Sleep Disorders 101: Insomnia

Insomnia develops in one of every four Americans each year, but despite its prevalence among the general population, insomnia continues to be vastly underdiagnosed. As explained in a 2016 study, patients should be screened for insomnia consistently as they age, as aging and diabetes are most commonly associated with insomnia symptoms.

And while aging is a very broad risk factor, screening is important to tackling insomnia head-on as 27% of insomniacs don’t realize they have the condition. 

Considering insomnia is such a widely documented sleep disorder, it’s fair to wonder how this is possible—but insomnia is a bit more complex than simply having it or not. See, 30-35% of people suffer from mild insomnia, meaning that their symptoms aren’t as obvious as someone who suffers from moderate or severe insomnia. On top of that, individuals can suffer from acute (short-term affliction) or chronic insomnia (long-term affliction).

Regardless of where one may fall on the insomnia spectrum, getting diagnosed is essential to getting on a path to effective treatment. Even with mild insomnia, a sufferer may continue to experience symptoms two years after the initial point of diagnosis. 

Has this gotten you thinking about those sleepless nights and exhausting mornings? Read on to see if you’re one of the 70 million Americans affected by insomnia. 

Do I Have Insomnia?

Insomnia can be experienced in three degrees of severity: mild, moderate, or severe. Insomniacs on the milder side of the spectrum may not experience a significant impact on their social functioning or work productivity, but as the severity increases, insomniacs can become crippled by conditions.

The challenge for those who have suffered from mild insomnia consistently throughout their lives is pinpointing the normal from what’s actually not normal and maybe having adverse health consequences.

Mild insomniacs report receiving inconsistent sleep—they may great sleep for a few days and then fall into a bout of restless sleep, which brings on the following symptoms:

• Restlessness 
• Irritability 
• Mild anxiety 
• Daytime fatigue 
• Consistent tiredness 

For insomniacs who suffer from moderate or severe insomnia, it’s obvious that there is an issue because they experience a significant impact on their personal and professional lives. They experience all of the above symptoms but to a more severe degree.

Moderate insomniacs report almost never experiencing a good night’s rest and can feel the impacts of their sleep deprivation in all aspects of their lives.

 Severe insomniacs may feel completely suffocated by this disorder. On top of having trouble sleeping each and every night, there will also be noticeable differences in their ability to maintain relationships and stay on top of their work duties. 

Other important specifics about insomnia: 

• You may be diagnosed with insomnia if your sleep problems persist for at least a month. 

• Insomnia may lead you to become anxious about sleep, exacerbating insomnia-induced anxiety.

• There isn’t a specific test that can be done to diagnose insomnia—it’s fully diagnosed based on patient-experience. The exception is if insomnia is an underlying condition of another serious sleep disorder, such as obstructive sleep apnea or narcolepsy.

You can also suffer from chronic or acute insomnia:

• Chronic: A person with chronic insomnia consistently suffers from their insomnia for at least three nights a week, for three months, on a cyclical basis. 
• Acute: Typically lasts a maximum of three months and stems from a stressful life event. As you recover from the event that triggered insomnia, symptoms should also begin to subside. 

Treatment For Mild Insomnia

If you suspect that you have mild insomnia, it is important to talk to your doctor and not ignore your symptoms. Insomnia, in any form, can be an indicator of a much larger, and potentially more serious, health issue. Luckily, for those who do have mild insomnia, there are some basic steps you can take to try and improve your sleep. 

• Don’t nap during the day. Naps can offset your already precarious sleep schedule. Instead, plan to start getting ready for bed earlier than you already do and set an alarm at the same time every morning—even on the weekends. While getting up “early” on the weekends can be difficult, it’s important to maintain a consistent sleep and wake regiment until you start getting quality sleep.
• Exercise earlier in the day versus in the evening. Being active can affect when we’re able to fall asleep. How? By working out in the evening, our biological clock starts to think we want to be more alert in the evenings. By exercising in the morning or early afternoon, we’re keeping a schedule that promotes our brain slowing down in the evenings and our body releasing the sleep-hormone melatonin before bed.
• Your diet is intrinsically linked to your sleep health. Consume a balanced diet of sleep-promoting foods. Avoid caffeine starting at least six hours before bedtime, avoid drinking alcohol too late in the evening, and limit dense, heavy foods directly before bed. 
• Your bedroom should be exclusively for intimacy and sleep. Working in bed/in your bedroom has been shown to be detrimental to our sleep health. Separate those spaces. 
• Avoid screen usage right before bed. The blue light emitted by electronic devices keeps our brains active. Instead, take a bath, read, or journal directly before bed. 

According to the Mayo Clinic, certain forms of alternative medicine have also been shown to improve sleep:

• Melatonin, which can be found at most groceries, pharmacies, and markets is a natural sleep hormone our body needs to have a regulated sleep cycle. While taking over-the-counter melatonin may improve our sleep that evening, it’s not considered a long-term solution for insomnia. 
• Acupuncture is a traditional Chinese medicine used to treat pain and help with stress management. For insomniacs, this can help alleviate the stress that can leave our brains “running” from thought to thought when we lay down to sleep. Again, while acupuncture can temporarily relieve insomnia symptoms, it’s not a long-term solution. 
• Yoga and Tai Chi are two stress-relieving practices that have been shown to improve sleep. Both practices relax the body, lower blood pressure and reduce anxiety. 
• Meditation is full of benefits –not only is it shown to improve sleep, but it can also help control chronic pain, reduce anxiety, improve memory and attention span, and lower blood pressure. 

Treatment for Moderate and Severe Insomnia 

While all the above suggestions are great for anyone suffering from insomnia, for those that suffer moderately and severely from insomnia, non-pharmacologic therapies and pharmacologic therapies may be necessary. 

• Stimulus Control Therapy: According to a 2010 NCBI study, “Stimulus control therapy is based on the premise that insomnia is a conditioned response to temporal (bedtime) and environmental cues that are usually associated with sleep.” In this form of therapy, the patient retrains their brain to associate their bed and their bedroom with sleep. 
• Sleep Restriction Therapy: The same 2010 study defines sleep restriction therapy as a therapy that “…consists of restricting the amount of time spent in bed to nearly match the subjective amount of time spent sleeping.” Only sleeping five hours each night? That’s the amount of time you’re allowed in bed. By restricting sleep, sleep deprivation is slowly induced, causing the person to sleep more heavily when they do get into bed.
• Relaxation Therapy: For some insomniacs, not only are their brains going nonstop during the day but at night as well—their arousal systems are constantly going. Relaxation therapy targets this. 
• Cognitive Therapy: As mentioned above, some insomniacs begin to develop anxiety around their bed, bedroom, and sleep. Cognitive therapy’s aim is to break down the negative thinking around sleep and the sleep environment. 
• Paradoxical Intention: This form of therapy works best on individuals who experience performance anxiety around sleep. The patient, instead of fixating on falling asleep, is encouraged to stay awake. Over time, this will change the way they think about sleep and the anxiety around sleeping.

All of the above therapies are best practiced under the supervision of a therapist, sleep physician, and/or general practitioner. Attempting to partake in any of these therapies alone or without the guidance of a professional may result in the insomniac’s symptoms worsening. 

Insomnia doesn’t have to be your normal. If you’re ready to take that next step to regain control of your sleep, click here to make your appointment.