Insomnia: Causes, Signs in Adults, Complications, Diagnosis

D

Medically reviewed by

Dr. Kavita Bhargva

General Health

12 min read

Key Takeaways

  • Insomnia is a sleep disorder which makes it troublesome for a person to fall asleep or maintaining sleep
  • It is essential to resolve the transient sleeping disorder before it turns out to be a chronic problem
  • If you think your insomnia is not getting any better by any means, it is best to approach a doctor who can help diagnose

Not long time back, people were not aware of this medical condition ‘Insomnia’ until lately when everyone not just knows about it but has faced it sometime or the other. Reasons can be many like; Stress, health conditions, relationship issues, mental ailments, poor habits and lifestyle can be the culprit behind sleeping disorders. Are there effective ways to manage Insomnia? What can be the complications of long-term insomnia? Let’s find out.

What is Insomnia?

Insomnia is a sleep disorder which makes it troublesome for a person to fall asleep or maintaining sleep. People often complain of waking up often during the night and having trouble going back to sleep and having sleep that is not refreshing. It can be Acute (short-term) that lasts for days or weeks or Chronic (long-term) that lasts for a month or more. It not just saps the energy but can affect overall health, performance level and quality of life.

Types of Insomnia

Primary Insomnia

It means that the patient's sleep issues is unrelated to any other medical conditions or issues.

Secondary Insomnia

This refers to sleep issues brought on by a medical condition (such as asthma, depression, arthritis, cancer, or heartburn), pain, medication, or substance abuse (like alcohol).

Some Other types you may hear about are:

Sleep-Onset Insomnia

In sleep-onset Insomnia, the patient experiences difficulty falling asleep.

Sleep-Maintenance Insomnia

This occurs when the patient has problems falling asleep or staying asleep at night.

Mixed Insomnia

It makes it difficult for the patient to fall asleep and stay asleep all night.

Early Morning Awakening Insomnia

It refers to waking up much earlier than desired or anticipated.

Paradoxical Insomnia

In paradoxical Insomnia, you overestimate the time you spend sleeping. As a result, you appear to sleep much less than you do.

Short-Term Insomnia

It often known as acute or adjustment insomnia. A stressful event, such as the death of a family member or loved one, a troubling medical diagnosis, a pandemic, etc., is frequently the root cause of short-term sleeplessness.

Chronic Insomnia

Chronic Insomnia is a pattern of persistent difficulties falling asleep. If a person has difficulty getting sleep or staying asleep at least three evenings a week for three months or more, their Insomnia is considered chronic.

what is insomnia

Symptoms of Insomnia

There can be one or multiple signs and symptoms indicating Insomnia:

  1. Difficulty in falling asleep at night.
  2. Waking up frequently during the night.
  3. Unrefreshing sleep and feeling tired after waking up.
  4. Waking up too early than desired.
  5. Frequent mood swings
  6. Daytime fatigue or sleepiness.
  7. Irritability, depression, or anxiety.
  8. Difficulty in concentrating and focusing on tasks or remembering.
  9. Tension headaches (feels like a tight band around the head).
  10. Grumpiness
  11. Increased errors or accidents
  12. Ongoing worries about sleep

What Causes Insomnia?

Whether it is primary or secondary, there can be many causes to insomnia. Treating the underlying problem can resolve insomnia, else it can become chronic or lead to further complications.

The common causes are:

Stress:

The most common cause of insomnia is stress. It can be concerning your work, family, finances, health, loss of loved one, or relationship issues.

Poor sleeping habits:

Exposure to blue-light from televisions and smartphones before sleep affects natural melatonin levels and leads to increased waiting time to sleep. Uncomfortable sleep environment such as noise, too high or low temperature or varying lighting, along with irregular bedtime routine, daytime naps, or simply eating a heavy meal just before bedtime can lead to improper and light sleep.

Disruption of your body's circadian rhythms:

Can occur due to drastic temperature changes, jet lag, frequently changing shifts, etc.

Medications:

Corticosteroids, statins, alpha-blockers and beta-blockers, certain antidepressants etc. can lead to secondary insomnia.

Medical conditions:

Cardiac conditions such as congestive heart failure and angina, Respiratory conditions such as chronic obstructive pulmonary disease (COPD) and asthma, Endocrinal disorders such as hyperthyroidism, chronic pain, stroke, brain lesions, tumours, sleep apnea, etc can contribute to insomnia. Not only physical conditions, but Neurological conditions such as Parkinson’s and Alzheimer’s diseases, and Psychological issues such as depression, anxiety disorders, or psychotic disorders can also cause insomnia.

Substance use:

Caffeine, tobacco, drugs or alcohol use

Risk Factors For Insomnia

Insomnia can affect people of any age, but there are certain risk factors which makes the condition more susceptible to some than others:

Women:

Insomnia is more common in women than men, as they suffer from hormonal changes during menstrual cycles, pregnancy and menopause.

Old age:

Chances of insomnia increases with age due to changes in health conditions and sleep patterns.

Mental health issues: Depression, anxiety disorders and other such mental ailments can lead to sleep disruption.

