Insomnia

Insomnia Definition

Insomnia is a common sleep disorder characterised by the inability to sleep. Specifically, we can define insomnia as:

The causes of insomnia vary and can be psychological and physiological from a clinical perspective. Psychologists consider insomnia a primary disorder in that insomnia is the issue and is the cause of the lack of sleep.

Types of Insomnia in Psychology

As insomnia is diagnosed, it can be acute or chronic. These are two types of insomnia.

Acute insomnia lasts for a short period, usually a few days or weeks, whereas chronic insomnia lasts for months, possibly even years.

Sleep Onset Insomnia and Sleep Maintenance Insomnia

Insomnia can manifest itself in a number of ways. Sleep onset and sleep maintenance insomnia differ.

Insomnia Symptoms

Symptoms of insomnia tend to focus on a lack of sleep and an unstable night of sleep. Insomnia symptoms include:

• Issues with falling asleep
• Difficulty staying asleep
• Waking up frequently when asleep
• After sleep, not feeling refreshed or rested
• Difficulty napping
• Feeling tired during the day, fatigued
• Problems with attention, motivation, and ability to concentrate
• Potential mental health repercussions, such as depression and anxiety

Insomnia can impact your health in different ways beyond affecting your ability to sleep, feel refreshed and concentrate. Those with chronic insomnia have higher risks of developing heart issues, a higher risk of becoming overweight, and higher chances of having a stroke, having memory issues, and developing diabetes.

It can be challenging to fall asleep for those with insomnia, freepik.com²

Consider the above example. If Jerry were to see a professional about his issues, they would likely suggest he has insomnia. Would Jerry be suffering from acute or chronic insomnia?

Insomnia Causes and Explanations

The causes and explanations of insomnia vary. Many reasons link back to lifestyle choices, suggesting our daily habits and activities affect our ability to fall asleep.

The nervous system is involved in sleep. When we are stressed and danger is present, the sympathetic nervous system (SNS) responds and readies the body for action by releasing hormones and flooding your system, often reducing normal bodily functions to divert energy to more pressing concerns.

When we are relaxed or the danger has passed, the parasympathetic nervous system calms the body down and allows normal functions, such as digestion, to resume.

Issues can arise when the SNS is activated at inopportune times, for example, being anxious before you sleep.

To combat issues with the nervous system when you are trying to sleep, relaxation techniques can be used to calm yourself down and allow the parasympathetic nervous system to do its job and bring you back to a state of equilibrium. These include:

• Deep breathing exercises
• Meditation techniques
• Having good sleep hygiene (reducing noise, light, and other sources of stress and anxiety in the bedroom)

Let's explore some of the other causes of insomnia:

• Caffeine is a stimulant that makes you feel more awake. If you drink caffeine during the day, it can affect your sleep pattern.
• Alcohol lowers the amount of REM (rapid eye movement) sleep you get during the natural sleep cycle (stages one through four and REM sleep). REM is essential to your sleep cycle and is crucial in retaining memories.
• Medications such as antidepressants can affect sleep, although this depends on the type of antidepressant a person takes. Some have sedative-like effects and can improve sleep. However, some have activating effects that disrupt sleep and worsen insomnia-like symptoms in those with depression (Wichniak et al., 2017).
• Cigarettes impact sleep as nicotine, like alcohol, is a stimulant, making your heart beat faster and facilitating communication between the brain and body. Cravings may be strong enough to rouse a person from sleep or be frustrating enough to make it difficult to fall asleep.

• If you are a frequent traveller, especially if you travel overseas via planes, jet lag can significantly impact your sleep-wake cycle.
• Working a night shift, for instance, if you are a nurse or doctor, can disrupt the sleep-wake cycle. Frequent night shifts can induce insomnia and even facilitate the development of other disorders, such as depression and anxiety. Some even have issues with chronic pain (Vallières et al., 2014).
• Poor sleep routines can affect your ability to sleep and may result in insomnia. The sleep-wake cycle runs on a circadian rhythm (24-hour cycle), and interruptions or delays to the biological clock your body runs on can impact your sleep.
• The environment in which you sleep can impact the ability to fall and stay asleep. Without adequate shading from light, for instance, if you use your phone frequently on a night or live close to a bright street light, you may struggle to fall asleep. Loud noises, such as car horns or city living can also negatively affect your sleep and potentially cause issues with insomnia. Watching television in your bedroom can cause your brain to associate the bedroom as a place to have fun and engage in activities in, rather than a place to sleep.

• Depression is associated with difficulty sleeping. As neurotransmitter dysfunction is closely linked with depression, difficulty sleeping and falling asleep is a natural consequence. One of the major symptoms of depression, fatigue and exhaustion, is also associated with insomnia. Depending on the medications those with depression take, as mentioned above, certain SSRIs (selective serotonin reuptake inhibitors) can have a stimulant effect and reduce sleep quality.
• Poor health can impact sleep, especially if it impacts the heart. According to the British Heart Foundation (BHF), around 44% of those with heart and circulatory issues struggle with sleep. Those with chronic pain issues often have issues with insomnia.
• Stress can instigate anxiety in a person and reduce their ability to fall asleep due to worrying, as cortisol, the stress hormone, wakes us up and gets us ready to move and run if necessary. Worrying and panicked thoughts can be particularly potent at night.

Lifestyle choices can impact the development of insomnia, freepik.com³

Insomnia Treatment: Sleep Hygiene

There are various ways to treat insomnia, and the efficacy of each treatment depends on the individual. One medication may be effective in person A but not very effective in person B.

Treatment options include:

• Sleep medication
• Therapy
• Mindfulness and meditation techniques
• Exercise
• Reducing caffeine, alcohol, and nicotine intake
• Reducing phone and electronic usage before bed
• Designate the bedroom for sleeping and associated activities only
• Have comfortable bedding, and a clean environment to sleep in
• Sleep in a place with a good, comfortable temperature for you
• Reduce sources of light and noise around the bedroom