Combatting Insomnia
Abstract
As sleep science advances, researchers are beginning to delve into the world of sleep disorders. Insomnia is a particularly prevalent condition that encompasses an impaired ability to get a good night’s sleep, leading to numerous negative health outcomes. Fortunately, many of the risk factors, causes, and consequences of this disorder have been aptly identified. Additionally, reports have been conducted to understand the secondary effects of this type of sleep deprivation. This has allowed experts to curate recommendations that involve medications and medical interventions. But besides just clinical solutions, lifestyle modifications and at-home routines can also work as a barrier and combatant against insomnia symptoms. However, these strategies have shown varying degrees of success, and the medications have been known to have unpleasant side effects. While insomnia is a multifaceted disorder that is difficult to pinpoint, the growing body of knowledge surrounding it helps shed light on future research and possible remedies.
Introduction: What is Insomnia?
Insomnia is a common sleep disorder characterized by difficulty sleeping, particularly falling asleep and staying asleep ("Insomnia", 2024). As a result, those diagnosed suffer degraded sleep quality and duration, which impacts how they function in the waking hours (Morin et al., 2015; Ramakrishnan and Scheid, 2007). Short-term insomnia - which can last days or weeks - is very common, while chronic insomnia is less prevalent ("Insomnia", 2024). Globally, there is a consensus that an estimated 30% of adults have at least one symptom of insomnia, while 10% experience chronic insomnia (Roth, 2007; Roth and Roehrs, 2003).
Multiple potential causes and risk factors of insomnia have been identified, with females and elderly populations being more commonly affected. (Morin et al., 2015; Ramakrishnan and Scheid, 2007). Extreme distress is a potential catalyst, as well as lack of social connection, divorce, and unemployment (Morin et al., 2015; Ramakrishnan and Scheid, 2007). Moreover, some medical conditions can contribute to the onset of insomnia, like gastroesophageal reflex disease and dementia, as well as certain medications, such as some blood pressure and weight loss medications ("Insomnia", 2024).
Some of the side symptoms of insomnia include crankiness and tiredness throughout the day, as well as feelings of depression and anxiety ("Insomnia", 2024). It’s also positively correlated with heightened morbidity and mortality related to heart disease, as well as comorbidity with other psychiatric conditions (Ramakrishnan and Scheid, 2007). Insomnia can reduce a person’s quality of life in a variety of ways, such as by instigating physical pain, poorer mental health, diminished social skills, etc. (Roth, 2007). Thus, it is overall clear that an insomniac’s happiness levels can be severely degraded by the condition.
What Medical Treatments are Used?
To start, there are a number of prescription medications used to treat insomniacs. The FDA has approved five benzodiazepines - which are a type of sleep medication that can cause dependency - for administration to insomniacs ("Treatments for Insomnia", n.d.). They are: Estazolam, Flurazepam Quazepam, Temazepam, and Triazolam ("Treatments for Insomnia", n.d.). Other prescription medications that are recommended by the National Heart, Lung, and Blood Institute include melatonin receptor agonists, which can have side effects of dizziness and fatigue, and orexin receptor antagonists, which can cause a person to be active when asleep (e.g. by sleepwalking) ("Treatment", 2022). It should be noted that because insomnia is a chronic condition that rarely ends with an abrupt remission, short-term medications that promote sleep are often not successful in treating insomniacs for life (Roth and Roehrs, 2003).
Cognitive-behavioural therapy is another option that is gaining traction in the field of insomnia treatment (Morin et al., 2015). CBT-I, or cognitive-behavioural therapy for insomnia, works to gradually improve sleep patterns until the individual can consistently get adequate rest. This involves altering the sleep environment to avoid distractions (such as phones) and repressing thoughts that make it difficult to sleep, such as stressful thoughts about work ("Treatments for Insomnia", n.d.). Another promising method is Relaxation Therapy. This type of sleep therapy aims to calm both the mind and body, such as through deep breaths, muscle relaxation, and meditation (Edinger et al., 2021). The goal of this tactic is to ease physical and mental tensions to promote sleep, and it’s a cost-effective method that has shown worthwhile results (Edinger et al., 2021).
What Personal Steps Should Be Taken?
There are also non-clinical practices that insomniacs can implement into their daily routines to get their sleep schedules back on track. One of the most effective methods of combatting irregular sleep patterns is going to bed and waking up at the same time every day ("Treatments for Insomnia", n.d.). Additionally, limiting caffeine, nicotine, and alcohol intake before bed prevents these substances from interfering with sleep quality, allowing insomniacs to fall asleep faster and mitigate nighttime arousals ("Treatment", 2022). Doctors also strongly encourage the adoption of healthy, thoughtfully planned daytime routines that involve daily exercise, regularly consumed meals, and limited napping ("Treatment", 2022). Practicing mindfulness frequently, such as through meditation, is another research-backed approach that can tie into the Relaxation Therapy discussed above (Edinger et al., 2021). Similarly, adopting a calming bedtime routine (such as by implementing warm baths, listening to soothing music, and reading light novels) can help prime the brain for quality sleep (Edinger et al., 2021; "Insomnia", 2024).
Lastly, researchers suggest an approach known as metacognition. With metacognition, insomniacs are encouraged to be more aware of their thought processes, so they can have a more reflective and controlled response to thoughts about their insomnia and about events and stressors that keep them up at night (Morin et al., 2015). It should be noted that these lifestyle modifications can also work as preventative measures against insomnia to avoid its appearance later in life.
Unfortunately, insomnia frequently goes undiagnosed and untreated (Morin et al., 2015). Additionally, it’s difficult for researchers to determine the severity of insomnia, so making an appropriate diagnosis and treatment plan can be complicated (Roth and Roehrs, 2003). Some factors that are commonly considered include the amount of sleep trouble endured by the individual and the extent of the consequences on daytime functioning (Roth and Roehrs, 2003). As our understanding of this condition continues to grow, the hope is that healthcare providers will become more efficient at diagnosing and treating it before it can become too detrimental to a person’s life.
Conclusion
Many of us struggle with getting enough quality sleep, and insomnia is the epitome of this dilemma. With a range of causes and consequences, the ideal treatment has been elusive for some time. However, given its detrimental implications and expansive presence, there is an urgent need to address this condition in its entirety.