High levels of stress:

An unfortunate event or stressful times can lead to temporary insomnia. Long term stress can make it a chronic one.

Not having a routine schedule:

Having a job involving changing shifts can disrupt your sleeping cycle.

Physical ailments:

Health conditions such as asthma, cancer, arthritis, heartburn etc. can lead to troubled sleep.

Diagnosis

Your doctor may do a physical examination to find out the underlying problem of your insomnia symptoms. He may also ask about your medical and sleep history and advise you to keep a sleep diary to analyse sleep patterns. Other tests might be advised to rule out certain medical conditions.

Direct diagnostic tests for Insomnia don't exist. Instead, testing aid in ruling out other illnesses that have symptoms that are comparable to sleeplessness. The following are the likely tests:

Polysomnography

A sleep study is a diagnostic procedure that involves monitoring several bodily systems while you sleep. Your brain, heart, respiration, and other important bodily functions are monitored. This test doesn't hurt and often takes one night to finish. This test is also quite popular and can be used to identify a variety of sleep-related illnesses.

Actigraphy

This test requires you to wear a gadget that looks like a watch and tracks your sleep habits to determine whether you have a sleep cycle that differs from conventional. To diagnose abnormalities of the circadian rhythm, you must do this.

Multiple sleep latency test (MSLT)

This test determines whether a subject has a propensity for daytime sleepiness. It's frequently important for a narcolepsy diagnosis.

Another testing may also be recommended depending on your symptoms and other considerations. Again, your healthcare provider is the best person to inform you what tests they advise.

How Does Insomnia Affect Pregnancy?

Insomnia during pregnancy can be common, particularly during the first and third trimesters. The following are the reasons for Insomnia during pregnancy:

  • Physiological modifications such as hormone shifts
  • Nausea
  • An urgent need to urinate
  • Increased tension and worry about the growing number of obligations you'll have as a new parent
  • Discomfort in the form of cramps and back pain

The good news is that pregnancy-related Insomnia causes no negative effects on the growth of your unborn child and goes away eventually. But getting the proper quantity of sleep is crucial for your health in general.

Causes of insomnia due to lifestyle changes in pregnancy include:

  • Engaging in regular exercise
  • Eating a balanced diet, drinking plenty of water, maintaining a regular sleep pattern, and using relaxation techniques throughout the day can all help reduce anxiety and encourage peace
  • A warm bath and some light yoga before going to bed

Before beginning any new workout regimens, drugs, or supplements, to treat it during pregnancy, make sure they are safe for use by consulting your healthcare team.

How Does Insomnia Affect Children?

The causes of insomnia in children are the same as in adults. Some of these reasons could include:

  • Prescription drugs for stress
  • Excessive coffee consumption
  • Physical or mental health issues
  • Your child may have Insomnia if they routinely wake up too early, have problems going to sleep or remaining asleep, or both.

Frequent Symptoms Include:

  • Daytime drowsiness or unrest
  • Angry behavior and mood swings
  • Persistent disciplinary problems
  • Issues with focus and memory
  • Setting a strict bedtime and sticking to it is typically the first step in addressing Insomnia in children.

Other Beneficial Habits Could Be:

  • Establishing a relaxing night ritual
  • Practising good sleep hygiene, such as limiting screen time before bed
  • Lowering the stressors in your child's life
  • Further information on how to treat children's sleeplessness can be obtained from a therapist or pediatrician.

How Does Insomnia Affect Adults?

Up to 75% of older persons, according to 2019 research, suffer from certain insomnia symptoms. [1] The following could be the reasons for Insomnia affecting older adults:

  • It may be more challenging to fall asleep or stay asleep as you become older because of changes in the circadian rhythms that control your sleep-wake cycle
  • If you're retired, it's possible that you no longer maintain a regular daily schedule or engage in consistent social activity, both of which might worsen Insomnia
  • Social isolation can exacerbate loneliness and enhance your risk of developing depression, both of which can worsen sleep issues
  • Ageing-related health issues, including chronic pain disorders, might also impact your ability to sleep
  • When you don't sleep enough at night, you may experience exhaustion and drowsiness during the day. As a result, you could feel more motivated to slumber. Of course, naps can reduce the amount of sleepiness you should feel at bedtime, perpetuating a cycle of Insomnia

A therapist or clinician can provide further assistance in locating what causes Insomnia in their patients and the best treatment alternatives.

Complications Related To Insomnia

Our body needs sleep to give chance to the organs to repair themselves from daily wear and tear. The average duration of sleep differs from a person to person, yet a minimum of 6-7 hours of quality sleep is required for every individual. Sleep is as essential as a healthy diet and exercise. People with insomnia report a lower quality of life compared with people who are sleeping well.

