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Insomnia: Types, Causes and Consequences

Table of Contents

According to National Sleep

Foundation (NFS), USA, following types of insomnia has been found.

  1. Acute insomnia – a brief episode of difficulty sleeping. Acute insomnia is usually caused by a life event, such as a stressful change in a person’s job, receiving bad news, or travel. Often acute insomnia resolves without any treatment.
  2. Chronic insomnia – a long-term pattern of difficulty sleeping. Insomnia is usually considered chronic if a person has trouble falling asleep or staying asleep at least three nights per week for three months or longer. Some people with chronic insomnia have a long-standing history of difficulty sleeping.
  3. Comorbid insomnia – Insomnia that occurs with another condition. Psychiatric symptoms such as anxiety and depression, are known to be associated with changes in sleep. Certain medical conditions can either cause insomnia or make a person uncomfortable at night (as in the case of arthritis or back pain, which may make it hard to sleep.
  4. Onset insomnia – difficulty falling asleep at the beginning of the night.
  5. Maintenance insomnia – Inability to stay asleep. People with maintenance insomnia wake up during the night and have difficulty returning to sleep.

Causes of insomnia

Psychiatric and medical conditions, unhealthy sleep habits, specific substances, and/or certain biological factors can cause insomnia. Since the brain has a sleep cycle and a wake cycle, when one is turned on the other is turned off, insomnia can be a problem with either part of this cycle: too much wake drive or too little sleep drive. According to National sleep foundation (NFS), USA, followings are the possible causes for insomnia.

  1. Medical Causes of Insomnia
  2. Recently many medical conditions (some mild and others more serious) have been found that can lead to insomnia. In some cases, a medical condition itself causes insomnia, whereas in other cases, symptoms of the condition cause discomfort that can make it difficult for a person to sleep. Examples of medical conditions that can cause insomnia are, Arthritis, Asthma, Gastrointestinal problems such as reflux, Endocrine problems such as hyperthyroidism, Nasal sinus allergies, Neurological conditions such as Parkinson’s disease, Chronic pain, etc.

    Medications such as those taken for the common cold and nasal allergies, high blood pressure, heart disease, thyroid disease, birth control, asthma, and depression can also cause insomnia.

    In addition, insomnia is considered to be a symptom of underlying sleep disorders. For example, restless legssyndrome. A neurological condition in which a person has an uncomfortable sensation of needing to move his or her legs can lead to insomnia.

    It is mentioned that if someone has trouble sleeping on a regular basis, it’s a good idea to review your health and think about whether any underlying medical issues or sleep disorders could be contributing to your sleep problems. In some cases, there are simple steps that can be taken to improve sleep (such as avoiding bright lighting while winding down and trying to limit possible distractions, such as a TV, computer, or pets). And in other cases, it’s important to talk to the doctor to figure out a course of action.

  3. Insomnia and Depression
  4. Insomnia can be caused by psychiatric conditions such as depression. Psychological struggles can make it hard to sleep, insomnia itself can bring on changes in mood, and shifts in hormones and physiology can
    lead to both psychiatric issues and insomnia at the same time.

    Sleep problems may represent a symptom of depression, and the risk of severe insomnia is much higher in patients with major depressive disorders. Studies show that insomnia can also trigger or worsen depression.

    It’s important to know that symptoms of depression (such as low energy, loss of interest or motivation, feelings of sadness or hopelessness) and insomnia can be linked, and one can make the other worse. The good news is that both are treatable regardless of which came first.

  5. Insomnia and Anxiety
  6. Most adults have had some trouble sleeping because they feel worried or nervous, but for some it’s a pattern that interferes with sleep on a regular basis. Anxiety symptoms that can lead to insomnia include:

    • Tension Getting caught up in thoughts about past events
    • Excessive worrying about future events
    • Feeling overwhelmed by responsibilities
    • A general feeling of being revved up or over stimulated

    It is not hard to see why these symptoms of general anxiety can make it difficult to sleep. Anxiety may be associated with onset insomnia (trouble falling asleep), or maintenance insomnia (waking up during the night and not being able to return to sleep). In either case, the quiet and inactivity of night often brings on stressful thoughts or even fears that keep a person awake.

    When this happens for many nights (or many months), the victims might start to feel anxiousness, dread, or panic at just the prospect of not sleeping. This is how anxiety and insomnia can feed each other and become a cycle that should be interrupted through treatment. There are cognitive and mind-body techniques that help people with anxiety settle into sleep, and overall healthy sleep practices that can improve sleep for many people with anxiety and insomnia.

Consequences of Insomnia

Due to its chronicity, insomnia is linked with substantial impairments in an individual’s quality of life. In several studies, insomniacs reported decreased quality of life on virtually all dimensions of the 36-item Short Form Health Survey of the Medical Outcomes Study (SF-36), which assesses 8 domains: (1) physical functioning; (2) role limitation due to physical health problems (role physical); (3) bodily pain; (4) general health perceptions; (5) vitality; (6) social functioning; (7) role limitations due to emotional health problems (role emotional); and (8) mental health. (McHorney, Ware, & Raczek 1993; Ware, Lu, & Sherbourne 1994).

Balter, Uhlenhuth, (1992) found that research has shown that among the daytime consequences of insomnia, the increased occurrence of accidents poses the greatest health risk. Insomniacs are 2.5 to 4.5 times more likely than controls to have an accident. Kuppermann et al. (1995) found that individuals reporting a current sleep problem were more likely than good sleepers to have decreased job performance and to
have been absent from work in the last month due to health problems.

Benca (2001) identified that population–and clinic-based studies have demonstrated a high rate of psychiatric comorbidities in patients with chronic insomnia. In fact, insomnia is more frequently associated with psychiatric disorders than any other medical illness. Additionally, depression and anxiety are the most common comorbid psychiatric disorders in insomniacs. It has traditionally been assumed that insomnia is secondary to the psychiatric disorder; however, given the chronicity of insomnia, it is possible that in some, if not most, cases the insomnia precedes the psychiatric disorder. In fact, it is possible that insomnia represents a significant risk for the development of a subsequent psychiatric disorder (Ohayon & Roth, 2003).

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