Insomnia: A Nighttime Monster
Many children are afraid of darkness and the monsters that might be hiding in it. Monsters that hide under your bed, kidnap you when you’re fast asleep, or yell at you if you get up in the middle of the night and cross their path. Fortunately, these childhood monsters are imaginary, but there is a real monster that appears at night for both children and adults: insomnia.
Insomnia is a sleep disorder. There are two different kinds of sleep disorders: dyssomnias and parasomnias. In dyssomnias, the amount, quality, and schedule of sleep is affected. In parasomnias, abnormal things happen while you’re asleep, like nightmares. Therefore, insomnia would be categorized as a dyssomnia.
“If a man had as many ideas during the day as he does when he has insomnia, he’d make a fortune.”
What is insomnia and how does it manifest?
Even though most people are familiar with the idea of “good and bad sleepers” and different sleep patterns (being a morning person or a night person), there are clear indicators of insomnia. The most common and evident sign is the discomfort that the person experiences in their daily life due to the lack of sleep, which occurs due to various factors, usually related to their own habits.
To differentiate between a passing difficulty getting sleep and insomnia, specialists say that it must occur for 3 or more nights per week over a period of at least 3 months.
Insomnia is a sleep disorder under the category of dyssomnias, in which there’s a persistent difficulty or inability to fall asleep and stay asleep. These people also tend to wake up early after they’ve fallen asleep late.
How to differentiate between insomnia and other sleep disorders
As a dyssomnia, people with insomnia don’t experience strange phenomena once they’re actually asleep, but they struggle with the amount, quality, and schedule of sleep.
To differentiate between insomnia and other similar disorders, first you must get to know them. Even though all sleep disorders share the same main problem, they don’t have the same causes or treatments. Let’s list a few sleep disorders:
- Disorders related to breathing while sleeping, including apnea and alveolar hypoventilation.
- Hypersomnias like Kleine-Levin syndrome.
- Issues related to one’s circadian rhythm, like delayed sleep, jet-lag, work shifts, etc.
- Unspecified disorders like restless leg syndrome and nocturnal myoclonus.
- Disorders related to the consumption of substances that affect the quantity and quality of sleep (caffeine, medications, drugs, etc.).
- Secondary sleep disorders related to other disorders or illnesses.
Once you’ve discarded all these other causes, you can be sure that you have insomnia that isn’t caused by any other organic cause or psychological disorder. Sometimes insomnia can develop as a result of depression, for example, which should therefore be treated differently than isolated insomnia.
The effects of insomnia
A lack of sleep can be completely infuriating for those who suffer from it. Not only are you tired all the time, but the fatigue also results in apathy, a lack of concentration, and irritability. Getting insufficient sleep has a direct impact on your energy levels for obvious reasons, which can affect your work and your relationships.
A lack of sleep can also affect your reaction time, learning, and memory. Even though many celebrated people have described themselves as night people, don’t be misled. It might be that even though they don’t sleep at night, they get enough sleep during the day, although this isn’t typical among most of the population.
Remember also that certain jobs have flexible schedules: dedicating yourself to writing isn’t the same as driving a bus. In one case, losing sleep isn’t that big of a deal, and in the other case it can have fatal consequences.
The best treatments for insomnia
If you’re going through a serious episode of insomnia in which you can’t sleep for days, your primary care doctor can prescribe you benzodiezapines or sleep medications. The latter is preferable since they last about 5 hours, which results in a smaller chance of dependence.
But these medications are just a Band-Aid for insomnia, because it’s caused by many different environmental and behavioral factors. Therefore, it’s best to consult a clinical psychologist experienced in a cognitive-behavioral approach to insomnia. The most common techniques they use are:
- Stimulus control: This involves controlling the temperature and the noise level of the place where you sleep and avoiding spending time in this place doing other activities like studying or watching a movie. However, it is recommendable to read before bed, as this is an activity that facilitates sleep. However, you should try not to read in bed.
- Sleep restriction: This is a technique created by Spielman that involves restricting the hours of sleep for a few days until the person gets so exhausted that they fall asleep at a better time. Sleep should not be reduced to less than 4 hours.
- Paradoxical intention: this involves contradicting your desire. If you’re thinking that you should sleep, think instead that you have to stay awake. It’s been demonstrated that this paradoxical cognitive struggle will end up inducing sleep.
- Relaxation techniques like autogenic training and progressive relaxation.
- Sleep hygiene: improving education related to good sleep habits (reducing caffeine intake, playing sports, nutrition, avoiding alcohol, etc.).