Insomnia

What is Insomnia?

Insomnia is a condition in which a person has difficulty falling and staying asleep. It's estimated that a third of Britons are affected by insomnia at any one time. It is more likely to affect women than men, especially during pregnancy and the menopause.

On the surface, a lack of sleep may not seem serious, but persistent difficulty getting a good night's sleep can pose a significant threat to your health and well-being.

Without sleep during the night, your productivity and alertness levels decrease during the day. This can make certain activities, such as driving a car, riding a bike, or operating machinery, considerably more hazardous to yourself and those around you.

Lack of sufficient sleep can also contribute to obesity, diabetes, heart disease, lower sex drive, lower immunity and increase your risk of mental health disorders.

Difficulty sleeping is often linked to mental health issues such as anxiety or depression. Not only can anxiety and depression cause insomnia, but lack of sleep can increase your risk of developing anxiety and depression.

Types of insomnia

Insomnia can be a short-term or long-term (chronic) condition.

Short-term insomnia is classed as transient, intermittent or acute insomnia symptoms which last for less than 3 months. Short-term insomnia includes transient insomnia - this is insomnia which lasts for less than a week and doesn't recur, such as jet lag.

Long-term or chronic insomnia is classed as persistent symptoms which last for more than 3 months. This can be caused by medicines, mental health conditions, physical conditions (such as chronic pain) or shift work.

What causes insomnia?

Insomnia can be caused by a number of different factors, including your diet and lifestyle.

Dietary causes of insomnia include:

• High caffeine consumption
• Excessive alcohol consumption
• Refined carbohydrates

Eating a large meal before bed can make you feel bloated and uncomfortable, making it harder for you to fall asleep. Drinking too many fluids before bed can disrupt your sleep, as you may need to wake up during the night to empty your bladder.

Spicy and fatty foods can trigger heartburn in some individuals, which can also impact their sleep quality. If you find that certain foods give you heartburn, you should avoid them before bed.

Caffeinated beverages should be avoided in the afternoon and before bedtime, as they can make it harder for you to fall asleep.

While alcohol can cause drowsiness, excessive alcohol consumption can also cause nausea, vomiting and a sensation of spinning when large quantities are consumed - these symptoms can disrupt your sleep.

Lifestyle causes of insomnia:

• Napping during the day
• Not exercising enough
• Using your phone or watching TV in bed
• Staying up all night to meet deadlines

Mental health conditions such as depression, anxiety and stress can also cause insomnia. You should speak to your doctor if anxiety, depression or stress is causing you to lose sleep.

Medicines can also cause insomnia. If you are unsure whether a medicine you are taking is causing your insomnia, speak to your doctor or a pharmacist for advice. They may be able to offer advice on how to take the medicine to minimise its impact on your sleep.

If you are unsure what might be causing your insomnia, it may be worth keeping a sleep diary to record your activities and diet before bedtime. Your doctor can help you identify the possible cause of your insomnia and provide a suitable treatment for you.

Preparing for sleep

Your events leading up to bedtime are important, as they can influence the quality of sleep you get.

If you're struggling to sleep, consider doing some exercises to tire yourself out. But doing intense exercises before you are due to go to bed can increase your body temperature, accelerate your heart rate and increase the amount of adrenaline. These can make it difficult to fall asleep. Light stretches, such as Yoga, can help you become more restful.

Electronic devices, including TVs, computers, and smartphones, have screens that emit blue light, which can disrupt your sleep pattern. You should avoid using such devices an hour or so before going to sleep. Instead, consider reading a book.

You should aim to go to bed at the same time every night. Make sure to go to bed at a reasonable time to ensure you get around 8 hours of sleep.

Taking a warm bath can also help you fall into a restful state. You may also wish to use a bath additive or body wash designed to help you relax.

If you struggle to get to sleep because you worry about what's happening the next day, write a "to-do" list before you go to bed. This helps to clear your thoughts, allowing you to relax and fall asleep.

Listening to the radio or an audio relaxation guide can help distract your mind before bed and promote a better night's sleep. You can find apps which are designed to help you sleep.

