Health Tips

Do you struggle to doze off into slumberland? Or do you wake up in the middle of the night and lie awake for hours, trying to count the sheep to get back to sleep? If yes, you’re not alone. Insomnia is a very common problem that can spoil your mood, ability to function, and wreck your energy during the day. It may also have a major effect on the quality of life and mental health.

DECIPHERING MEDICAL JARGON Insomnia: A sleep disorder characterized by difficulty falling and/or staying asleep 

What are the symptoms?

Types of Insomnia

Primary insomnia: Sleeplessness that is not attributable to a medical, psychiatric or environmental cause.

Secondary insomnia: Insomnia that occurs with other conditions or situations; like emotional stress, anxiety, depression, chronic pain, certain medications, or substance like alcohol or stimulants.

What are the causes of Insomnia?

Insomnia can be acute (short-term) or chronic (ongoing). The causes are as below:

Acute insomnia:

• Significant life event (death of a loved one, loss/change of job, divorce)
• Emotional or physical discomfort 
• Acute illness (flu)
• Interferences in normal sleep schedule (rotating work shift or jet lag)
• Noise, light or extreme temperatures 
• Some medications (antihistamines for allergies, decongestants for cold, beta-blockers for high blood pressure or heart failure, antidepressants, theophylline for asthma)

Chronic Insomnia:

• Obstructive sleep apnoea
• Congestive heart failure
• Depression and/or anxiety
• Hyperactive thyroid
• Pain from chronic illnesses like arthritis
• Chronic stress 

Treatment

Non-pharmacological interventions

• Cognititve behavioural therapy: Aims to improve sleep habits and behaviors by addressing and changing the misconceptions, incorrect beliefs and attitude that affect the ability of a person to sleep well.

• Relaxation therapy: Examples include meditation, breathing exercises and yoga
• Good sleep hygiene. The do's and don'ts of beating insomnia are as below:

Do’s:

• Maintain a sleep schedule; sleep at the same time each night and get up at the same time each morning
• Limit naps to less than 1 hour per day
• Exercise regularly, at least 30 minutes per day. Ensure not too close to bedtime.
• Establish a good and comfortable sleeping environment. Be sure that the bedroom is dark, quiet, and cool.
• Follow a routine to help you relax before sleep. Read a book, listen to music, or take a warm bath.
• Use the bedroom only for sleep and intimacy

Don’ts:

• Avoid prolonged use of phones or reading devices (such as e-books) before bed.
• Avoid caffeine, nicotine and alcohol late in the day. 
• Avoid heavy meals late in the day.
• Avoid late afternoon naps (beyond 3pm)
• Avoid lying in bed awake. If you are worry about things, make a to-do list before you go to bed. This may help you to not focus on those worries overnight.

Pharmacological interventions

Several medications can help to relieve insomnia and re-establish a regular sleep schedule. Some are meant for short-term use, while others are meant for longer use.  

• Melatonin
• Benzodiazepines
• Selective hypnotics
• Barbiturates

However, remember to ask your doctor about the benefits and risks of insomnia medications as some may have some undesirable side effects.

By addressing the underlying causes and making simple changes to your sleeping habits, lifestyle and dietary modifications — you can put the frustration of insomnia to a stop and finally get a good night’s sleep.

References:

1. Insomnia: What to Do When You Can't Sleep | Help Guide
2. Why Can’t I Sleep? Insomnia — Both Acute and Chronic — Explained | Everyday Health
3. Insomnia | NIH 

Image credit:

1. https://amp.insider.com/images/577ba293dd089512128b46bd-750-500.jpg
2. https://cdn.psychologytoday.com/sites/default/files/blogs/34240/2013/10/135431-135386.jpg
3. https://www.vectorstock.com/royalty-free-vector/insomnia-common-symptoms-vector-12283244
4. https://miro.medium.com/max/1838/1*EhRAuLMN1ztjK3qMWup52A.jpeg
5. https://pbs.twimg.com/media/Bs2pCznCUAAqjLQ.png:large
6. https://i0.wp.com/images-prod.healthline.com/hlcmsresource/images/News/6050-woman_reading_phone_night-1296x728-header.jpg?w=1155
7. https://assets.firstbeat.com/firstbeat/uploads/2018/05/sleep-in-elite-sports-header-1300x754.jpg

Written by

Dr Amirah Ekhsan