Insomnia, sleep problems – symptoms, treatment

Insomnia is the most common psychological problem. It is estimated that insomnia affects between 15% and 30% of the adult population, with twice as many women as men experiencing the problem. Most of us have experienced sleep problems at times in our lives that have been overly demanding or stressful. However, when the problem becomes long-lasting, recurring and lasts for more than a month, it is important to consider what insomnia might mean, and perhaps even consult a specialist.

Sleep disorders are very diverse. They can manifest themselves: difficulty falling asleep at night, waking up and being unable to fall asleep again, or waking up early in the morning(morning insomnia). An important point to consider is that insomnia can be associated with other psychiatric disorders such as depression, generalized anxiety disorder and post-traumatic stress disorder (PTSD). Therefore, it is worth not underestimating the importance of long-term insomnia, as it can be a symptom of a more complex problem.

The role and function of sleep

Sleep is an essential part of our lives – we need it, just like air, water and food. Sleep has a regenerative function, both mentally and physiologically. It is important for overall physical health, restoring energy, healing injuries and illnesses, well-being, attention, memory, productivity and even communication with others.

Stages of sleep

1. The REM phase is the one in which there is rapid eye movement under closed eyelids. It lasts about 25% of the total sleep time and is characterized by high brain activation and very relaxed muscles. REM sleep provides energy to the brain and body and promotes daytime performance. Daydreams most often occur during this phase of sleep, although they can occur at any stage.
2. The NREM phase is sleep in which there is slow eye movement. This type of sleep lasts for the remaining 75% of the time. The NREM phase is followed by the Delta phase, in which the most restorative sleep is experienced: blood pressure drops, breathing becomes slower, muscles relax, tissue growth and repair occur, and hormones are released.

The Delta phase is believed to be most involved in restoring the body’s physical energy, while the REM phase is most important for restoring mental functions, such as memory and concentration.

The symptoms of insomnia are clinical signs

Insomnia, or problems falling asleep or maintaining sleep, can manifest itself in many, varied clinical symptoms.

1. Difficulty falling asleep: A person with insomnia may experience difficulty falling asleep, that is, an inability to start sleeping in a satisfactory manner. This may include taking longer to fall asleep after going to bed, waking frequently during the night and having difficulty falling asleep again.
2. Sleep maintenance problems: People with insomnia may have difficulty staying asleep and wake up frequently during the night. They may wake up early in the morning and be unable to fall back asleep, leading to an inadequate amount of sleep.
3. Shallow sleep: Insomnia may also manifest as shallow or restless sleep, in which the person wakes frequently and is unable to achieve deep sleep.
4. Early waking: People with insomnia may wake up early in the morning without being able to fall back asleep, even if they have not had enough sleep.
5. Daytime fatigue and lethargy: Lack of satisfying sleep can lead to feelings of fatigue, lethargy and decreased energy during the day. A person may be less focused, less productive and more prone to stress.
6. Tension and stress: Patients with insomnia may experience tension, anxiety, fear or stress related to difficulty falling asleep or maintaining sleep.
7. Problems with concentration and cognitive functioning: Insomnia can affect cognitive abilities such as concentration, memory, learning and decision-making. A person may have difficulty performing daily tasks, both at work and in everyday life.
8. Mood changes: Improper sleep can affect a person’s mood, leading to mood changes such as irritability, irritability, anxiety, depression or mood disorders.
9. Physical symptoms: Insomnia can also manifest itself in physical ailments, symptoms include – headaches, feeling of muscle tension, nausea, abdominal pain or feeling of general discomfort.

Types of insomnia

Insomnia can be divided into different types, depending on the causes, duration and characteristic symptoms. Some of the main types of insomnia are:

1. Transient insomnia: This is a type of insomnia that occurs for a short period of time, usually lasting a few days or a few weeks. It can be triggered by specific circumstances, such as traveling to another continent, changing time zones, stressful events or illness. Once the triggering factor subsides, sleep usually returns to normal.
2. Short-term insomnia: This is a type of insomnia that lasts from one to three months. It can be related to factors such as stress, lifestyle changes, health problems or hormonal changes, such as during the peri-menopausal period in women.
3. Chronic insomnia: This is a type of insomnia that lasts longer than three months and can be associated with a variety of causes, such as sleep disorders, diseases, unhealthy sleep habits, stress, mental disorders or environmental factors. Chronic insomnia can have a serious impact on the affected person’s health and quality of life.
4. Adverse insomnia, also known as sleep inertia, is a term used to describe periods when a person experiences difficulty falling asleep or maintaining sleep, usually as a result of stressful situations or circumstances. This can include situations such as travel, a change in time zone, being in a new place, a change in routine, emotional stress, or also the excitement of exciting events or adventures.
5. Primary insomnia, also known as primary insomnia or primary sleep disorder. These are chronic sleep disorders that can be caused by genetic or neurobiological factors, and can also be inherited.

