Is falling asleep at night a struggle, no matter how tired you feel? Or do you fall asleep easily enough, but then wake up in the middle of the night and wind up lying awake for hours? Insomnia takes a major toll on your energy, mood, and health, and not just at night — it affects sufferers all day long. In our next two blog posts, we’ll be taking an in-depth look at insomnia. For this post, we’ll focus on what insomnia is, its symptoms, and its causes. In our next post, we’ll turn to ways that you can overcome insomnia and get the restful, restorative sleep that your body needs.
What is insomnia?
Insomnia is defined, simply, as the inability to get the amount of sleep you need to wake up feeling rested despite having adequate time and opportunity to do so. Even though many people assume eight hours a night is what’s supposed to be “natural”, different people need different amounts of sleep. Hence, insomnia is defined by the quality of your sleep and how you feel during your waking hours rather than being based on how many hours you sleep, or how easily you fall asleep. Even people who sleep eight hours a night may be experiencing insomnia if they still feel fatigued during the day.
Insomnia is extremely common, and it varies tremendously from person to person. It’s hard to pin it down as one specific sleep disorder. Some people will experience insomnia intermittently due to short-term changes in their daily lives, while for others it can be a side effect of another problem. This type of insomnia is categorized by doctors as either transient (lasting less than one week) or short-term (lasting from one to four weeks). Persistent, long-term insomnia, or chronic insomnia, may be a symptom of an underlying medical condition, so if you are experiencing sleeplessness on a regular basis it is a good idea to see a doctor. Chronic insomnia also has many physical and psychological consequences, which we’ll discuss in a moment.
What are the symptoms of insomnia?
The symptoms of insomnia vary depending on the type of insomnia: For some people, the primary issue is difficulty falling asleep, while for others staying asleep is the issue. Some people have both problems. For other sufferers, even though they sleep “normally,” still feel exhausted when they awaken. Any of these can lead to feeling drowsy and irritable, and having issues concentrating, during the day. Feeling you have to rely on sleeping pills or alcohol to fall asleep, or that you require massive amounts of caffeine to wake up in the morning, is symptomatic of insomnia (and likely making it worse, as you’ll see in our next post).
What are the consequences of insomnia?
Research has shown that even transient or short-term insomnia can have significant effects in terms of cognitive impairment, taking a toll on your memory, concentration, problem solving, reasoning, and ability to perform basic tasks. When your nighttime sleep is cut into by even as little as an hour and a half for one night, your daytime alertness drops by nearly a third. This can have major consequences: Drowsiness doubles the risk of an occupational injury, and the National Highway Traffic Safety Administration estimates (conservatively) that each year drowsy driving is responsible for at least 100,000 automobile crashes, leading to 71,000 injuries and 1,550 fatalities. Even at this level, insomnia can also put you at greater risk for anxiety, depression, and drug and alcohol use. It also reduces your quality of life. Irritability and inattention can strain your relationship with your partner and with your children, and sleepiness makes both work and leisure harder. You can’t enjoy your favorite TV show if you can barely pay attention to it.
The good news is that with intervention, the effects of short-term sleep deprivation can be alleviated. Memory and other cognitive deficits can generally be brought back. Over the long term though, the consequences of chronic insomnia can be severe. They include high blood pressure, heart attack, stroke, obesity, accelerated aging, disruption to hormone production, a weakened immune system, and mental impairment. Chronic insomnia has also been linked to psychiatric problems, including depression, mood disorders, and attention deficit disorder. If you are suffering from chronic insomnia, it is important that you see a doctor for proper diagnosis and treatment.
What causes insomnia?
There are numerous causes of insomnia, some of which are easy to control through simply changing your habits and others of which require more careful intervention. In order to find an effective cure for insomnia, it’s important to understand the underlying cause.
Temporary causes: In some cases, insomnia only lasts a short time and resolves on its own. In this instance, insomnia is usually caused by something that’s going on in your life. This could be jet lag, stress over a particular upcoming event, or an effect of something you did during the day (like that latte you had after 3 pm).
Psychological issues: Chronic stress, as opposed to short-term, event-specific stress, can contribute to long-lasting insomnia. Depression, anxiety, bipolar disorder, and PTSD can also cause insomnia. People who suffer from depression or an anxiety disorder often have difficulty sleeping, and in a vicious cycle, insomnia can worsen the symptoms of depression and anxiety. If a psychological issue is implicated in your insomnia, treating that underlying issue is key to getting back your sleep.
