Insomnia

What is insomnia?

Insomnia is an inability to fall or to stay asleep.
What causes insomnia and who is at risk?

Causes of insomnia include anxiety, depression, alcohol and drug abuse, jet lag, and chronic painful medical conditions. These and other causes are set out in greater detail below.
Insomnia is very common. As many as one in three adults will suffer insomnia at some time or other in their lives.
Anxiety

Anxiety is characterised by increased alertness and an unpleasant sensation of fear and apprehension. Often anxious people will lie in bed for hours attempting to get to sleep. The inability to get to sleep generates more anxiety, making the problem self-perpetuating. Other symptoms of anxiety include trouble staying asleep, poor concentration, feeling wound up, irritability, muscular aches, distractibility, being easily tired, palpitations, dizziness and nausea.The anxiety may be the result of stressful life events which may include illness, difficulties with work, problems with family life or some sort of loss including bereavement.
Depression

Disturbance of sleep rhythm is very common in people suffering from depression (see separate Factsheet). In severe depression, waking early in the morning is common, typically in the very early hours, often at 4 or 5am with great difficulty getting back to sleep. This results in chronic tiredness.
Alcohol

Alcohol abuse is often related to anxiety and depression; disturbance of sleep may occur as a result of these conditions. Alcohol taken in large quantities by people who do not abuse alcohol also frequently leads to disturbed sleep, often in the early hours of the following morning. This is due to the declining alcohol levels in the body leading to increased wakefulness.
Drugs

Drugs that stimulate the brain frequently lead to disturbed sleep patterns. These include cocaine, amphetamines and ecstasy. When taken in large amounts, it may be impossible to get to sleep for many hours. This is followed by long periods of sleep when the effects of the drug have worn off.
Jet-lag

This is a particular problem among business men and women whose work involves international travel. The susceptibility to developing jet-lag varies greatly between individuals. Some people are completely unaffected by jet-lag, whereas for others the effect is particularly marked and will interfere with normal functioning of everyday life.
Most people develop some degree of jet-lag when travelling East or West to a time zone five or more hours different from home. On travelling East, the effect will be of one of inability to get to sleep at the normal retiring time of the time zone travelled to. On travelling West, the problem is one of drowsiness very early in the evening and then waking in the early hours of the morning.
Poor sleep hygiene

Individuals who take 'cat naps' during the day will require less sleep at night and may say they have insomnia. This phenomenon is known as 'poor sleep hygiene'. The requirement for sleep during any 24-hour cycle varies greatly between individuals.
What is the treatment for insomnia?

Self-care action plan

Often identifying stressful events and eliminating them or reducing them may improve sleep patterns.
Jet-lag may be managed by attempting to switch sleep patterns to the new time zone before travelling. For poor sleep hygiene, advice about healthy sleep patterns is often all that is required to treat the condition. Stopping cat naps in the day is often beneficial.


Complementary therapy
Relaxation therapy, reflexology, Alexander technique, yoga and tai chi may all help promote a sense of well-being, relieve anxiety and may improve sleep patterns at night.