Insomnia: Causes, Treatment, and Symptoms

Learn about the causes and types of insomnia, common symptoms, and treatment options for this sleeping disorder.

By Alesandra Woolley

Insomnia is a common sleep disorder in which an individual fails to fall and stay asleep. It’s estimated that one in three people suffer from a mild form of insomnia, and nearly every person will experience some form of insomnia at some point in their lives.

Symptoms of Insomnia

For being so common, insomnia can be difficult to diagnose. However, experiencing one or more of the following symptoms is a good indication you suffer from insomnia:

  • Difficulty falling asleep on a consistent basis
  • Frequently waking up and failing to fall back asleep
  • Excessive tiredness throughout the day
  • Growing concern or frustration about sleep

Types of Insomnia

There are two main categories of insomnia: primary and secondary.

Primary insomnia is when you experience difficulty sleeping for no apparent reason, such as another health condition or life circumstance.

Secondary insomnia occurs when you experience sleep problems as a direct result of something else. For example, depression, menopause, medication, or pain.

Insomnia also varies in severity. In some cases, insomnia is experienced only for a short amount of time, from one night to a couple of weeks. This is called acute insomnia. In other cases, insomnia is experienced for long periods of time. This is called chronic insomnia and is diagnosed when an individual experiences insomnia at least three times a week for longer than three months.

Learn More: Types of Insomnia

Insomnia can also be classified according to its general causes: psychophysiological insomnia (the classic type, arising from to a variety of psychological and behavioural stressors and/or environmental and situational causes); paradoxical insomnia (genuine complaints of little or no sleep that are not corroborated by objective evidence of actual sleep disturbances); and idiopathic insomnia (persistent insomnia, usually beginning in childhood, which is unrelated to psychosocial stressors or medical disorders).

Insomnia may also be classed depending on its regularity and persistence: transient insomnia (insomnia that persists for just a few days, usually following a stressful event or excessive use of stimulants like caffeine or nicotine); episodic (short-term) insomnia (insomnia symptoms that last up to three weeks, interspersed with periods or more or less normal sleep); or chronic (persistent) insomnia (ongoing insomnia symptoms that recur at least two days a week for at least a month).

Finally, insomnia is sometimes categorized according to the part of the sleep period which is disrupted: sleep-onset (initial) insomnia (difficulty getting to sleep in the first place); sleep-maintenance (middle) insomnia (difficulty staying asleep or getting back to sleep once woken); or terminal (late) insomnia (waking up too early in the morning).

Causes of Insomnia

Insomnia can be caused by a variety of things. Acute insomnia and chronic insomnia have very different causes.

Causes of Acute Insomnia

You might experience acute insomnia if:

  • You are under a significant amount of stress from work, after the death of a loved one, divorce, or some other life circumstance. Stress and anxiety about difficulties in sleeping may in itself be enough to perpetuate the insomnia, in a kind of vicious circle (sometimes referred to as conditioned insomnia).
  • You are sick or recovering from an injury that causes physical discomfort.
  • Your environment is not conducive for sleep (i.e. it’s noisy, too bright, or too hot).

Acute insomnia is experienced temporarily but can develop into chronic insomnia.

Causes of Chronic Insomnia

The causes of chronic insomnia are more difficult to identify and vary from person to person. It’s possible for chronic insomnia to develop as a result of short-term insomnia that goes untreated, but it’s more likely that a combination of factors is contributing to the problem.

The Spielman Model of Chronic Insomnia (aka the 3 P’s)

The Spielman Model of chronic insomnia identifies three components that contribute to chronic insomnia:

  • Predisposing factors
  • Precipitating factors
  • Perpetuating factors
Predisposing factors

Some individuals are more prone to developing insomnia than others. While some people have a low predisposition to insomnia and can drink caffeine, experience chronic pain or undergo stress without missing a lick of sleep, others have a high predisposition to insomnia and may develop insomnia with nearly any physical, emotional, or cognitive arousal.

For example, genetics is a predisposing factor to insomnia that may make an individual more prone to developing this type of sleep disorder. It’s believed that light sleepers, or those who are aroused more easily while sleeping, have a greater tendency to develop insomnia. When untreated, predisposing factors can become perpetuating factors.

