Sleep - insomnia

Insomnia is a symptom, not a disease. It means being concerned with how much you sleep or how well you sleep. This may be caused by difficulties in either falling or staying asleep. Self-reported sleeping problems, dissatisfaction with sleep quality and daytime tiredness are the only defining characteristics of insomnia. It is an individual perception of sleep. Long-term chronic insomnia needs professional support from a sleep disorder clinic.

The concept of ‘a good sleep’ differs widely from person to person. While the average night’s sleep for an adult is around eight hours, some people only need five, while others like up to 10 hours or more. What seems like insomnia to one person might be considered a good sleep by another.

Insomnia is a common complaint

Over one third of people experience insomnia from time to time, but only around five per cent need treatment for the condition. Transient or short-term insomnia is typically caused by such things as stressful life events, jet lag, changes in sleeping environments, some acute medical illnesses and stimulant medications. Normal sleeping habits return once the acute event is over.

If a person has experienced sleeping difficulties for a month or more, this is called persistent or chronic insomnia. There are many causes of persistent insomnia. These include:

• Secondary insomnia – due to a range of medical and psychiatric problems and the chronic use of drugs and alcohol.
• Primary sleep disorders – include circadian rhythm disorders, central sleep apnoea-insomnia syndrome, inadequate sleep syndromes and periodic limb movement or restless legs syndromes.
• Idiopathic insomnia – sleeplessness without a known cause, formerly called childhood onset insomnia.

Keep sleep in perspective

People who suffer from insomnia are normally frustrated or annoyed by it. Paradoxically, this emotional state contributes to keeping them awake, starting a vicious cycle. It helps to stop expecting a set amount of sleep every night. Having less sleep than you’d like doesn’t cause any harm. Allow yourself to fall short of the ideal without getting anxious about it.

Home remedies for short-term insomnia

Reducing anxiety and sticking to a day–night routine can improve sleep quality. Suggestions include:

• Don’t nap during the day.
• Cut down on smoking and drinking.
• Avoid tea, coffee and other caffeinated drinks before bed.
• Don’t exercise strenuously before bedtime.
• Do something to relax, such as meditate or have a warm bath.
• Only go to bed if you feel sleepy.
• Go to bed later.
• Stop reading, worrying or watching television in bed and limit your activities in the bedroom to sleeping and sex.
• If you can’t sleep, get up, go to another room and do something else until you feel sleepy again.
• Get up at the same time every morning regardless of how much sleep you have had.
• Avoid ‘judging’ your sleep on a day-to-day basis.

Treatment for long-term insomnia

Insomnia that has persisted for years needs professional support and a lot of patience. It might take some time to re-establish normal sleeping patterns.

Some of the techniques used by a sleep disorder clinic might include:

• a sleep diary, to help pinpoint the pattern of insomnia
• a program of mild sleep deprivation
• medication to help set up a new sleeping routine
• exposure to bright light in the morning
• behavioural therapy.

Where to get help

• Your GP (doctor)
• Sleep Health Foundation
• Sleep disorder clinic / sleep specialist - a sleep specialist is a medical doctor who has undertaken specialised training in the field of sleep medicine.