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Insomnia – causes, symptoms, diagnosis and treatment

InsomniaInsomnia, the inability to fall asleep, among people all around the world is rising. This is partly due to uncontrolled factors like age and health status of a person and largely due to the invasion of sleep cycle caused by technology and unhealthy practices followed by people in every part of the world today.

But insomnia is a disorder and even doctors warn against taking it lightly. 'Sleep is the most important part of a person's life and one should get at least 7-8 hours of good quality sleep every day,' says Dr Sudhir Kumar, consultant neurologist. Here's a deeper insight into insomnia to make you more aware why you need to take it more seriously.

What is insomnia? What causes it?

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Medically, insomnia is defined as a condition or disorder that makes a person difficult or unable to fall asleep. But, it may or may not make a person sleep deprived. Sleep deprivation is a condition when a person does not get enough time or opportunity to get enough sleep.

Dr Sudhir explains three circumstances that better explain insomnia:

  • Increased sleep latency: Ideally a person should fall asleep within 15-20 minutes after going to the bed. If you take longer (30 minutes to 1 hour), you have an increased sleep latency causing insomnia
  • Reduced total sleep duration: If you sleep for less than the required amount (about 2 to 5 hours) then you have insomnia.
  • Frequent awakening: If you have restless sleep then you have insomnia. A person may wake up after every 1-2 hours and then may take a longer time (about 45 minutes) to fall asleep again

Causes of insomnia can be broadly categorized into two types:

Primary insomnia: It means that the person is unable to sleep due to factors not related to environmental or physiological factors.

Secondary insomnia: It means that sleep problems occur because you are either suffering from a health condition, mental illness or external factors like drug abuse or exposure to certain substances.

Insomnia can also be short-term (acute insomnia), intermittent or long-term (long-term). Short term or transient insomnia can be caused due to stress and lasts for 2-3 weeks. If transient insomnia keeps recurring then it is termed as intermittent insomnia. And chronic insomnia is a serious condition as it lasts for more than a month.

Acute insomnia can be caused due to

  • Stress
  • Side-effects of some medicines
  • Environmental factors like temperature, jet lag, noise
  • Emotional distress
  • Pain
  • Poor eating habits

Chronic insomnia can be caused due to

  • Depression
  • Chronic stress
  • A medical condition

What are the symptoms of insomnia?

Not being able to sleep clearly indicates insomnia. But here are some other symptoms that you might link to insomnia.

  • Depression
  • Anxiety
  • Headache in the daytime
  • Gastrointestinal problems
  • Poor concentration and focus
  • Irritable behavior

If you have any of these symptoms along with inability to sleep that are constantly interfering with your day-to-day activities then you must not delay your visit to the doctor.

Is there any way to diagnose insomnia?

The doctor will first do a physical examination to check the cause of insomnia. You may have to undergo specific test to identify the underlying cause of insomnia. Some specific tests to record brain waves, breathing capacity, heart beat and eye and body movements may also be required.

Is it safe to have over-the-counter sleep pills?

'No. Unless your doctor prescribes you sleeping pill you should not take them as they can have serious side-effects. Sometimes, the effect of these drugs is carried over and the person may feel sleepy during the day. This can affect concentration and can lead to accidents. Overdose of sleep pills can be lethal. Moreover, a person can easily get addicted to or get dependent on these pills and the withdrawal symptoms are even more troublesome. Withdrawal of these pills can cause anxiety, increased irritability and seizures. Also, people who suffer from chronic conditions like kidney disease have to face even severe consequences because these pills are stored in the body for a longer time as the kidneys may not be able to eliminate them effectively,' explains Dr Sudhir.

How is insomnia treated?

Dr Sudhir suggests that changes in lifestyle should be the first thing people should try if they are unable to sleep. Here are some ways he recommends:

  • The best time to go to sleep is between 9-11 pm. That's the ideal time because you body has its own clock and a hormone called melatonin (responsible for inducing sleep) is secreted by the pineal gland during this time.
  • Have a fixed time for sleeping and waking up. It's preferable to sleep early and wake up early by completing full 7-8 hours of sleep.
  • Ensure your bedroom has an ambience conducive to sleep. Don't convert it to an office or a reading room. Switch off the lights and sleep because the sleeping hormone will be secreted only in the dark.
  • Maintain a gap of at least 2 hours between dinner and bedtime to avoid sleeplessness due to acid reflux.
  • Avoid consuming tea, coffee or colas at bed time.

If you're still unable to sleep after making these changes then you should definitely go to a specialist like a neurologist or a psychiatrist if the underlying cause is depression or anxiety.

Medication: People with chronic insomnia may be prescribed sleeping pills like zolpidem and ramelteon. But these medicines are not to be taken long-term as they can have side-effects. There are several other ways that can help you can get a good night's sleep.

Read more about causes, symptoms, diagnosis and treatment of insomnia.

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