Consequences of insomnia

People vary in their needs for the amount of sleep; some function well when they sleep a little less; others when they sleep a little longer. The average sleep duration for adults is 6-8 hours per night. Regardless of individual needs, when there is poor quantity and quality of sleep, one can experience consequences such as impaired cognitive function, irritability, lowered mood, impaired reaction time, and poor motor coordination. Lack of sleep or sleep deficiency can significantly affect interpersonal relationships, contributing to conflicts in relationships. Of course, the more chronic the problems with insomnia, the more severe the consequences experienced.

Insomnia and mental disorders

Insomnia can be associated with mental disorders, and can influence the development or worsening of symptoms of mental disorders.

1. Depression: Insomnia is a common symptom of depression. People with depression may have difficulty falling asleep, staying asleep, waking up early in the morning or experiencing restless sleep. Insomnia can exacerbate symptoms of depression, as lack of adequate sleep can affect mood, energy and ability to function in daily life.
2. Anxiety: People with anxiety disorders, such as generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD) or post-traumatic stress disorder (PTSD), may experience sleep difficulties. Anxiety can lead to restlessness, mental distress and tension, which can make it difficult to fall asleep and maintain sleep.
3. Bipolar affective disorder: People with this mood disorder, characterized by episodes of mania and depression, may also experience sleep difficulties. Episodes of mania may result in a decreased need for sleep, while episodes of depression may be associated with insomnia.
4. Schizophrenia: Insomnia is also a common symptom of schizophrenia. People with this disorder may have difficulty falling asleep, maintaining sleep, and experience abnormal sleep-wake rhythms, such as inappropriate bedtimes and abnormal sleep phases.

What are sleep nightmares?

Another common sleep problem is sleep nightmares. By themselves, sleep nightmares should not worry us very much. This is a normal phenomenon, worse when their frequency is very high. Experiencing daily nightmares may mean that we have experienced very difficult events for us. If this is the case, it is advisable to embrace the problem holistically by working therapeutically on unpleasant experiences that may be traumatic, rather than solely on a single problem. Fortunately, we most often experience nightmares sporadically, with varying intensity. From time to time, we may experience realistic nightmares that may involve some dangerous or threatening life situation, related to personal failure or social embarrassment. The images in these nightmares appear to be real, and therefore trigger intense fear or other unpleasant emotions, such as sadness, shame or guilt, during sleep. These feelings can persist for minutes or even hours after waking up. We may then find it difficult to return to daily life or feel anxious during the day. Often we find that the problem is not so much the content of the nightmares, but how we react to them.

Sleep nightmares – what do they mean?

We often tend to assign meanings to unpleasant dreams. Searching for meanings can paradoxically add to the problem. We can interpret nightmares as if they contain meanings about ourselves, others or the world: “I am weak and helpless,” and “the world is dangerous. We may perceive nightmares as uncontrollable: “I can’t handle them.” We can also see these unpleasant dreams as powerful or meaningful: “my nightmares are trying to tell me something important”, “it’s a warning that something bad might happen”. Because of these beliefs, we may be more preoccupied with these experiences, over-focusing on them and giving them additional meanings. We can also often try to prevent these nightmares by avoiding the dream itself.

Insomnia during pregnancy

Insomnia in pregnancy is a fairly common phenomenon and can affect many women at different stages of pregnancy. There are many factors that can contribute to the occurrence of insomnia in pregnant women, such as physiological changes in the body, changing hormones, physical discomfort, as well as stress and emotions associated with pregnancy and future motherhood.

Here are some factors that may influence the occurrence of insomnia in pregnant women:

1. Physiological changes in the body: During pregnancy, a woman’s body undergoes many physiological changes, such as weight gain, changing hormones, a growing belly and pelvic pressure, which can affect sleep comfort. Often there can be discomforts such as heartburn, a choking sensation, frequent urination, cramps and other discomforts that are somatic in nature, which can make it difficult to fall asleep and maintain sleep.
2. Hormonal changes: Hormonal changes, such as an increase in progesterone, which is associated with pregnancy-related regulation of respiratory function, can affect sleep. Hormones can also affect the regulation of mood and emotions, which can affect sleep during pregnancy.
3. Stress and emotions associated with pregnancy: Pregnancy can be a stressful and emotional time. Anxieties, fears, excitement, preparation for future motherhood and other emotions associated with pregnancy can affect sleep and lead to insomnia.
4. Discomfort and inappropriate sleeping position: The changing shape of the abdomen and the increasing size of the uterus can cause discomfort during sleep and make it difficult to find the right sleeping position. This can lead to more frequent awakenings at night and sleep disturbances.

