For years I suffered from insomnia and still to this day have trouble falling and staying asleep. According to the American Sleep Association, nearly 70 million Americans have a sleep disorder and about 10% of people have long-lasting insomnia.
Most cases of insomnia are related to lifestyle or environmental factors such as poor sleep habits, depression, anxiety, lack of exercise, chronic illness, or certain medications. It is rare for insomnia to be an isolated medical or mental health condition.
Johns Hopkins sleep researcher Patrick H. Finan, Ph.D. says “Poor sleep may create difficulties regulating emotions that, in turn, may leave you more vulnerable to depression in the future—months or even years from now.”
Women are 40 percent more prone to insomnia than men. Individuals with sleep disorders are twice as likely to develop depression compared to those without sleep issues. Among individuals with depression, 75 percent have trouble falling asleep or staying asleep.
There are two main types of insomnia: short-term or acute insomnia and chronic insomnia which indicates a long-term pattern of difficulty sleeping. Before getting treatment, it is important to identify the type of insomnia for the best possible outcome.
Many adults experience short-term (acute) insomnia, which can last for days or weeks and is usually brought on by stress or a traumatic event. Those with long-term (chronic) insomnia typically struggle with a sleep disorder for a month or longer.
Many clinicians used to think that depression caused insomnia, but now know that the relationship is more circular than causal. Yet, medical treatment for one will not necessarily cure the other. Selective serotonin reuptake inhibitors (SSRs) may help alleviate depression but often do not assist with sleep disorders.
Similar to depression, individuals with anxiety also have trouble sleeping and no one knows which came first. Truth is stress and anxiety can cause sleep problems which worsen over time and can cause irritability and anxiousness.
Regular use of alcohol and drugs is also known to affect sleep patterns as well as cause insomnia. Despite alcohol being a sedative in limited quantities, a person who is intoxicated is more likely to have trouble staying asleep. 1
In addition to mental health risks, people who are deprived of sleep can have difficulty with decision-making, performance, and slower reaction times, and are at a greater risk for developing obesity, diabetes, and heart disease.
The American Academy of Sleep Medicine and the Sleep Research Society recommend that adults aged 18–60 years get at least 7 hours of sleep.
The National Sleep Foundation suggests older adults (age 55-84) average seven hours of sleep on weekdays and 7.1 hours on weekends. In older adults, sleep is most often disturbed by the need to use the bathroom, physical pain, or general discomfort.
Screen time before bed can also impact sleep. Studies show the use of electronic devices before going to bed increases the amount of time it takes to fall asleep, reduces sleep quality, and affects attentiveness the following day.
Sleep is essential in maintaining your overall health. The good news is that there are treatments that you can try at home including the following:
- Keep a regular sleep schedule
- Minimize noise and light
- Institute a “No Screen” rule close to bedtime
- Maintain a comfortable room temperature
- Exercise to reduce stress and anxiety
- Drink less water before bedtime
- Decrease alcohol use and caffeine, especially in the late afternoon or evening
- Eat low-carbohydrate meals before bedtime
Depending on the type of sleep disorder you have, your doctor may recommend a medical treatment that can include:
- Sleeping pills or melatonin supplements
- Allergy or cold medication
- Medications for underlying health issues
- An assistive breathing device or surgery (usually for sleep apnea)
- A dental guard (usually for teeth grinding)
- In some situations, over-the-counter or prescription medication may be necessary.
If you suspect that you may have a sleep disorder, discuss your symptoms with your physician. Oftentimes, a sleep study or polysomnogram (PSG) is ordered to determine whether sleep apnea or any other medical condition is the problem.
Reference: Brower KJ. Insomnia, alcoholism and relapse. Sleep Med Rev. 2003 Dec;7(6):523-39. doi: 10.1016/s1087-0792(03)90005-0. PMID: 15018094.