Learning to understand insomnia so you can sleep easy again


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Insomnia is no fun. It's all too easy to feel alone when you're wide awake in the wee small hours but, according to some sources, around 60 million Americans are regularly affected by sleepless nights with women and older adults being most prone to the condition. What causes insomnia and how can you best go about settling into a happier routine?


Depression and anxiety

At one time or another, having something on their mind can cause anyone the odd restless night. But when worry or stress interferes with sleep on a regular basis, anxiety-based insomnia can become a significant problem. It's a sad fact that a large percentage of those who experience prolonged insomnia do so because they are suffering from the psychological burden of worry or stress. According to the National Sleep Foundation (NSF) anxiety and depression are two of the biggest causes behind chronic insomnia. And the not getting enough sleep can then make the depression worse still. The NSF says: "sleep problems may represent a symptom of depression, and the risk of severe insomnia is much higher in patients with major depressive disorders." What can end up feeling like the inevitability of another sleepless night can feed into anxiety, worsen depression and so create a cycle of insomnia. Though there is a proven link between depression and insomnia, they say, both conditions are treatable.


Medical problems

Some medical problems are an obvious cause of insomnia: asthma, eczema, arthritis, allergies, hyperthyroidism, acid reflux, kidney disease, cancer or any kind of physical pain. The lack of sleep may be a symptom of a disease itself or other symptoms of the condition — as with chronic back pain — may cause vital hours of sleep to be missed. Of course, lying there worrying about a real or imagined illness won't help, either. If any aspect of your health is keeping you awake, talk to someone — it might just put your mind at rest.



As well as medical conditions, medications themselves can cause insomnia. Over-the-counter decongestants and diet pills can contain caffeine, which is a surefire way to miss out on the zees. However, according to AARP, insomnia can affect patients using medications for many more serious conditions, including hypertension, inflammation of the blood vessels, coronary heart disease and heart failure treatments, depression, dementia, allergies and joint and muscle pain. If you suspect any of your medications are causing insomnia, do not change your prescribed dosage. Discuss your concerns with your doctor and find out if there are any alternative treatments he or she can recommend.


Environment and routine

As the figures for depression, worry and anxiety might suggest, a lot of the battle for sleep is in the head. Being in a relaxing place is half the battle when it comes to successfully nodding off. Switching off the mind is just as important as calming the body. It should be no eye-opener that a poor sleeping environment will result in equally poor sleep patterns. Is your bedroom quiet and comfortable? So you can't move the revelers at the bar across the road at 3 a.m. on a weeknight — a purring air-conditioner or a white noise machine can take the edge off your soundscape. Have you removed all those distractions that can interrupt a good night's rest? You probably need an alarm to wake you up but do you need to stare at it all night counting the hours? Put it out of sight. Do you need that cellphone, primed and ready to ring? Leave it in another room — voicemail is your friend. Helpguide.org recommends that you remove all distracting items from the bedroom — yes, including that computer and TV — so that you only "associate the bedroom with sleep and sex." That way, when you enter your bedroom, your brain gets the right signal and knows exactly what's on your mind.


Combating insomnia

There are plenty of small, common sense adjustments you can make to your routine: avoid caffeine after the early afternoon, avoid naps during the day, avoid heavy meals and alcohol before bed, lower the lights as bedtime approaches, do something relaxing — read a book, listen to relaxing music, knit — put those thoughts of work (or whatever) out of your head. There's absolutely nothing to gain by wrestling with an issue when you should be drifting off.

The NSF recommends using a sleep diary to help identify and fix bad habits. "Some habits are so ingrained," they say, "that you may overlook them as a possible contributor to your insomnia…All you have to do is jot down daily details about your daytime habits, sleep routine, and insomnia symptoms. For example, you can keep track of when you go to sleep and when you wake up, where you fall asleep, what you eat and drink, and any stressful events that occur during the day."

There are tried and trusted methods for getting yourself into a good frame of mind for sleep. Relaxation training — where you tense and relax muscles in a progressive sequence in different areas of the body helps to calm the body and induce sleep. Some prefer other approaches including breathing exercises, mindfulness, meditation, guided imagery or more involved procedures such as cognitive behavioral therapy. If you are worried by insomnia, speak to your doctor — don't lose sleep, help is out there.