The Facts About Insomnia

Insomnia is a common disorder characterized by difficulty falling or staying asleep. If untreated, insomnia can have serious long-term effects on your health, such as hindering cognitive function and leading to an overall decreased quality of life.

Frequently cited estimates, including some published in the Journal of Clinical Sleep Medicine, place the prevalence of insomnia at about 10 percent to 30 percent of the world's population. Some studies place this number as high as 60 percent. While people of all ages can suffer insomnia, it's more common in older adults, women and people with physical and mental health issues.

Insomnia can be acute (short term) or chronic (long term). Acute insomnia is typically caused by an event, such as work stress or the loss of a loved one. Chronic insomnia usually has a secondary cause, such as another medical or psychological issue.

Causes of insomnia may include anxiety, depression, post-traumatic stress disorder (PTSD), headaches,restless legs syndrome and, in women, symptoms of menopause. Some medications, such as cold medicines, may also cause insomnia, as can the use of caffeine, tobacco and alcohol.

Some studies have suggested exposure to computer or smartphone screens late at night may also contribute to insomnia.

Many common prescription and over-the-counter medications can lead to insomnia. Medicines most commonly associated with insomnia include:

• Alpha blockers. These drugs treat high blood pressure and prostate problems. They can keep you from getting enough deep REM (rapid eye movement)sleep and make you feel tired during the day. (REM sleep is a deeper-level sleep.)
• Beta blockers. These drugs treat high blood pressure, heart rhythm problems and chest pain. They also appear to lower your body's level of melatonin, a hormone that helps control your sleep cycle. Beta blockers are also associated with waking up at night and nightmares.
• Antidepressants. Selective serotonin reuptake inhibitors (SSRIs) are a specific type of antidepressant that increase your brain's serotonin levels, which improves mood. SSRIs (such as the brands Prozac and Zoloft) are often effective against depression, but can also make it difficult to fall asleep and stay asleep.
• Asthma medications. Theophylline, an asthma drug that is used to reduce inflammation and aid in clearing airways, can make you jittery and sleepy during the day, as can bronchodilators (such as albuterol and levalbuterol) used for asthma rescue. Prednisone and other corticosteroids are widely administered for asthma and can contribute to insomnia.
• ADHD medications. Attention-deficit/hyperactivity disorder (ADHD) is typically treated with stimulants (such as the brands Dexedrine and Ritalin) that increase alertness. However, these drugs can also lead to insomnia. Once people on these drugs are able to fall asleep, they may spend more time in non-REM sleep.

Hormones are chemical messengers essential to controlling the body's numerous processes, including the sleep-wake cycle. Progesterone, estrogen and testosterone are a few hormones that may be involved in sleeplessness. Premenstrual, pregnant and menopausal women are especially impacted. However, when hormone levels return to normal, sleep issues usually go away.

Getting insufficient sleep at night might have an impact on your hormones, which can lead to future sleeplessness. The ability to regulate a variety of hormones, including cortisol, estrogen, progesterone, melatonin, thyroid hormones and growth hormones, depends on getting a good night's sleep. When sleep is disturbed by insomnia, the hormone balance is upset, which may result in a variety of health issues.

As we age, we tend to get tired earlier in the evening. This might happen as a result of getting up early. Less REM and slow-wave sleep (the deepest sleep) are more common in older men and women. Experiencing less REM sleep may make it harder for memories to stick. Additionally, older people are more likely to experience sleep disruptions, which can exacerbate insomnia and sleep apnea. The protein amyloid, which is linked to Alzheimer's disease, is increased by sleep apnea. Older individuals with Alzheimer's are more likely to experience sleep issues, such as sleeplessness.

Common symptoms of insomnia include:

• Anxiety
• Daytime fatigue
• Decreased motivation
• Depression
• Difficulty focusing on tasks 
• Feeling as if you have not slept
• Impaired memory
• Irritability and disturbed mood
• Sleeping for short periods
• Trouble falling asleep at night
• Inability to sleep through the night
• Waking up too early
• Worrying about sleep

Insomnia is not a disease and there is no specific diagnostic test for it. A doctor generally conducts a physical exam and asks about your sleep problems. A blood test could rule out certain medical conditions, such as thyroid disease, which can contribute to a lack of sleep. If your insomnia is caused by breathing problems, such as sleep apnea, your doctor may order an overnight sleep study at a sleep lab.

Sometimes all it takes to put an end to sleepless nights is making a few minor adjustments to your lifestyle. The following prevention tips can help:

• Avoid alcohol and nicotine. Limit your drinking and abstain from it for at least four hours before going to bed. Nighttime sleep disturbances get worse based on the amount of alcohol someone consumes before bed. Nicotine from smoking is another stimulant that might make it difficult to fall asleep.
• Eat light at night. A heavy or spicy dinner eaten too soon before bedtime can create indigestion and make it difficult to fall asleep.
• Get regular exercise. Try to finish your workout three to four hours before going to bed to avoid feeling too awake to fall asleep.
• Limit caffeine. This stimulant can linger in your bloodstream for up to eight hours. Try cutting back to one cup of coffee in the morning.