Few complications associated with insomnia can be:

  • Increased risk of health problems like high blood pressure, weak immune system, diabetes, inflammation, obesity, and heart disease
  • A higher risk of falling and accidents
  • Trouble focusing and memory loss
  • Anxiety, depression, disorientation
  • Lack of judgement
  • Slow reaction time
  • Lower performance on the job or at school
Additional Read: Alzheimers Disease

Prevention

It is essential to resolve the transient sleeping disorder before it turns out to be a chronic problem and leads to other complications. Here are a few tips that can help:

  • Set up a bedtime routine which should be followed even during weekends. A regular sleep-wake time helps a lot.
  • Switch off your gadgets like television, mobile or laptop at least 1 hour before sleep. Research suggests that their light affects sleep.
  • Stimulating drinks or foods should be avoided late in the day such as caffeine, nicotine, alcohol or junk foods which can cause acid reflex and disturb your sleep.
  • Keep your room tidy and comfortable in terms of lighting and temperature. Clutter in the room may be distracting. If the light is a problem, use a sleeping mask and try earplugs if noise is troublesome.
  • Regular exercise helps physically and mentally which in turn helps get sound sleep. Try to avoid exercising at least 3 to 4 hours before bed.
  • Don't eat a heavy meal late in the day. But a light snack before bedtime may help you sleep if you are hungry.
  • Relax and think positive before going to bed. Taking a bath or listening to soothing music or reading a good book can help you relax.
  • Aromatherapy can help to promote and sustain sleep. A study suggested lavender oil to be especially useful for sleep.
  • Check your medications to see if they may contribute to insomnia.

What Are The Ways To Treat Insomnia

Several methods exist for insomnia treatment, including therapy, prescription drugs, dietary supplements, and natural therapies.

Cognitive Behavioural Therapy (CBT): For individuals with chronic Insomnia, CBT is considered first-line therapy. CBT-1 is created particularly to handle Insomnia.

The following methods are used to deal with Insomnia, usually with the assistance of a therapist:

  • Stimulus Control: In this method, the patient is encouraged to get out of bed and engage in a peaceful and calming activity until you feel drowsy enough to fall asleep. This is done to reduce the amount of time you spend lying awake on your bed and stressing about going to sleep
  • Sleep restriction: This method helps you get more rest by initially limiting your time spent in bed to gradually increasing it
  • Bright light therapy: Based on whether you have more problems falling asleep or staying asleep, you would be exposed to bright light in the morning or evening.

To address habits keeping you from sleeping well, your therapist would advise you on several relaxation techniques and sleep hygiene measures. For instance, as a part of your insomnia treatment, they could advise against the following:

  • Consuming caffeinated beverages right before bed
  • Eating big or spicy meals just before bed
  • Exercising vigorously right before bedtime
  • Utilizing your bed for purposes other than sleep or sex

A therapist would also assist you in identifying the underlying various mental health concerns that cause your insomnia symptoms. Taking care of these different causes and contributors will greatly aid in reducing your insomnia symptoms.

Medicines For Insomnia

For insomnia treatment, other sleep aids that your doctor might recommend are as follows:

  • Triazolam
  • Zolpidem (Ambien)
  • Eszopiclone (Halcion)

Various supplements and over-the-counter (OTC) sleep aids like melanin are also known to help with insomnia symptoms. For example, taking melanin pills can help you fall asleep faster since your body naturally creates the same hormone during your sleep cycle.

Lifestyle changes and home remedies that aid in the treatment of Insomnia

Often, home remedies for insomnia and lifestyle modifications can help control the symptoms of sleeplessness. For insomnia treatment, you could try the following:

Natural Sleep Aids

Before going to bed, try warm milk, herbal tea etc. Light yoga is also known to be beneficial. Lavender and other calming scents also have some advantages.

Aromatherapy

To help relieve the symptoms of various diseases, people frequently inhale these oils or massage them into their skin. The name of this practice is aromatherapy. Your chances of successfully using aromatherapy increase by picking the proper essential oil. The following essential oils are thought to encourage sound sleep:

  • Chamomile
  • Cedarwood
  • Bitter orange
  • Neroli
  • Sandalwood
  • Lavender

Meditation

Meditation does more than facilitate better sleep and makes falling asleep simpler. Also, it can aid in the reduction of pain, tension, and anxiety—all of which may contribute to Insomnia. You can start practicing meditation with the aid of many applications.

Acupuncture

Many have found relief from sleeplessness with the help of conventional Chinese medicine procedures in which tiny needles are inserted into pressure points throughout the body.

If you think your insomnia is not getting any better by any means, it is best to approach a doctor who can help diagnose the root cause of the problem. It is best to act fast before it turns into a chronic problem.

Find the best doctor for the job on Bajaj Finserv Health. Locate a Neurologist near you in minutes, view doctors’ years of experience, consulting hours, fees and more before booking an e-consult or in-person appointment. Apart from facilitating appointment booking, the Bajaj Finserv Health also offers health plans for your family, medicine reminders, healthcare information and discounts from select hospitals and clinics.

Published on 15 Jul 2020Last updated on 7 Apr 2023

Please note that this article is solely meant for informational purposes and Bajaj Finserv Health Limited (“BFHL”) does not shoulder any responsibility of the views/advice/information expressed/given by the writer/reviewer/originator. This article should not be considered as a substitute for any medical advice, diagnosis or treatment. Always consult with your trusted physician/qualified healthcare professional to evaluate your medical condition. The above article has been reviewed by a qualified doctor and BFHL is not responsible for any damages for any information or services provided by any third party.

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