Precipitating factors

Precipitate means to cause. Unlike predisposing factors that are inherited, precipitating factors of insomnia are catalyzed by an event that causes stress or an existing medical condition that leads to insomnia.

Examples of medical conditions that contribute to insomnia include:

  • Another sleep disorder like sleep apnea or restless leg syndrome
  • Chronic pain
  • Cancer
  • Depression or anxiety
  • Arthritis
  • Cardiovascular disease
  • Asthma
  • GERD

Other common precipitating factors of insomnia are often caused by stressful events related to relationships and careers. For example, divorce, the death of a loved one, a big move, or a job transition.

Perpetuating factors

Finally, perpetuating factors are those that don’t go away. They are a result of a change in behavior or cognition. For example, even if the original cause of insomnia is resolved, insomnia continues (or perpetuates) because the individual’s mindset or lifestyle has been altered to accommodate the initial battle with insomnia. Perpetuating factors, like a sedentary lifestyle or poor sleep hygiene, last indefinitely and prevent an individual from re-establishing proper sleep.

Health Risks if Insomnia Goes Untreated

There a number of health risks associated with chronic insomnia that goes untreated. Chronic sleep deprivation puts your mental, physical, and emotional well-being in jeopardy.

A decline in Physical Health

Sleep is the glue that holds us together. It is the body’s time to rest and regenerate cellular tissue. Without it, every system in the body is affected. Below are a number of physical consequences associated with long-term sleep deprivation:

  • Immunodeficiency
  • Weight gain
  • Increased risk of diabetes
  • Increased risk of heart disease
  • Increased risk of stroke
  • Sensitivity to pain

Increased Risk of Mental Illness

Sleep and mental health are very closely related. In many ways, sleep is the fuel our brains need to operate at full capacity. Without proper sleep, we cannot properly process new information, memories, or emotions. Not to mention, our brains regulate and produce hormones during sleep. Therefore, when we don’t sleep hormone levels are disrupted, leading to a whole slew of mental and emotional consequences. Chronic insomnia can result in the following mental health consequences:

  • Increased risk of depression and anxiety
  • Hormonal Imbalances
  • Increased risk of hallucinations
  • Memory impairment

But don’t be fooled. Even if you experience acute insomnia, you are at risk for short-term effects of sleep deprivation that include:

  • Irritability
  • Lack of concentration
  • Decreased sex drive
  • Increased appetite (especially craving for carbs)
  • Delayed memory retrieval
  • Slower reaction times
  • Daytime sleepiness
  • Increased risk for accidents

Treatment for Insomnia

So what can one do? First and foremost, consult a physician regarding your sleep disorder. They can help craft the most effective treatment plan for you. But depending on the type and cause of insomnia, your sleep disorder can be treated via therapy, medication, or simple lifestyle changes.

Therapy

If you regularly suffer from insomnia, your best bet is to see a sleep therapist. There are a number of therapies used to treat insomnia, but two of the most popular and effective are Cognitive Behavior Therapy and Stimulus Control, also known as sleep restriction.

Cognitive Behavioral Therapy for Insomnia

Cognitive Behavioral Therapy for Insomnia consists of seeing a sleep specialist to help cure you of insomnia. The primary objective of CBT-I is to change behavior in such a way that you are able to train yourself to fall and stay asleep. CBT is achieved by devising a custom plan that reveals the root of the problem (what is keeping you up at night) and implements strategies that improve your sleep behavior. The ultimate goal of CBT is to challenge unhealthy beliefs about sleep and replace these fears with positive thinking backed by healthy sleep hygiene.

Stimulus Control

The purpose of stimulus control is to help an individual associate their bedroom with nothing but sleep. This is achieved by restricting certain activities, like watching TV or working, in the bedroom. One important aspect of stimulus control is retiring to bed only when you are sleepy and leaving the room if you have lain awake for 20 minutes or more. This helps eliminate the association between your bedroom and wakefulness.

