What is Insomnia?

Insomnia is an inability to sleep in spite of the opportunity and circumstances for sleep leading to negative daytime consequences, such as difficulty in concentrating. It could be that you find it difficult to fall asleep, fail to stay asleep, or wake too early. Anyone can have a bad night, or a spell of poor sleep, but with insomnia the individual has poor sleep on several nights a week over the course of months.

There are 3 types of insomnia and it is possible to suffer from a combination of them.

Sleep-onset insomnia

This is where there is a difficulty in falling asleep, regularly taking more than 30 minutes to fall asleep on the majority of nights. On average most people take less than twenty minutes to fall asleep after turning the light off.

Sleep-maintenance insomnia

This is where there is a problem staying asleep and you repeatedly wake up during the night. It is normal to wake momentarily numerous times during sleep to check that all is right with the world, but these awakenings are very short, and we do not remember them. Someone with sleep-maintenance insomnia wakes during the night but then finds it difficult to get back to sleep. Stress or anxiety is a common cause of sleep-maintenance insomnia, but medical factors could be involved, such as pain or repeatedly needing to use the toilet during the night (nocturia). It may be that the physical factor wakes you, but worry, or thinking too much, then keeps you awake

Early morning waking

This is where you wake earlier in the morning than you wish and cannot then fall back to sleep. This type of insomnia is often linked to depression but may also be related to the changes in circadian rhythm that occur as a result of being a shift-worker, or naturally as we get older: it can be more of a problem in summer when the sun rises early.

What are the consequences of untreated insomnia?

Mental health problems, including but not limited to stress, anxiety and depression, are also linked to disturbed sleep. Beliefs about sleep, and the effects of a lack of it, can cause anxiety and exacerbate sleep problems. Poor sleep is also associated with problems with physical health. People with insomnia also complain of lack of energy or difficulties in concentration, for example.

What treatment options are there?

Cognitive behavioural therapy for insomnia (CBT-I) has been proven to be successful in treating insomnia. In contrast to sleeping tablets, the benefits of CBT-I have been found to persist beyond the end of treatment. It targets the inappropriate thought processes and behaviours that can lead to sleep problems, or perpetuate them.

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