What is insomnia?
Insomnia is a term used to describe inadequate or poor quality sleep. It is normal for people to experience the odd night where they have difficulty sleeping. However if you are experiencing difficulty falling or staying asleep for at least 3 nights a week for 1 month or more you are likely to have insomnia. Insomnia can result in excessive sleepiness during the day affecting concentration, short term memory and work performance. Ongoing insomnia has also been found to influence depression and anxiety as well as worsening existing medical conditions.
What causes insomnia?
There are a number of factors that can influence the onset of insomnia. Perhaps the most common cause is stress build up during the day that interrupt the ability to fall asleep or stay asleep at night. Closely connected to this is thinking and worrying in bed. Beyond stress and anxiety related issues, insomnia can be influenced by such life events as a job loss, shift work, the death of someone close to you, new borns in the household, environmental factors such as traffic noise, trauma or relationship difficulties. Although the life events that initially caused insomnia usually pass, sometimes the insomnia remains. This is because sleep has a tendency of developing patterns that tend to remain until treated.
Sleep quality can also be influenced by physical factors such as sleep apnoea [the interruption of breathing hundreds of times during the night], restless legs, periodic limb movement and physical pain. Physical factors that influence sleep quality are best referred to your GP.
How common is insomnia?
It is estimated that about 30-40 per cent of the adult population will experience insomnia to some extent during their life time. Insomnia tends to increase with age and is more common in women.
How can I improve my sleep?
Generally, you will improve your sleep if you follow some basic rules. It is important to remember that sleep tends to fall into a pattern. For people who are sleeping well, that pattern will mean going to bed tonight at 10.30 pm, falling asleep within 15 minutes and sleeping relatively uninterrupted throughout the night. When our sleep becomes disrupted, after a while it develops a different pattern. This may involve difficulty falling asleep or waking in the middle of the night, every night, at the same time and then experiencing difficulty getting back to sleep.
I have attached a PDF file with some basic rules for improving your sleep. If you decide to apply these strategies to improve your sleep you will need to be patient. It can take up to 4-5 weeks before your sleep improves.
How does stress affect my sleep?
For many people insomnia is associated with stress. Stress can build up in our system as a result of major challenges or changes that we maybe be facing in our life such as a job change, interpersonal conflict, family conflict, relationship change, illness or financial problems. More often than not stress accumulates in our system as a result of common daily hassles such as getting stuck in traffic when running late or generally over committing and trying to pack too much into our day. In either case, the stress that we experience during the day can affect our ability to fall asleep or stay asleep at night. The way stress is likely to affect our ability to sleep is through excessive thinking and worrying in bed or as many of my clients report, a feeling of being adrenalised at night and unable to settle. If you are having difficulty controlling racing thoughts at night you might find the attached PDF ‘Managing Thinking and Worrying in Bed’ useful.
There are a number of things that you can do to reduce stress during the day that can help you sleep better at night. The attached PDF ‘Managing Stress in your life’ covers a number of strategies you may find useful.
Why do teenagers experience difficulty sleeping?
Delayed sleep phase disorder (DSPD) is a common condition experienced by adolescents. It is estimated that 7 % of adolescents and young adults have DSPD. It involves difficulty falling asleep until the early hours of the morning and difficulty waking up in time for school the next day. This problem is often reinforced by sleeping in until late morning or early afternoon during the weekends and school holidays, making it more difficult to fall asleep at a reasonable time during school nights. Teenagers who experience this problem have difficulty making school on time and often find themselves falling asleep during class.
There are two suggested reasons why teenagers are susceptible to this condition. The first relates to the sleep hormone melatonin which appears to be released by the brain later in the evening for adolescents than it does for adults resulting in a higher level of alertness later at night. The second relates to the introduction of technology into the bed room resulting in teenagers communicating to friends or playing on the computer late into the evening. The bright light emitted by a computer screen or mobile phone together with the added stimulation of communicating with friends late at night can further interrupt the the release of the sleep hormone melatonin. In severe cases teenagers can have difficulty falling asleep until 3-4 am and unable to rise until well after mid-day resulting in significant loss of school time.
The treatment of this condition usually involves slowly bringing back the wake up time over a number of weeks to create a mild sleep debt while slowly fading the bed time earlier in the evening. In severe cases of DSPD the treatment plan should be conducted in conjunction with your GP and a psychologist who specialises in sleep disorders. I have attached some suggested strategies to ensure your teenager maintains good sleeping habits (Refer to the PDF file ‘Sleep for Teenagers’, under this topic’s heading).
Living with a snoring partner
It has been estimated that 25% of the population have their sleep disturbed by a partner who snores. Sleeping with a snoring partner can be distressing for many people. The attached PDF will give you some practical strategies for dealing with this problem.