Good sleeping practices, known as sleep hygiene, can help you get a good night's sleep. These practices can include:

• Ensuring your bedroom is peaceful, dark and at a suitable cool temperature
• Setting an alarm for the same time every morning and going to bed at the same time every evening
• Taking electronics, including laptops, TVs and smartphones, out of the bedroom

Many people can get back to sleeping well by altering their sleeping patterns and taking care of any problems, such as stress, underlying medical disorders or drugs, that may be contributing to their insomnia. If these steps are unsuccessful, your doctor may advise cognitive behavioral therapy (CBT), medication or a combination of the two to help with sleep and relaxation.

Cognitive behavioral therapy can help you manage or stop unpleasant thoughts and behaviors that keep you awake. CBT can be just as effective as sleep aids.

You can use prescription sleeping drugs to aid in falling asleep, staying asleep or both. Doctors generally advise against relying on prescription sleeping drugs for more than a few weeks.

You might find the following advice helpful in getting rid of insomnia:

• Adhere to a regular bedtime
• Avoid stimulants such as cigarettes and coffee
• Create a peaceful, dark and cool environment that promotes restful sleep
• Limit naps during the day to no more than a half-hour
• Make use of natural light
• Switch off all electronics for at least an hour before going to bed
• Use your bed only for sleeping and having sex

Melatonin, which is produced naturally in the body, does not make you sleep. However, increasing melatonin levels at night puts you into a state of quiet wakefulness that contributes to good sleep.

Most people naturally produce enough melatonin for sleep, but there are melatonin supplements you can take on a short-term basis if you're suffering from insomnia. There is no official recommendation on dosage, but sleepfoundation.org notes that 1 to 5 milligrams generally appears to be the effective range.

Lack of sleep has been linked to a host of sexual health issues, including loss of sexual desire, infertility and erectile dysfunction (ED).

In men, one of the reasons insomnia impacts sexual health is because of its effect on testosterone levels. Insomnia can lower testosterone, which affects libido and erectile function.

In both men and women, insomnia has been linked to decreased arousal and desire for sexual activity. Thus, sleeplessness may increase the likelihood of sexual dysfunction.

When you struggle with fatigue and the inability to focus, you can lose interest in past passions since you lack the energy to pursue them. Your former experiences of intimacy, fun and sexual attraction as a couple may have given way to anger and resentment. One partner can feel unable to overcome their insomnia, while the other might feel ignored and unimportant.

The longer this cycle continues, the more potential damage it can do to your relationship.

Insomnia can get in the way of your sexual function in several ways:

Low libido. It's possible that sexual arousal and the amount of sleep you get are related. One study found every additional hour of sleep increased the likelihood of sexual activity with a partner by 14 percent. Other research has shown that insufficient sleep may lower a man's testosterone levels, which in turn may result in reduced libido.

Infertility. Male reproduction and fertility depend on sperm, which is produced using testosterone. Males who don't get enough sleep may not have enough sperm to reproduce. Low testosterone levels might also impair the quality of already-produced sperm. These elements, together with reduced libido, can affect a man's capacity to conceive.

In women, long-term sleep deprivation has been associated with irregular menstrual cycles, which can lead to issues with ovulation, which is when women are most likely to become pregnant.

Erectile dysfunction. The inability to get or maintain an erection impedes intercourse. This condition affects more than half of men in the United States between the ages of 40 and 70. ED is frequently a sign of another health issue, such as diabetes, high blood pressure, heart disease or sleep deprivation. Studies indicate that ED is more common among males with sleeping difficulties. One study found 69 percent of males who had obstructive sleep apnea also had erectile dysfunction.

What is the main cause of insomnia?

Numerous factors can contribute to insomnia. A state of mental and/or physical hyperarousal that prevents people from going to sleep or remaining asleep is thought to be the primary cause.

How do I get rid of insomnia?

The following tips could assist you in overcoming insomnia:

• Abstain from stimulants such as caffeine and tobacco
• Create a calm, dark and cool environment that encourages restful sleep
• Get natural light
• Limit daytime naps to no longer than 30 minutes
• Reserve the bed only for sleeping and having sex
• Stick to a sleep schedule
• Turn off electronics at least one hour before bedtime

How can I make myself fall asleep faster?

The following tips may help you fall asleep quicker:

• Breathe with your mind. Our autonomic nervous system, which controls heart rate, muscle tension and motivation, is influenced by our breathing patterns. Deep, slow breaths can be calming, whereas quick, shallow ones can make you feel anxious.
• Don't overthink it. Although it may seem paradoxical, quit thinking about falling asleep if you want to do so. Someone who sleeps well typically doesn't think about it at all; instead, they pay attention to their bodies and go to bed when they feel drowsy.
• Keep a regular schedule. Maintaining a consistent sleep pattern is a great way to ensure that you begin dozing off on time, especially on weekends when you might not have to get up early.
• Reduce your stress. Insomnia is frequently caused by stress. It's a good idea to use relaxation techniques to help you unwind. Studies show that practicing mindfulness and meditation enhances sleep quality in adults.