Medical issues: Insomnia can brought on by numerous medical conditions. Sleep disorders like sleep apnea, restless leg syndrome, and even narcolepsy can play a role in insomnia. Other illnesses can also exacerbate insomnia, including acid reflux disease, allergies, asthma, cancer, chronic pain, hyperthyroidism, kidney disease, and Parkinson’s disease. Treatment for the condition is likely to aid your sleep.
Medications: Numerous medications — both over-the-counter and prescription — can contribute to insomnia. Though drowsiness is a common side effect of medications, restlessness is too. Cold and flu medications that contain alcohol, pain relievers that contain caffeine (like Excedrin and Midol), diuretics, corticosteroids, and some antidepressants can inhibit sleep. Never stop taking a prescription medication without consulting a physician first. Instead, bring up your insomnia — in many cases, there will be an alternative treatment option that’s less likely to disrupt sleep.
The gut-brain connection: Something fewer people know about but that is becoming more prominent in the medical literature is the gut-brain connection. The idea is that we can think of the gut as a “second brain.” This comes from folk and holistic traditions. Holistic health practitioners have been putting this into practice for decades, and in Chinese culture it has long been believed that food is mood altering. There’s science behind this: The gut is where most of the body’s serotonin — one of our main “feel good” chemicals — is made. Interest in the gut-brain connection has led to the emergence of the field of neurogastroenterology, specifically devoted to the correlation between mental health and gut health. In Dr. Michael D. Gershon’s book The Second Brain, he goes so far as to posit that the gut can operate totally independently from the brain. Depending on the foods we eat, these unconscious processes initiated by the gut can make your brain feel sluggish (like when you eat something and feel sluggish afterward) or excited (for some people, glutamate — what wheat is broken down into upon digestion — can activate the brain, making sleep difficult).
Hormones: Another major cause of insomnia that many people are unaware of is hormone imbalance. This is frequently seen in women who are peri-menopausal or going through menopause. The hormone progesterone, which we experience decreasing levels of as we age, works on the GABA receptors to help relax the brain and get us ready for sleep. Progesterone is the “calming” hormone — diminished amounts lead to moodiness, anxiety, and irritability in addition to a poorer quality of sleep.
Other hormones affect sleep as well. Thyroid hormone impacts the quality of sleep — and again, for women there’s a connection to menopause. After menopause, approximately 10% of women experience hypothyroidism — their bodies stop producing enough thyroid hormone. This generally leads to weight gain, and higher body weight increases risks for snoring and sleep apnea, both of which make it difficult to stay asleep. There’s evidence that decreased levels of thyroid hormone can cause your airway to narrow, further increasing the risk of developing sleep apnea.
Cortisol — the “stress hormone” — affects sleep for both men and women. The body produces cortisol to address our daily needs, but it is made particularly when we experience stress. When higher levels of stress are constant, we have a harder time shutting off the response. Excessive cortisol can keep your brain keyed up even when your body is exhausted. High levels of cortisol are also often linked with hypothyroidism. Rather than making you fall asleep more easily though, levels of cortisol that are too low can also cause sleep issues. When cortisol is below normal levels, the body compensates with adrenaline, making it difficult to fall asleep and stay asleep.
Last, HGH — human growth hormone — is important for deep, restorative sleep. If you’re sleeping all through the night but still waking up tired, HGH may be a culprit to look into. HGH levels decrease with age, and so some point to it as part of changing sleep patterns as we age. HGH is especially important for men: During deep sleep, the male brain secretes HGH, signaling the body to undergo restorative processes like burning fat, building muscle, and tightening skin. At the same time though, research has found that — at any age — men who get less quality sleep secrete less HGH. Checking the levels of this hormone by indirectly measuring IGF-1 is likely to be important no matter what your age.
In our next blog post, we’ll look closely at what you can do to combat insomnia. If this post has you thinking about your hormone levels, we encourage you to come in and see Dr. Tang for hormone testing. Call Rejuvé today at (408) 740-5320 to learn more about the testing and hormone balancing solutions that we have to offer.
image: Fairy Heart
