child has a sign of above both BIC.

BIC can usually be treated with a few behavioral changes, following healthy sleep routine or relaxation
techniques.

What Are the Symptoms of Insomnia?

Insomnia symptoms may include:

  • Difficulty falling asleep at night
  • Waking up during the night and up too early in the morning
  • Not feeling well-rested after a night's sleep or feeling low energy during the day
  • Daytime tiredness or sleepiness
  • Irritability, depression or anxiety
  • Difficulty in concentration, attention, focusing on tasks or remembering
  • Increased errors or accidents
  • Ongoing worries about sleep

Insomnia Causes
Insomnia may be either primary or secondary. Primary insomnia is insomnia that’s caused by life
changes, any stressful events like death of any family member or loved one or loss of job or starting a
new job. Secondary insomnia is cause by physical and mental health condition or lifestyle habits or
excessive daytime sleeping.
Common causes of chronic insomnia include:

  • Stress. Concerns about work, school, health, finances or family can keep your mind disturbed at
    night, making it difficult to sleep. Stressful life events or trauma such as the death or illness of
    any family member or loved one, divorce, or a job loss also may lead to insomnia.

  • Travel or work schedule. A circadian rhythm a natural internal process that regulates the sleep-
    wake cycle, metabolism and body temperature. Disrupting your body's circadian rhythms can cause insomnia. Causes include fatigue from frequent traveling, working late or early shift, or
    frequently changing shifts.

  • Poor sleep habits. Poor sleep habits include an irregular bedtime routine, any activity before
    bed, an uncomfortable sleep environment, eating or watching TV while bedtime. Computers,
    TVs, video games, smartphones or other screens just before bed can disturb your sleep cycle.
  • Eating too much late in the evening. Having a light food before bedtime is good, but eating
    heavy may cause you to feel physically uncomfortable while lying down. Many people also
    experience heartburn, a backflow of acid and food from the stomach into the esophagus after
    eating, which can keep you awake.
  • Mental health disorders. Anxiety disorders, like post-traumatic stress disorder, may disrupt
    your sleep. Awakening too early are often a symbol of depression. Insomnia often occurs with
    other psychological disorders also.
  • Medications. Many prescribed medicines can interfere with sleep, like certain antidepressants
    and medications for asthma or blood pressure. Also OTC medications like pain killer, anti-
    allergic, cold and weight-loss medicines which some stimulants can disrupt your sleep quality.
  • Medical conditions. Medical health conditions like chronic pain, cancer, diabetes, heart disease,
    asthma, gastro esophageal, overactive thyroid, Parkinson's and Alzheimer's disease also cause
    insomnia.
  • Sleep-related disorders. Sleep apnea and sleeping sickness interrupt your sleep. Restless legs
    syndrome causes sensations in your legs and an almost irresistible desire to move them, which
    can prevent you from falling asleep.
  • Caffeine, nicotine and alcohol. Tea, Coffee, cola and other caffeine drinks are stimulants.
    Drinking them late evening can keep you from falling asleep at night. Nicotine in tobacco
    products is another stimulant that can cause sleeping difficulty. Alcohol may help you fall asleep,
    but it prevents deeper stages of sleep and sometime causes awakening during the night.
  • Hormonal Condition. Hormonal changes during the menstrual cycle and menopause may play a
    role. During menopause sweating and hot flashes at night often disrupt sleep. Insomnia is also
    common with pregnancy.

Insomnia in children and teenagers
Children can have insomnia for the same reasons as adults. Sleep problems may be a concern for
children and youngsters as well. However, some children and teens simply have trouble going to sleep
or regular bedtime because their body’s internal process are more delayed. They want to sleep late in
night and wake up late in the morning.
These reasons might include:

  • stress
  • medications
  • excessive caffeine intake
  • psychiatric disorders
  • daytime sleepiness or restlessness
  • irritability and mood swings
  • repeated disciplinary issues
  • memory problems and attention deficits

Insomnia treatment for children is as same as for adults. Children must follow home remedies in the
beginning before taking any medical treatment. They will avail more benefits from routine and good
sleep hygiene.  

Risk factors for Insomnia
Nearly everybody has associate occasional sleepless night. It can be happen at any age and the risk of
insomnia is higher if:

  • suffering with any long-term health issues or any mental health problem
  • Working in rotational shifts specially in night shift
  • high levels of emotional disorders like stress, depression or anxiety
  • lower income source or disturbed financial conditions
  • frequent traveling and inactive lifestyle
  • Certain medical conditions like obesity, cardiovascular disease, and menopause can also
    increase risk of insomnia.

