Insomnia is a sleep disorder, in which a person sleeps badly and thus has no normal sleep, accompanied by functioning problems during the day. We speak of normal sleep when a person sleeps five to ten hours. On average, a person needs about fifteen minutes to fall asleep. Waking up two to three times at night is normal, unless it takes a long time to fall asleep again.
Cause
In most cases, there are no obvious causes of insomnia. Light or not sleeping can sometimes be caused by stress or events during the day. Insomnia can also be learned. Then the cause is lost, but the learned behavior remains, so the insomnia doesn’t disappear. Possible causes of insomnia are:
- Mental disorders, such as depression, anxiety and stress.
- Physical conditions, such as itch or pain.
- Hormonal disorders.
- Sleep apnea.
- Alcohol consumption.
- External causes, such as an uncomfortable place to sleep, noise or light pollution.
- The menopause can also cause insomnia.
In children, insomnia can be caused by the absence of an evening rhythm. The transition from active (playing outdoors) to rest (sleeping) is too great then.
Symptoms
When a person suffers from insomnia, he or she has the feeling of having had too little night’s rest. Signs and symptoms that may indicate insomnia are:
- Poor sleep.
- Waking up often at night (sleeping light, not sleeping properly).
- Waking up early.
- Insufficient invigorating sleep.
These symptoms of insomnia can also occur simultaneously. Anyone who suffers from sleep problems, may suffer during daytime from fatigue, difficulty concentrating, memory problems, lethargy, irritability and drowsiness.
In case of chronic insomnia, symptoms occur three or more nights per week and last for longer than three months.
Diagnosis
The doctor makes the diagnosis of insomnia based on the story of the patient. In some cases, it is important to investigate other causes that disturb sleep. Usually by means of a sleep study, in which a person is monitored during the night. This study asesses the sleeping pattern and certain functions of the body during the night, such as breathing, heart rate, leg movements and oxygen level in the blood. For this, one has electrodes and sensors placed at different locations on the body.
Treatment
Treatment is mainly made up of practical sleep advice, explanation and reassurance and/or guidance by a psychologist. It may also help to temporarily use medications. The doctor can then prescribe sleeping pills for a short period or for occasional use.
Prognosis
Many people with insomnia return to a normal sleeping pattern within a few days, especially when the lifestyle has been adapted. In people with chronic insomnia, the prospects are depending on the underlying problem.
Considerations
A good night’s sleep is as important to health as good nutrition and regular exercise. The following advices may help to improve sleep:
- Good distribution of sleep and wakefulness (sleep/wake). Use regular times of going to bed and getting up and follow this rhythm even in the weekend. In children, it helps to apply a fixed evening ritual.
- Sleep environment. Ensure a fresh and quiet bedroom, a good bed and an environment with minimal noise. Use ear plugs when needed. Don’t wear tight clothing during sleep.
- Physical exercise. Get sufficient exercise and do this especially in the morning and in the afternoon. Don’t sport at least four hours before bedtime. Sports make the adrenaline level rise and one will feel fitter.
- Relaxation. Try to relax both mentally and physically before going to bed. For example, by reading a relaxing book or magazine, drinking herbal tea or taking a hot shower or bath.
- Sleeping in recovery position. It’s advisable to sleep in the recovery position, because sleeping on the back may cause problems for some people. In a recovery position, one keeps the underlying leg stretched down with the uppper leg pulled over. The head is sideways and facing forward.
- Reduce the use of stimulants, such as coffee, tea, chocolate, alcohol and smoking as much as possible. Especially alcohol before the night causes restless sleep.
- Don’t eat or drink before going to sleep. If one cannot sleep on an empty stomach, take something that’s easy digestable.