Sleep

4. What is Insomnia?

Types

There are two types of insomnia. They are:

  • Short-term insomnia: This type of brief insomnia lasts for up to three months. It occurs in 15 to 20 percent of people.
  • Chronic insomnia: This type of insomnia occurs at least three times per week and lasts for at least three months. About 10 percent of people have chronic insomnia.

Causes

There are many causes of insomnia. These include:

  • Stress. This varies from relatively minor things like work or personal stress, to more severe changes such as death, divorce or job loss.
  • Other sleep disorders. Some sleep disorders can cause insomnia or make it worse. For instance, people with restless legs syndrome or obstructive sleep apnea may have a hard time falling or staying asleep
  • Medical Conditions. Many physical illnesses can cause insomnia. People who experience pain, discomfort or limited mobility from medical problems may have difficulty falling asleep or staying asleep.
  • Mental Disorders. Depression is one of the most common mental illnesses in the United States and a frequent cause of insomnia. People with depression often have trouble falling asleep or staying asleep. Difficulty falling asleep is also common in people with anxiety disorders. Other mood disorders such as bipolar disorder may also cause sleep problems.
  • Medication or substance use or abuse. Insomnia can be an unwanted side effect of many prescription or over-the-counter medications. Common cold and allergy medicines contain pseudoephedrine and can make it difficult to fall asleep. Antidepressants and medications to treat ADHD, high blood pressure or Parkinson’s disease can also cause insomnia. Drinking alcohol before bedtime can cause frequent awakenings during the night. Insomnia also can occur if you suddenly stop using a sleeping pill. Caffeine and other stimulants can prevent you from falling asleep. Stimulants also cause frequent awakenings during the night. Some people are sensitive to certain foods and may be allergic to them. This can result in insomnia and disrupted sleep.
  • Environmental factors. Disruptive factors such as noise, light or extreme temperatures can interfere with sleep. Sleeping with a bed partner who snores also can cause sleep disruption. Extended exposure to environmental toxins and chemicals may prevent you from being able to fall asleep or stay asleep.
  • Habits or lifestyles. Irregular sleep schedules such as those seen in shift workers can cause insomnia in workers who try to sleep during the day.

Young Adults

Young adults are still in developmental stages and require more sleep than a grown adult—usually a little over 9 hours per night. Insufficient sleep during this critical growth period arises from physiological, behavioral, sociocultural, and environmental changes. These changes include but are not limited to:

Hormonal time shift and early school start times

Hectic after school schedule

Leisure activities

Light exposure

Social attitudes

Sleep Disorders

Older Adults and Elderly

Insomnia due to medical conditions is most common in older adults because people tend to have more chronic health problems as they age. As you age you are more apt to experience physical, psychological, social, and situational changes and conditions that can wreak havoc with your sleep. These can become key causes for elderly insomnia and they include:

  • Menopause or other hormonal changes
  • Changes in brain activity
  • Changes in natural sleep patterns
  • Medication and ailments
  • Social changes
  • Anxiety/Depression

Pregnancy

You may lose sleep during pregnancy for a variety of reasons to include but not limited to:

  • Discomfort due to the increased size of your abdomen
  • Back pain
  • Heartburn
  • Frequent urination during the night
  • Anxiety
  • Anticipating the arrival of your baby
  • Frequent and Vivid Dreams
  • Hormonal changes

Whatever the reason may be, it is important to understand that insomnia is not harmful to your baby. Insomnia during pregnancy is normal and affects approximately 78% of pregnant women.

Insomnia and Night Sweats (Menopause)

Sleep can be impacted by many things, such as hormonal and lifestyle changes.

  1. Hormonal changes . During the course of perimenopause through menopause, a woman’s ovaries gradually decrease production of estrogen and progesterone, a sleep-promoting hormone. This shift contributes to the inability to fall asleep. Also, waning levels of estrogen may make you more susceptible to environmental and other factors/stressors which disrupt sleep.
  2. Hot flashes . A hot flash is a surge of adrenaline, awakening your brain from sleep. It often produces sweat and a change of temperature that can often be disruptive to sleep and comfort levels. Unfortunately it may take time for your adrenaline to recede and let you settle down into sleep again.
  3. Depression/Mood Swings . About 20% of women will experience depression during this time frame and some cases have been linked to estrogen loss. However, hormonal changes may not be the only cause.
  4. Coincidental Social Issues . Aside from the hormonal changes you may be experiencing, this time in life can present many social changes. Whether your children are moving out of the house, retiring, moving to a smaller home or you are just feeling some of the “midlife crisis” stress of getting to a new phase in life, these issues can interfere with your ability to sleep.

Since hormonal and social issues are at play, it is important for you to be in touch with how your sleep is impacted by this transitional period. The perimenopaual period may last from 3-10 years.

Symptoms

  • Fatigue
  • Problems with attention, concentration or memory (cognitive impairment)
  • Poor performance at school or work
  • Moodiness or irritability
  • Daytime sleepiness
  • Impulsiveness or aggression
  • Lack of energy or motivation
  • Errors or accidents
  • Concern or frustration about your sleep