Insomnia is defined as a disorder of disturbed sleep condition. It is simply described as an inability to fall asleep or stay asleep as long as desired. The biggest drawback for those suffering from insomnia is the functional impairment following a sleepless night. Most individuals who suffer from insomnia respond positively to the following questions:
1. Do you experience any difficulty falling asleep?
2. Do you face difficulty while staying asleep?
Causes of Insomnia
We are used to thinking of insomnia as a cause of stress or other psychological conditions. Insomnia or recurrent sleeplessness can however be caused by a variety of other conditions. Insomnia can be considered a sign and symptom for many underlying illnesses. Poor sleep quality can be caused by many sleep, medical and psychiatric disorders. Here are a few causes that may be causing you to experience insomnia:
- Stimulant drugs like herbs, caffeine, nicotine, excessive alcohol intake, aripiprazole and MDMA
- Withdrawal phase of anti-anxiety drugs like benzodiazepines or strong pain killers like opioids
- Restless leg syndrome which causes feelings of discomfort causing the individual to move legs
- Hormonal imbalances in the body such as those before menstruation and those at the time of menopause
- Chronic or severe pain from various causes like injury can also lead to sleeping troubles
- Some psychological causes like fear, stress or anxiety can also be an important cause for insomnia
- Mental illnesses like bipolar disorder, depression, schizophrenia, generalized anxiety disorder, post traumatic stress disorder, obsessive compulsive disorder and dementia can also lead to troubled sleep
- Gastrointestinal problems like heartburn, acidity or constipation might also lead to unrest that causes sleep disturbances
- Poor sleep hygiene such as caffeine before going to bed and noisy environment can also lead to sleeplessness
- Exercise induced insomnia is common in athletes as a form of prolonged sleep onset latency
- Some drugs like flouroquinolone antibiotics can also causes chronic insomnia as a side effect
The Biological Importance of Sleep
Sleep is essential for life. Sleep deprivation can be potentially dangerous even if it does not become lethal. Although in one form of prion induced disease insomnia can result in death. Insomnia can raise havoc in the normal functioning of your body which usually requires sleep to maintain its balance. Various studies have been performed to analyse the effects that sleep deprivation can have on our body and here are a few of them:
- Sleep deprivation can result in worsening of migraines or other forms of headaches
- Insomnia makes you fall sick more often
- Statistics have shown that insomnia precedes 40% of psychiatric disorders and 20% of mood disorders are found coexisting with insomnia
Insomnia and Back Pain
Before we begin to investigate whether insomnia can cause pain it is important to observe whether insomnia worsens any kind of pre-existing pain. According to various researches, it has been proved that insomnia and sleep discontinuity can in fact produce distinguished hyperalgesic changes.
Sleep deprivation has also shown to make the trigger points worse for pain. Another survey showed that 52% of low back pain patients in fact complain of insomnia as well. While it may seem convenient to assume that the pain keeps these individuals awake at night, there is another possibility that we can consider. Most of these lower back pain individuals are in fact poor sleepers and the insomnia may actually precede the onset of pain symptoms in these individuals. Hence this proves that poor sleeping habits are the trigger for pain and not the other way around.
There is further proof that insomnia is specifically associated with musculoskeletal pain as proved by fibromyalgia and migraine patients complaining of pre-existing or co-existing insomnia. But insomnia is also a cause of joint pain in normal healthy individuals. In a study performed 24% decrease* in musculoskeletal pain threshold in sleep deprived individuals
Treatment of Insomnia
This can prove to be quite challenging, because insomnia is usually a symptom of another disease. Unless the root cause is identified, most attempts at treating insomnia will be ineffective.
- Before starting medications, it is better to try some basic things at home. These include going to bed early, avoiding stressful factors near bedtime, avoiding tea, coffee and other stimulants. Eating a couple of hours before sleep is also helpful.
- Exercising and keeping the body in good shape has also proven to improve* sleep cycles. Exercise releases chemicals in the brain called endorphins that give a feeling of peace and serenity.
- If the above mentioned things do not help, medical therapy may be prescribed. This, however, is a slippery slope, and all sort of sedatives and anxiolytics are to be used under the strict supervision of a physician. This class of drugs includes benzodiazepenes, barbiturates, Selective Serotonin Reuptake Inhibitors (SSRIs), Norepinephrine Serotonin Reuptake Inhibitors (NSRIs), Tri-cyclic Antidepressants (TCAs).