Creating the perfect environment to sleep

First and foremost, keep your bedroom dark. Darkness promotes the pineal gland in your brain to produce the sleep-inducing hormone called melatonin, while light halts the production of this hormone. Draw your curtains. If light still seeps through, consider thicker or darker curtains. Ensure that all screens are turned off before going to bed.

Try to eliminate noise from your bedroom. Some people might not mind the hum of a fan or the soft sweeping sounds of passing traffic outside their bedroom window, while others may find them annoying. Sit in your room and take a moment in silence to listen for sounds that might disrupt your sleep, and work to eliminate them.

You might be surprised to learn that keeping your bedroom cool can improve your sleep. You should keep your bedroom between 16°C and 18°C. Before you sleep, your body temperature drops by a few degrees and remains constant throughout the night. Studies have shown that warm and humid environments have a greater negative impact on sleep than cool temperatures.

Finally, your bed should be comfy. This can be subjective, so take your time to find what works for you. If you have difficulty breathing when lying flat, prop your head up with cushions or use a neck cushion. If you sleep on your side, you may experience benefits from placing a firm cushion between your knees, as sleeping on your side can pull your spine out of alignment. Using a cushion between your knees prevents the twisting action which affects your spine.

Monitoring your sleep

Modern technology enables us to monitor how much sleep we get. Some fitness bands can track your sleep and provide feedback on how much sleep you got, whether you woke up during the night and other information which can benefit you or healthcare professionals.

It might be worth keeping a sleep journal. In your sleep journal, make a note of when you went to bed, whether you woke up during the night, what time, and how rested you feel in the morning. You should also include events leading up to bedtime - this can help you identify lifestyle habits which might affect your sleep. For example, you can note down what medicines you took before bed, whether you felt stressed or in pain before bedtime, as well as what you ate and drank before bed.

Treatments for insomnia

You should always speak to your doctor before taking any medicine to treat insomnia. Your doctor will be able to recommend the most suitable treatment for you based on the severity of your insomnia and your medical history.

Adjusting your lifestyle

In some cases, you might find that making adjustments to your lifestyle can help you fall asleep. For example, cutting down on caffeine, using your phone less before bed, going to bed at the same time or adapting your sleeping environment could make a significant impact on the quality of your sleep.

Underlying medical conditions

Insomnia can be caused by an underlying condition such as chronic pain, depression, anxiety, heartburn or sleep apnoea. Typically, treating the underlying condition can also alleviate your insomnia.

If an underlying medical condition is affecting your sleep, it's important to speak to your doctor about what you can do to manage your condition and the ensuing insomnia.

Medicines

If adjusting your lifestyle makes little to no difference in the quality of your sleep, you may consider seeking medications that can help.

Over-the-counter treatments such as Nytol can help you get a good night's rest. While they can be bought over the counter, you should still speak to your doctor before taking them, as they could interact with other medicines you might be taking.

Some cold and flu medicines are formulated to promote a good night's sleep, such as Night Nurse. This is because colds and the flu can make it difficult for you to fall asleep. Again, consult your doctor or pharmacist before taking these medications.

If over-the-counter insomnia treatments have not worked, you should speak to your doctor. They may be able to prescribe a medicine to manage any underlying issues which might be causing your insomnia, or the insomnia itself.

Cognitive behavioural therapy for insomnia (CBT-I)

Cognitive behavioural therapy (CBT) can be used for both short- and long-term insomnia. It is a type of talking therapy which helps you identify the causes of your insomnia and work on re-associating actions with sleep. Unlike medicines, the effects of CBT on insomnia are long-lasting and can prevent insomnia in the future.

Your doctor can provide you with more information about CBT and how it can help your insomnia.

Authored & Reviewed By

Adil Bhaloda

Pharmacist

This content has been written and checked for quality and accuracy by Adil provides governance for the online services, overseeing prescription dispensation in line with UK pharmacy standards.

Published on: 27/10/2020 Reviewed on: 10/11/2020