Insomnia is a problem where the patient cannot sleep even without any environmental or other disturbances. As a result, the daytime function of the patient is impaired. Poor quality or less quantity of sleep result in insomnia. Insomnia is a common problem and it is generally found in 30% to 50% of the population. Among them, about 10% may suffer from insomnia which is chronic.
Insomnia is a problem that may occur in every age. However, it is most commonly seen in case of adults. With age, the frequency of the problem increases. It affects women more than men.
There are three types of insomnia present based on the duration of symptoms-
1. Transient insomnia- this type of insomnia last only one week or less
2. Short-term insomnia- this type of insomnia may last from one week to three weeks
3. Chronic or long term insomnia- this type of insomnia stays for more than three weeks.
Difference with other sleep related problems
Insomnia is different from short duration sleep and sleep deprivation. Short duration sleep is seen in some individuals and it is normal. Some people sleep for less time without having any daytime impairment. On the other hand, in insomnia, patients suffer from daytime impairment.
In case of sleep deprivation, the patient suffer from lack of sleep because of non-availability of time and opportunity to sleep. However, in case of insomnia, even with the necessary time and opportunity, the patient can not sleep.
Causes of insomnia
Insomnia may result from different causes. Insomnia is also classified based on the causes of the problem.
- Stress and situational factors that can result in insomnia include
- jet lag,
- physical discomfort which may include hot, lighting, cold, unfamiliar surroundings, noise etc.
- working in shifts
- stressful life situations which may include death of a loved one, separation of divorce, preparing for an examination, losing a job.
- illicit drug use
- caffeine intake before sleeping
- alcohol intoxication
- certain medicines
Most of these factors that cause insomnia at transient and short term and when they are corrected, insomnia also goes away.
Sleep hygiene is very crucial for preventing and avoiding insomnia. If you have poor sleep hygiene, then you may easily have insomnia. The physical factors that cause poor sleep hygiene-
- using the bedroom for many things other than sleeping
- eating before sleep
- exercising before sleep
- going to bed hungry
- the bedroom is full of lots of noise or lighting
- working in bed
There are several medical and psychiatric conditions that may cause insomnia. Some of them are-
- breathing problems due to chronic lung or heart disease including chronic obstructive pulmonary disease (COPD), asthma
- obstructive sleep apnea
- congestive heart failure
- acid reflux
- Parkinson’s disease
- urinary problems such as frequent urination, urinary incontinence
- chronic pain
There are some common psychiatric problems that may result in insomnia-
- Posttraumatic stress disorder (PTSD)
Some common physiologic conditions may also cause insomnia –
- menstrual cycle
Causes related to sleep disorders may also cause insomnia-
- sleep walking
- restless leg syndrome
- circadian sleep disturbance
- sleep apnea
- periodic limb movement disorder
Other causes of insomnia
In this type of insomnia some of the learned behaviors of the patient prevent sleep. The patient is not able to relax his mind, causing higher mental function while sleeping.
In this type of insomnia, the problem occurs without any obvious reason. It may start in the childhood of the patient and then continue into adulthood.
In this type of insomnia, patient may complain about insomnia even when they have a normal pattern of sleep.