Some people with insomnia have trouble falling asleep, whereas others wake up throughout the night and struggle to fall back asleep.
Sleeplessness affects both the quantity and quality of sleep, making it hard for individuals to reach the therapeutic levels of sleep, which causes daytime sleepiness and fatigue, and over time—feelings of irritability, anxiety, and depression.
This can lead to professional and personal problems and day-to-day challenges like falling asleep while driving.
Although insomnia can happen without an underlying cause, it can also accompany and worsen other problems like pulmonary diseases, psychiatric conditions, and a whole variety of conditions that might cause pain.
Sleeplessness is a side effect of stimulants like caffeine and depressants like alcohol, disrupting the regular sleep cycle.
Finally, and probably most commonly, sleeplessness can result from daily stresses from work or relationships and environmental factors such as working a night shift or having a newborn baby.
People with insomnia are also more sensitive to the effects of cortisol, typically waking up at much lower levels of cortisol compared to the general population.
In addition, sleeplessness is also associated with reduced estrogen levels and reduced levels of progesterone, which can happen during menopause.
Alcohol abuse can lead to several physical and psychological changes that can rapidly worsen the sleep-wake cycle and cause become dependent.
Similarly, benzodiazepines, especially short-acting ones, can also create dependence and have high abuse potential, worsening insomnia if someone tries to stop using them.
One method of treatment is getting good sleep hygiene, which includes going to sleep and waking up at the same time every day, including weekends, getting good exercise (but not right before bed), reducing alcohol intake, avoiding daytime naps, avoiding caffeine, and smoking in the evening, and not going to sleep hungry.
Another potential treatment is stimulus control which includes using the bed only to sleep rather than a place from which to watch television, text, or talk on the phone.
It also helps keep the environment calm by removing bright lights like a computer or a phone screen and minimizing noise. Sometimes, though these are unavoidable, eye covers and earplugs can help.
It’s also not helpful to force sleep to happen, which means that people who can’t sleep after 20 minutes should leave the bed and return when they feel ready to sleep.
These suggestions help the individual associate sleep—and only sleep—with the bedroom. Also, there’s behavior therapy, which includes relaxation techniques and cognitive behavior therapy to help better manage problems and life stressors.
While these techniques are being used, some medications such as melatonin agonists, non-benzodiazepine sedatives, and occasionally benzodiazepines might be prescribed to help sleep.
Though these medications can often have side effects, they are generally used for less than two months, usually combined with behavioral therapy techniques.
Sleeplessness can be managed with good sleep hygiene, stimulus control, behavior therapy, and occasionally short courses of medications.