Insomnia Explained

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What do I do if I can’t sleep?

Insomnia Explained

We all know how a bad night’s sleep feels. At night, we’re frustrated and uncomfortable; in the morning, we’re tired, grumpy, and ‘foggy’. We’re more likely to make mistakes, and we might have trouble concentrating or remembering things. Having a few sleepless nights here or there is normal, especially during times of change or high stress. For some people however, sleeplessness can become a persistent problem.

Today, around one in three adults suffer from insomnia – a serious and sometimes debilitating sleep disorder. People with insomnia struggle to fall and stay asleep, and as a result, end up feeling exhausted. Insomnia can significantly impact your mental and physical health.  So, if you feel constantly tired, and are worried about your sleep, then it may be helpful to learn more about this disorder.

What is Insomnia?

Insomnia is a very common sleep disorder, characterised by difficulty falling or staying asleep. People with insomnia find it hard to fall asleep, wake up frequently during the night, or wake up too early in the morning and can’t get back to sleep. As a result, they don’t get enough good quality sleep.

Unsurprisingly, people with insomnia also struggle with low energy. They often feel tired, snappy, irritable, and ‘foggy’. Insomnia can also impact people’s concentration, memory, and attention to detail, and in turn, their performance at work, relationships, psychological wellbeing, and overall quality of life.

Insomnia can also be a symptom of another mental or physical health condition. Nearly 50% of people with depression also have insomnia. Insomnia is also common in people with anxiety, substance use problems, heart disease, thyroid problems, chronic pain, or asthma.

What Are The Signs of Insomnia?

Physical Signs

  • Difficulty falling asleep.
  • Waking up too early.
  • Waking up during the night.
  • Difficulty going back to sleep.
  • Feeling tired despite having enough opportunity to sleep.

Psychological Signs

  • Difficulty concentrating.
  • Worrying about sleep.
  • Feel tense and on edge.
  • Difficulty remembering things.
  • Feeling depressed.
  • Feeling irritable.

To be diagnosed with insomnia, a person must be experiencing sleep difficulties at least 3 days a week, for at least 3 months. However, only a qualified medical or mental health professional can diagnose insomnia through a thorough assessment of your personal situation and circumstances. If you’re concerned about your sleep, please don’t delay speaking with your regular healthcare provider or check out our anonymous online test below and see if one of our online courses could help.

What Causes Insomnia?

Insomnia can be a person’s primary concern, or it can be a symptom of another condition. In either case, insomnia can have many causes.

Stress is a common cause for insomnia. Stress can cause some biological changes in the body that make it difficult to relax, unwind, and fall asleep, for example, disrupted cortisol levels. We’re also more likely to feel anxious and worried when we’re stressed, which can keep us up at night.

Unhealthy sleep habits can also be a culprit. Drinking too much caffeine or alcohol, having long naps during the day, smoking, doing something energising before bed, or sleeping in on the weekends can contribute to insomnia. Shift work and regularly travelling across time zones can also disrupt people’s sleep patterns.

Many people with insomnia also have mental health issues, like anxiety or depression. Anxious and negative thoughts can make it difficult to fall asleep, and some people with depression can have an unbalanced sleep pattern, where they feel tired during the day but awake at night.

Some medical conditions can also contribute to insomnia, including diabetes, some cancers, pain conditions, other sleep disorders, neurocognitive illnesses, asthma, and thyroid problems. Some medications can also impact sleep, such as steroids, pain medications, and some psychiatric medications.

How To Deal With Insomnia

There are many effective treatments for insomnia, including psychoeducation, sleep hygiene, cognitive behaviour therapy (CBT), and medications.

Psychoeducation refers to learning about what insomnia is, what keeps it going, and how it can be managed. Psychoeducation helps people identify the lifestyle factors that could be impacting their sleep and implement appropriate management strategies. In doing so, it can give people a greater sense of control over their sleep, improving their sense of well-being. Educating family members on insomnia can also help them offer advice and support.

The most important pieces for information for a person with insomnia to know are:

  • Insomnia is a common sleep disorder.
  • Insomnia is not a sign of weakness or a character flaw.
  • Not everyone needs 8 hours of sleep each night.
  • Small lifestyle changes can have a significantly improve people’s sleep.
  • People can have good quality of life even when they’re tired.

Sleep hygiene refers to developing good sleep habits. Some examples of healthy sleep habits include:

  • Reducing caffeine and alcohol intake in the afternoon and evenings.
  • Reducing screen time before bed.
  • Doing something relaxing before bed, like a warm bath.
  • Making sure your bedroom is dark and quiet.

Improving sleep hygiene can have a significant impact on insomnia. It can help people change unhealthy habits that might be contributing to the disorder and develop new habits that will boost their sleep quality. Some sleep hygiene strategies, like relaxing before bed, can also have the added benefit of reducing feelings of stress, anxiety, and depression.

CBT is an effective treatment for insomnia. CBT involves learning skills to:

  • Identify and overcome unhelpful beliefs about sleep and insomnia.
  • Manage the side-effects of insomnia, like tiredness, irritability, and worry about sleep.
  • Implement strategies to improve the quality and quantity of sleep.

CBT for insomnia also often includes psychoeducation and sleep hygiene. CBT will often be recommended when:

  • The person has found CBT helpful in the past.
  • The person wants to take an active role in their recovery.
  • The person wants to learn skills to help them get well and stay well.
  • A competent, trained clinician who has expertise in CBT is available, or the person is prepared to use internet CBT (iCBT).
  • The person prefers CBT or iCBT.

There are many different medications that can be prescribed for sleep, such as sleeping tablets, benzodiazepines (sedative medications), or antidepressant medications. However, while these kinds of medications are commonly prescribed for insomnia, they are not always effective and can have significant side effects.

Sleeping tablets and benzodiazepines can help people fall asleep in the short-term. However, long-term use is not often recommended. These medications can be addictive and tend to become less effective the longer they’re used. They can also have side effects, such as grogginess, tiredness during the day, and difficulty concentrating.

Although antidepressant medications are generally safer and more effective for sleep, especially when prescribed alongside CBT. However, they still have side effects, such as nausea, dry mouth, and weight gain. These medications can be prescribed for sleep, whether or not the person has depression.

What is CBT?

Cognitive Behavioural Therapy for Insomnia

Cognitive Behavioural Therapy or CBT is considered to be one of the leading psychological treatments for depression. All of our online courses use CBT strategies to help ease symptoms of anxiety and depression. Click below to see if CBT can help you tackle your symptoms to improve the way you feel.

Strategies for Coping with Insomnia

Sometimes, make a few small changes can have a significant impact on insomnia. If you struggle with sleep, you could try some of the following:

  • Try not to nap during the day.
  • Cut down on your tea, coffee and alcohol intake, especially in the afternoons.
  • If you can quit or cut down on smoking.
  • Try not to watch TV or use your phone in bed.
  • Get up at the same time every day.
  • If you can't sleep, do something relaxing in another room such as listening to music.
  • Develop a relaxing pre-bed routine (e.g. have a warm bath, meditate or read).

Interested in learning more?

The Insomnia Course

Check out our practical, self-paced online course that teaches step-by-step strategies for tackling symptoms of depression.