Everything you need to know about insomnia

According to the American Academy of Sleep Medicine, insomnia is a clinical diagnosis. It’s defined as the subjective perception of difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity for sleep and results in daytime impairment. Insomnia becomes chronic when a person begins having difficulty falling asleep or staying asleep for as little as three nights per week for at least two consecutive weeks up to three months.

“So, if you find it difficult to get the rest you need despite giving yourself sufficient time to sleep, it might be time to speak to a health professional, who can diagnose you.”, advises Dr Robbins.

Savoir: What are the most common causes of insomnia?

Dr Robbins: There are many causes of insomnia, ranging from physical, such as hormonal fluctuations, injuries or pain. Psychological causes such as depression and anxiety, and situational, such as when we experience jetlag.

We all can likely relate to the experience of insomnia symptoms at one time or another in our lives. The truth is, sleep is the result of our waking days. This can include stressful events like frustrating professional or personal experiences. All of these can limit our ability to fall asleep or maintain sleep.

Is there a link between circadian rhythm and insomnia?

Circadian rhythm disorder symptoms are similar to those of insomnia. They can include difficulty falling, staying asleep or waking up too early.

However, symptoms of the former are due to a disruption in the timing of sleep, which can be caused by irregular sleeping times, inadequate time in the daylight and poor diet. Whereas an individual suffering from insomnia can experience all the symptoms even if they practise healthy sleep hygiene.

Are there any groups of people who are more likely to be at risk of insomnia?

There are a few groups that are at greater risk of insomnia. Unfortunately, sleep systems decline with age, making it more difficult to fall asleep and consolidate sleep. For these reasons, insomnia is more likely among older adults than younger adults. However, individuals with family history of insomnia and those that are prone to stress and worry are also at greater risk. There are certain medical and psychiatric disorders, such as heart disease, asthma, anxiety, and depression that can make an individual more likely to experience insomnia too.

What are the consequences of untreated insomnia?

Untreated insomnia can present short consequences, including irritability, feelings of anxiety and depression. It can also affect our immune system and increase the risk of colds and flu. There is also research that estimates the costs of untreated insomnia to be as high as $100 billion US dollars per year. This is due to additional healthcare costs, reduced productivity, and accidents.

Concerningly, in the longer term, including increased risk for chronic conditions, such as cardiovascular disease and obesity. There is also evidence that untreated insomnia could place older adults at an increased risk of dementia and Alzheimer’s disease, therefore, underscoring the importance of being treated.

How does insomnia affect our mental and physical well-being?

Those suffering from insomnia can face myriad challenges to their mental and physical well-being and performance. Untreated insomnia presents risks for brain fog and lower productivity, shorter attention span, and less creative problem-solving. An individual may also experience increased feelings of anxiety, which can greatly affect both their personal and professional life.

We’re more aware of our well-being and the importance sleep plays in this. Does this mean there are fewer people suffering from insomnia than before the COVID-19 pandemic?

We do have evidence that symptoms of insomnia increased in prevalence across the globe amidst the COVID-19 pandemic, which was marked by conditions ripe for insomnia, including tremendous uncertainty and unknown.

What can someone do to manage the symptoms of insomnia?

Fortunately, there is a range of treatments for insomnia. These include both pharmacological interventions as well as behavioural treatments. Excitedly, research shows that these two pathways are both highly efficacious for attenuating insomnia symptoms and improving quality of life.

On the behavioural side, the gold standard treatment is called “Cognitive Behavioural Therapy for Insomnia” and includes specific recommendations to help the person suffering from insomnia to reframe how they think about sleep and their bedroom. Another central piece of CBTI is relaxation training and learning meditation and mindfulness exercises to ease tension around bedtime.

Lastly, are there any precautions we can take to prevent insomnia?

There are a handful of precautions we can all take. Following a healthy diet and exercising regularly can greatly impact an individual’s likelihood to experience insomnia. You should also introduce a consistent sleeping routine, spend an adequate amount of time in the daylight and outdoors and avoid alcohol and caffeine after 2pm.

If the symptoms of insomnia sound like something you are experiencing, we recommend reaching out to a Sleep Specialist, who can assist you further and recommend the right treatment for you.

Dr Robbins is Assistant Professor in Medicine at Harvard Medical School and an Associate Scientist at the Brigham and Women’s Hospital and has been an expert on the science of sleep for Savoir since 2020.