Are you suffering from insomnia?

Insomnia is a common sleeping disorder where a person struggles to get to sleep, can’t maintain sleep, and/or wakes frequently during the night. Bouts of insomnia can be temporary or persistent. Sufferers of insomnia not only feel physically drained but also experience mental fatigue, mood swings, poor work performance, and decreased quality of life. Around 45% of New Zealand adults report experiencing insomnia symptoms at least once a week.

The initial symptoms of insomnia include:

• Trouble falling asleep
• Waking up frequently during the night
• Waking up early, unable to fall back to sleep
• Feeling fatigued during the day

Other symptoms develop over prolonged bouts of insomnia, and include:

• Poor performance at work
• Irritability
• Depression
• Anxiety around sleep
• Difficulty paying attention

Most people experience bouts of temporary (acute) insomnia, which can last just a few days or several days. More severe (chronic) insomnia can last months or years. The causes of acute and chronic insomnia vary.

Causes of acute insomnia

Acute insomnia is often caused by temporary stresses or changes in your lifestyle. Common causes of acute insomnia include:

• Shift work (switching between night shift and day shift)
• Stress
• Jet lag
• Physical pain or discomfort in the body
• A sudden life change (a death, a break-up, loss of employment)
• Caffeine intake late in the day
• Eating late in the evening
• Alcohol/drug use
• An inconsistent sleep schedule

Causes of chronic insomnia

Chronic insomnia can be caused by underlying medical conditions, psychiatric disorders, poor sleep hygiene, or other sleep disorders.

• Medical conditions linked to chronic insomnia: nasal allergies, asthma, obesity, acid reflux, congestive heart failure, arthritis, dementia, Parkinson’s disease, hyperthyroidism, chronic pain.
• Psychiatric conditions linked to chronic insomnia: anxiety, depression, PTSD, psychosis, mania.
• Sleep disorders linked to chronic insomnia: sleep apnoea, restless legs syndrome, sleep walking, circadian sleep disturbance.

Treating temporary insomnia

Temporary insomnia can often be alleviated through simple lifestyle adjustments and good sleep hygiene. Recommendations for rediscovering a good night’s sleep include:

• A consistent sleep schedule – keep a consistent bedtime and wake up time, including on weekends
• Regular exercise – stay active with daily exercise to help you get to sleep and stay asleep
• Create a comfortable sleep environment – limit light and outside noise and don’t use your bed for other activities such as work or browsing the internet
• Limit caffeine intake – cut down on your coffee intake and avoid caffeine from mid-afternoon.

Treating chronic insomnia

Treatment for chronic insomnia varies depending on whether it has been triggered by a medical condition, a psychiatric condition, or a sleep disorder. There are often multiple factors contributing to chronic insomnia, so it is important to get a comprehensive diagnosis. One of the most successful treatments for chronic insomnia is cognitive behavioral therapy.

Cognitive behavioral therapy for insomnia (CBT-I) instigates changing behaviors that are preventing you from sleeping. Using methods such as stimulus control, CBT-I can remove frustration and anxiety around not falling asleep. CBT-I also includes relaxation training and sleep hygiene training to make bedtime a relaxing, pleasant experience.