Complications of Insomnia
Sleep is as necessary for your good health as a healthy diet and regular physical activity. Our body and
brain require sleep so that they can repair themselves. No matter your reason for sleep loss, insomnia
can destroy your both mental and physical health. There is big difference in the quality of life in people
with better sleeping habit compared with those who have sleep disorder problem.
Complications of insomnia may include:

  • lower performance in work and study
  • reduce the reaction time ability
  • inattentive driving and high risk of accidents
  • high risk of stress, depression or anxiety
  • chances of long-term health problems like diabetes, cardiovascular disease, blood pressure
    problems, obesity and other disorders
  • difficulty in concentration and attention
  • feeling of mood swings, irritability, dissatisfaction

Insomnia Prevention
You should follow some preventions to avoid insomnia. Here are some recommendable tips for healthy
sleep habits and sleep hygiene to follow:
Do’s:

  • A regular bedtime routine should be followed.
  • Go to bed to sleep in night and get up in morning at the same time every day.
  • The bedroom should be quite, dark and comfortable.
  • Do some yoga, meditation and light talk with your room partner this will help you to feel
    pleasant at bed time.
  • You can watch some comedy videos sometimes this also help you to sleep better because
    laughter makes our brain happy and relaxed.
  • do exercise every morning to stay fit and active
  • follow bedtime habits like reading book, listening soft music, or take a warm bath to relax
    yourself before to sleep.
  • do check your medications if there is any which can promote insomnia
  • avoid heavy meals and beverages before go to bed.
  • If you are not feeling sleepy then get up and do something like reading, singing, listen music till
    you feel sleepy.

Don’t s

  • Do not do heavy exercise in the evening specially before bedtime
  • Do not change your bed routine frequently
  • If you awake in middle of the night and feeling difficult to sleep back then leave the bed and
    come back when you are ready to sleepy
  • do not take naps during the day because it will not make you sleepy at night.
  • Do not take stimulants like tea, coffee, or nicotine in the evening because these can create
    restlessness sand sleeping problem.
  • Don’t smoke and take alcohol because it can affect your sleep quality.
  • Don’t go to bed with any negative thought.

Insomnia and Anxiety
Anxiety can be the reason of insomnia and insomnia can be the reason of anxiety. According to one
report anxiety or excessive worrying can result in symptoms of insomnia. Anxiety and insomnia is inter
related. Sometime anxiety can go away once the issue of anxiety is resolved and once the anxiety is
over, you can feel insomnia is also resolved. This will also return your sleep to normal as well.
The same lifestyle changes and behavioral practices advised to treat insomnia can also treat anxiety and
anxiety related insomnia. 
Insomnia and Depression
Alike anxiety depression can result in insomnia and insomnia can cause depression. High level of stress
or depression can result in chronic insomnia. The same treatments can be followed for both depression
and insomnia, no matter which condition comes first. As soon as depression is resolved, your insomnia
can also be solved. Both insomnia and depression affect our sleep quality badly.
Insomnia and pregnancy
Insomnia during first and third trimesters of pregnancy is very common. It happens due to hormonal
changes and frequent need of urination. Pain like cramps and back discomfort will also keep you awake.
Pregnant body is undergoing many changes like an active metabolism, increase in progesterone and a
new life growing in you.
You can follow below tips which will help you out of insomnia during pregnancy:

  • keep yourself active during your pregnancy with proper rest
  • Follow a healthy diet
  • Drink water properly to stay well hydrated
  • Follow a consistent sleep routine, wake up and go to bed on time
  • Do meditation, yoga and light exercise during the day for refreshed mind.

What Is the Treatment for Insomnia?

There are both medical and non-medical treatments available for insomnia. These treatments for
insomnia may include some medications or non-medical therapies like developing better sleep habits or
psychotherapy. Some time you may also advised to change your lifestyle to correct your insomnia.
To treat insomnia it is must to find out root cause of the disorder only then the correct method of
treatment can be taken. If your insomnia is caused by any medical condition like anxiety, depression,

stress, diabetes, menopause or any other, treating those problems will also help you out. If insomnia is a
side effect of any medication you are taking, changing the medication or its dose will help. Always
consult your doctor before making changes to any medications you are taking.

Diagnosis of Insomnia

Your doctor will must do some physical exams, take medical and sleep history to understand the main
reason of insomnia. Sleep disorder tests are also require to diagnose insomnia.
During the exams, your doctor may ask you questions if you are suffering from anxiety, depression,
stress or any other health conditions that can disturb your sleep quality. He can also ask you about any
medications you are taking and might that’s side effect is causing your sleep disorder.
Depending on your health conditions below diagnosis method can be follow:

  • Sleep diary: Doctor may ask you to maintain sleep diary to track your sleep patterns. Your sleep
    diary will have all the information related to your sleeping problems like when you sleep, wake
    up, any physical problems, time table of your daily routine including having food, tea coffee,
    alcohol, medications, wake up time in middle of night etc….
  • Epworth Sleepiness Scale: ESS is a tool in which some validated questionnaire is asked by the
    patient to assess daytime sleepiness. This will be helpful for your doctor in diagnosing sleep
    disorders.
  • Polysomnogram: PSG also known as sleep study, is a test used to diagnose sleep disorders.
    Polysomnogram is use to records body’s internal like oxygen level in blood, brain waves, heart
    and breathing rate and eye & leg movements during we sleep.
  • Actigraphy: Sleep actigraphs are generally watch-shaped device that measure sleep-wake up
    patterns over time to assess and worn on the wrist. It is useful to test sleep patterns and
    circadian rhythms and advised to wear for several weeks.
  • Mental Health Exam: To know the reason of insomnia mental health exam, mental health
    history, psychological evaluations can be conducted. This is require to understand the reason
    and symptoms of depression, anxiety, or another mental health disorder that are causing
    insomnia.

Prescription Medications for Insomnia

Doctor can prescribe you some medicines which can help you to sleep better. However, doctors
recommend some prescription sleeping pills but not more than a week. You should also not take any
sleeping pills without consultation of doctor. These kind of sleeping medication should only be taken
before bedtime and should not use frequently or daily.
Common prescription sleep medicines include:

  • Doxepin (Sinequan)
  • Eszopiclone (Lunesta)
  • Zolpidem (Ambien)
  • Ramelteon (Rozerem)
  • Zaleplon (Sonata)

Cognitive Behavioral Therapy (CBT) for insomnia

Cognitive Behavioral Therapy for insomnia (CBT-I) is a most popular and effective treatment for chronic
sleep disorder and doctors usually recommend it as the first line of treatment. CBT is a specific type of

therapy that helps you to find those thoughts and behaviors that cause sleep disorder. Sometimes
thoughts and behaviors disturb our sleep quality which cause insomnia.
During the therapy you also be asked to follow sleep hygiene training and the same will be given to you.
Sleep hygiene training will help you to leave some disruptive behaviors like:

  • To follow strict bedtime routine, wake up and sleep at same time every day
  • To take sleep for at least 7-8 hours every day
  • to avoid stimulants like tea, coffee, tobacco, alcohol before bedtime
  • to avoid exercise before bedtime
  • to avoid watching TV, working on laptop, surfing on phone internet
  • to do all the possible activity like yoga, meditation, relaxation, exercise advised during the
    training

In the beginning you will be asked to follow some routine to change our lifestyle but if it doesn’t work
then the doctor can recommend you CBT. This therapy will help you to develop good sleep habits that
improve the sleep quality. CBT will help you to control negative thoughts and behaviors that keep you
awake or not letting you to sleep.
While using Cognitive Behavioral Therapy your doctor may use below therapies depending on your sleep
disorder condition:

  • Stimulus Control Therapy. This therapy guide you to avoid few factors that prevent you to sleep
    better. The main objective of this therapy is to reduce the anxiety and arousal at the time of
    sleep. This Stimulus Control Therapy train you:
  1. to use your bedroom just to sleep not for working on laptop or watching TV
  2. to fix wake up and sleeping time for every day,
  3. to enter bedroom when you willing to sleep,
  4. to leave the bedroom if you finding hard to sleep,
  5. to avoid napping in daytime and evening
  • Relaxation Therapy that helps you to relax, reduce muscle stress, lowers blood pressure,
    increase calmness; reduce pain, anxiety, stress and anger. In this therapy you are advised to
    follow some techniques like meditation, deep breathing, yoga, visualization etc. This method will
    helps you to calm your body and mind.
  • Sleep Restriction Therapy is a behavioral technique that decrease the time spending in bed to
    get sleep, increase depth of sleep and helping to avoid daytime naps. Once your sleep is
    improve, your time to get sleep will gradually decrease.
  • Remaining passively awake is also called paradoxical intention. This therapy’s objective is to
    reduce the worry and anxiety about being able to sleep and trying wake up. To worry about to
    sleep generates anxiety that keeps you awake, letting go of this worry and making no effort to
    sleep is the result of this therapy.
  • Light therapy. Your body has an internal clock called circadian rhythm that tells you when it is
    time to sleep and when it is time to wake up. This Light therapy is used to maintain this circadian
    rhythm sleep disorders. Exposure to bright light produce melatonin in brain that regulate the
    circadian rhythm.

In light therapy, every day you sit near a special light box for some time. The light from this box
is the outdoor light. Exposure to this bright light helps your body to adjust circadian rhythm. And
this circadian rhythm helps people to sleep early at night and wake up in the morning.