Paradoxical Therapy

Paradoxical therapy, which asks the insomniac to do the exact opposite of trying to fall asleep, has proven to be a surprisingly effective therapeutic approach to conquering insomnia. By instructing a patient to continue the symptomatic behaviour instead of stopping it, this forces them to confront the problem and to make a deliberate decision on how to proceed, which in some cases may serve to eliminate any subconscious resistance to treatment.

Medication

Depending on your lifestyle and/or personal preferences, you may opt for a medication to help aid in sleep. Sleep aids can be purchased over-the-counter or prescribed by a physician. Some people may prefer taking an all-natural supplement to assuage your insomnia.

Over-The-Counter (OTC) Sleeping Pills

OTC sleeping medications may be a good option for those who are experiencing a small bout of short-term insomnia. They are not intended for regular use. Nonprescription sleeping pills contain antihistamines that make you drowsy. Be aware that they can cause side effects such as daytime sleepiness, dizziness, confusion, cognitive decline and difficulty urinating, which may be worse in older adults. Some examples include:

  • Diphenhydramine (Benadryl, Aleve PM, others)
  • Doxylamine succinate (Unisom SleepTabs)

Prescription Medication

Prescription medications should never be a long-term solution for insomnia (although some prescription medications have been approved for long-term use). However, they may be prescribed when you first see a doctor about your insomnia. Examples of prescription medications for sleep include:

  • Eszopiclone (Lunesta)
  • Ramelteon (Rozerem)
  • Zaleplon (Sonata)
  • Zolpidem (Ambien, Edluar, Intermezzo, Zolpimist)

Natural Sleeping Aids

If you prefer not to taking medication, there are a plethora of natural remedies to sleep. See our in-depth guide to the best all-natural sleeping aids here. Other natural sleeping aids include:

Lifestyle Changes

In conjunction with therapy and sleeping aids, making a few simple changes to your lifestyle can help combat insomnia. The following tips can also help prevent the onset of insomnia or keep it from worsening:

  • Change your diet (here’s why)
  • Create and bedtime and stick to it
  • Craft a wind-down routine that includes a warm bath or meditation to help prepare your mind and body for sleep
  • Keep your bedroom cool
  • Stick to calming hues in your bedroom
  • Make sure your room is as dark as possible (invest in blackout curtains if it receives a lot of natural light)

Dietary Changes

In order to prevent or reduce your insomnia, try to balance your blood sugar during the day properly. Feeling fatigued, irritable, and tired during the day is ordinary with AFS, but making changes to your diet could help give you the energy and relief you need. Here are some tips:

  • Begin your morning with breakfast. Skipping breakfast after a long night without food could lower your blood sugar levels. Essentially, don’t load your breakfast up with sugar-loaded cereals, waffles, granola, or toast. Instead, try having eggs, oatmeal with walnuts or almonds, or other foods high in protein and minerals.
  • Drink calming herbal teas, such as peppermint, lavender, chamomile, or passionflower.
  • Have healthy snacks on hand. Eating organic raw nuts, a bit of dried fruit, hummus and vegetables, seeds, or nut butter could balance your blood sugar, without you consuming too many sweeteners.
  • If you are reaching for fruit, try consuming them whole. Don’t go for fruit gummies, fruit juice, or other drinks loaded with added sugar. More importantly, if you are eating a high glycemic food such as a pear or an apple, try pairing it with a protein and fat- such as almond butter. This stabilizes your blood sugar and causes the carbohydrates to be absorbed into your system more slowly.
  • If you experience hypoglycemia, eat every two to three hours; don’t wait until your body is in starvation mode to decide to snack or have a meal.
  • Focus on a diet high in protein and quality fats, like wild-caught salmon, raw and organic nuts such as almonds, cashews, hazelnuts, pecans, and walnuts, avocados, extra virgin olive oil, and virgin coconut oil.
  • Have a light snack before bed to calm your body, balance your blood sugar, and provide you with improved sleep.
  • Avoid consuming coffee, caffeinated tea, alcohol, refined sugar, high fructose corn syrup, and processed food.

Want to learn more about the different types of insomnia and how to manage it? See our related articles on insomnia below.


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