Sleepless nights: Unravelling the mystery of insomnia

Strongly associated with rest and healing, sleep is a fundamental pillar of health. However, the promise of a pleasant night’s rest sometimes fades into the distance in our world that truly never sleeps, especially for those whose restlessness and discomfort often spiral into insomnia. 

Approximately 30-50% of adults report experiencing at least one symptom of insomnia, and 10-15% of these have their daily functioning negatively impacted by inadequate sleep, according to a clinical review in ScienceDirect.com and Taylor & Francis Online: Peer-reviewed Journals. Prevalence can vary across different demographics, such as age, gender, and socioeconomic status. Up to 23.8% of teens may be affected by insomnia, while older adults and women are more susceptible to it.

Now, insomnia is a common sleep disorder that makes it difficult to fall asleep, stay asleep, or both, even when you have the opportunity to get enough sleep. Its key features include lying in bed for extended periods without being able to drift off, waking up frequently during the night or waking up too early and being unable to fall asleep again, and feeling unrested even after a full night’s sleep. It can be acute, in which case it is short-term—lasting a few days or weeks, or chronic, in which case it is long-term—occurring at least three nights a week for three months or more. 

Insomnia can stem from various factors. Worries about finances, work, school, or relationships can keep your mind racing at night, making it difficult to fall asleep. Stressful life events like the loss of a loved one, divorce, or job loss can trigger insomnia. Also, conditions like anxiety, depression, and other psychiatric disorders are strongly linked to insomnia.

In addition, going to bed and waking up at different times each day disrupts your body’s natural sleep-wake cycle. An uninviting sleep area, an uncomfortable bed, or excessive noise or light can hinder sleep. Engaging in stimulating activities, like using electronic devices or exercising vigorously, close to bedtime, can make it difficult to fall asleep. A late-night snack or heavy meal can cause heartburn and discomfort, thus disrupting sleep.

Furthermore, conditions like arthritis and headaches can cause pain that interferes with sleep; so can asthma, sleep apnoea, and other conditions that affect breathing. Imbalances in thyroid function can similarly affect sleep quality, while stomach acid backing up into the oesophagus can cause discomfort and nighttime awakenings.

In the same vein, some medications for allergies, heart disease, hypertension, and thyroid problems can cause insomnia. Caffeine, nicotine, excessive alcohol consumption, and drug use can disrupt sleep patterns. Jet lag and shift work can disrupt your body’s natural circadian rhythm. Sleep patterns tend to change with age, so older adults may experience more sleep difficulties. Sleep traits and conditions like insomnia sometimes run in families.

The truth is that insomnia can lead to a range of consequences affecting both physical and mental health, as well as daily functioning. It can cause slowed reaction time, leading to a higher risk of accidents, particularly while driving or operating machinery. Difficulty concentrating, remembering things, and slowed thought processes are common complaints among people with insomnia. In addition, insomnia is closely linked to mental health conditions like depression, anxiety, and increased risk of substance misuse.

Insomnia can equally contribute to weight gain, obesity, high blood pressure, heart disease, and diabetes. People with insomnia often report a lower overall quality of life, impacting their daily activities and social life. It can similarly worsen existing health problems like high blood pressure and heart disease. Sleep deprivation can lead to increased irritability, sadness, and general unwellness. Insomnia can cause persistent fatigue, making it difficult to function effectively during the day. Insomnia can equally lead to memory problems since adequate sleep is crucial for memory consolidation.

Now, insomnia can be prevented and treated through various lifestyle adjustments and, in some cases, medical interventions. Good sleep hygiene, including establishing a regular sleep schedule and creating a relaxing bedtime routine, is crucial for prevention. So, it is important to establish a regular sleep schedule by going to bed and waking up around the same time every day, even on weekends, to regulate your body’s natural sleep-wake cycle. Create a relaxing bedtime routine by engaging in calming activities, like listening to soft music, taking a warm bath, or reading before bed. You can make your bedroom sleep-friendly by ensuring it is dark, quiet, and cool.

It is equally important to limit or avoid caffeine, nicotine, and alcohol, as these can interfere with sleep. Avoid large meals and excessive fluids before bed, as this can prevent nighttime awakenings due to discomfort or the need to use the restroom. Engage in regular daytime exercise, as physical activity can promote better sleep, but avoid exercising too close to bedtime. Manage stress by finding healthy ways to cope with it, such as practising meditation, engaging in exercise, or spending time in nature.

Treatment options are similarly available, and they include behavioural therapy, which helps people identify and change negative thoughts and behaviours that contribute to insomnia. Various medications, including antidepressants, sedatives, and hypnotics, can also be prescribed to help with sleep, but should be used under the guidance of a healthcare professional.

Also important is treating any medical conditions that may be contributing to insomnia, such as chronic pain or sleep apnoea. In addition, some studies suggest that acupuncture may help improve sleep quality in those with insomnia.

The truth is that napping, especially in the afternoon, can make it harder to fall asleep at night, so avoid it as much as you can. It is also advisable to limit screen time before going to bed, as the blue light emitted from electronic devices can interfere with sleep. Equally consider using earplugs or a white noise machine, as these can help block out distracting sounds and create a more conducive sleep environment.

Sleep is a vital component of health, not a luxury. While establishing consistent sleep habits can significantly reduce the risk of developing insomnia, there is hope for you if you are already struggling with the condition. Strategies exist that can help you reclaim your night’s rest—from optimising your sleep environment to exploring behavioural therapies. Take the first step today by speaking with your doctor. 

Ojenagbon, a health communication expert and certified management trainer and consultant, lives in Lagos.