Lifestyle and Home Remedies for Insomnia

Millions of people are suffering with insomnia. This common health problems in people makes it difficult
to fall asleep. You need to change your lifestyle and follow some home remedies to improve your quality
of sleep.
Here are some effective and fruitful home remedies for you to follow:

Good Sleep Habits

While we sleep our body and brain get relaxed and restoring its energy rebuilding the broken tissues and
cells. Good sleep habits will give you better quality of sleep and you will be able to avail benefits for your
physical and mental health. This will help you to reduce the risk of stroke, diabetes, heart disease,
cancer, Alzheimer’s etc.
Good sleep habits increases energy level, improves mood and fights against insomnia, anxiety and
depression. In the direction of good sleep habits, please follow these tips which are very important:

  • A regular bedtime routine should be followed.
  • Go to bed to sleep in night and get up in the morning at the same time every day.
  • Must take sleep for at least 7-8 hours every day
  • Keep your bedroom should be quite, dark and comfortable.
  • do not take naps during the day because it will not make you sleepy at night.
  • Do not take stimulants like tea, coffee, or nicotine in the evening because these can create
    restlessness sand sleeping problem.
  • Follow a relaxing bedtime exercise like reading book. Listening soft music, light talk with your
    partner, warm shower before to sleep.
  • Don’t smoke and take alcohol because it can affect your sleep quality.
  • Don’t go to bed with any negative thought.
  • Sleep on a comfortable bed with soft mattress and pillows.
  • If you don’t fall asleep after 20 minutes, get out of bed.
  • Exercise regularly and maintain a healthy diet.

Meditation

Meditation is a natural and easy method of treating insomnia. This will help you sleep better and can
make it easier to fall asleep. As a relaxation technique it can relax the mind and body while enhancing
inner peace. You only need to have a quiet area, sit and close your eyes and breathe slowly-Inhale and
exhale deeply. Focus on your breathing. If any thought bouncing in your mind just let it go and keep
concentrate on your breathing.
Meditation is a simple practice that can be done anytime and anywhere. It doesn’t require any special
support things only you need few minutes. You should meditate 15 minutes every morning and before
bedtime.
Meditation has huge health benefits that give you healthy lifestyle with good sleep habit. It will reduce
stress, improve concentration, and boost immunity. All these positive health signs improve insomnia and
overall sleep patterns.

Yoga

You must have healthy body and mental status to enjoy a good sleep quality. Yoga is one of the most
effective method for good quality of sleep. Alike exercise yoga also reduce stress, depression and
anxiety.
You should follow correct and appropriate yoga style that will help you to boost your energy and health
which will results in good sleep quality. Here is best five yoga poses which you should perform before
bedtime and this will help you to relax and get sleep and feel refreshed in the morning.

  • Supta Jaṭhara Parivartānāsana
  • Balasana
  • Supta Baddha Konasana
  • Viparita Karani
  • Savasana

Yoga is the most fruitful way for better sleep every night. Anyone who is suffering with insomnia will
find relief with yoga practices. Regular practice of yoga will give your benefits of Reduce Stress,
Depression and Anxiety, will relax your mind and muscles and improve your breathing.

Relaxation

Relaxation
Relaxation means to calm the body and mind. Once your body is properly relaxed and calm, you will fill
peace inside you. Relaxed body can sleep better than tired body. The objective of getting relaxed is to
have physical and mental relaxation. Relaxation technique reduce your physical and mental tension and
slow down the thought processes which can affect your sleep. If your insomnia is caused due to high
stress or depression you must take proper relax to come out of it.
You can follow below tips anytime and anywhere to get relaxation:

  • Sit or lie down in a comfortable position and lose your body.
  • Don’t think more anything and leave your physical tension.
  • Can have shower with warm water also can do swimming.
  • Listen soft and soothing music.
  • Inhale deeply through nose, hold for a while and exhale through your mouth.
  • Keep your eyes close during breathing and feel light body and calm.
  • Must do breathing exercise or have some massage which will make you feel relaxed and light.
  • Also you can watch some laughter videos for this.

Exercise

Exercise boosts overall health. It will enhance your mood, create lot of fresh energy, helps in weight loss,
and promote healthy sleep. Try to exercise at least 20-30-minute every morning and keep follow this
routine. It will help you to reduce symptoms of insomnia and also depression and anxiety.
To have benefits of exercise you should seriously follow exercise routine for 20-30 minutes every day.
You can add some heavy or aerobic exercise in your routine.

When to consult a Doctor?

If your symptoms persist more than couple of weeks, consult your doctor. Persistent insomnia could also
be the reason of an underlying health concern. This includes:

  • diabetes
  • asthma
  • arthritis, chronic pain
  • thyroid disease
  • cardiovascular disease, heartburn
  • musculoskeletal disorders
  • kidney disease
  • neurological disorders
  • respiratory problems
  • hormonal changes related to menopause

Prescription and over-the-counter medications can also affect your sleep quality. If this left untreated, it
can increase your risk for:

  • anxiety
  • depression
  • heart failure
  • high blood pressure
  • substance abuse

Your doctor will assist you to let you know the main cause and will treat the disorder with the best and
more appropriate method of diagnosis.

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