Read more: stress in pregnancy

Treatment methods – sleep problem

There are many factors that can contribute to insomnia (insomnia): chronic pain, side effects of medications, alcohol, caffeine and nicotine, anxiety or depression, stressful life events, bad habits such as staying in bed during the day or taking naps during the day. It is worth noting that there may be one set of factors associated with the initial causes of insomnia and a completely different set of factors that exacerbate sleep problems, increasing the risk of chronicity.

What insomnia can mean – vicious circles in our lives

First of all, a very common secondary problem that amplifies insomnia is getting stuck in a vicious circle of insomnia. Our thoughts about sleep, the compulsion to fall asleep, which begins to become our main goal, can increase anxiety and worry. Going to sleep becomes the main goal, we begin to focus excessively on this area, which is often counterproductive. For example, initial poor sleep due to pain can foster negative thoughts such as: “I can’t manage without eight hours of sleep at night” or “if I don’t get enough sleep, I’ll definitely feel terrible at work tomorrow.”

Unrealistic expectations

Often we may manifest unrealistic expectations of sleep, such as “I must fall asleep immediately upon getting into bed” or “I must never wake up during the night.” Even the most outstanding sleepers do not achieve this ideal! We all sometimes experience a night that we sleep less well, especially if a particular period is more difficult for us. Usually such sleep troubles pass after two or three nights.

Catastrophizing

In this way of thinking, we give sleep difficulties the worst meaning. For example: “I haven’t slept well for the past week, this must mean that I have lost my ability to sleep”. With such thoughts, we are likely to feel much worse than if we try to think, “I didn’t sleep well last week – I might be stressed about something at work or at home, I’d like to think about it.”

The reason is only one

Blaming everything on sleep is another common thinking trap. Sometimes we think that if we slept better, our lives would be better – we would be happy and relaxed. It’s true that poor sleep can affect mood, concentration, memory and productivity, but sleep alone can never be the sole cause of our problems. Insomniacs also tend to classify sleep as “great” or “terrible,” without leaving room for “okay” or “good enough.”

How to beat insomnia – ways to beat insomnia

A miracle cure for insomnia does not exist. However, there is a lot of research dedicated to strategies to help improve the quality of sleep.Often the key may be to improve sleep hygiene. Keep in mind that if the following remedies for insomnia do not work, the problem may be deeper and it is worth going to a specialist.

1) Regularity. One of the best ways is to build stability and good habits in the area of sleep. It’s a good idea to go to bed and get up at about the same time every day, including weekends and holidays.

2) Fatigue. Try to sleep only when you really feel tired or sleepy, and don’t spend too much time in bed. Strenuous efforts to fall asleep aggravate the problem.

3) Get up and try again. If you are unable to fall asleep after about 20-30 minutes or more, get up and do something calming or boring. Wait until you feel sleepy, then go back to bed and try again. Sit quietly on the couch by a dim lamp or read something boring. Avoid doing anything stimulating or interesting, as it can stimulate you even more.

4) Avoid caffeine and nicotine. It is best to avoid consuming coffee, tea, cola, chocolate and medications with caffeine, as well as cigarettes and other nicotine products for at least 4-6 hours before going to bed. These substances act as stimulants and interfere with the ability to fall asleep.

5) Avoid alcohol. Alcohol is also best not to drink for at least 4-6 hours before going to bed. Many people believe that alcohol has a relaxing effect and initially helps you fall asleep, but it actually interferes with the quality of sleep and the next day we may feel even more unrested and tired.

6) The bed is for sleeping. Try not to use your bed for anything other than sleeping and sex, so that your body begins to associate the bed with sleep and pleasure. If you use your bed as a place to watch TV, eat, read, work on your laptop, pay bills and other things, your body will not learn to rest in that space.

7) No naps. It’s best to avoid naps during the day to make sure you’re tired before bedtime. If you can’t get through the day without a nap, make sure it lasts no longer than an hour.

8) Sleep rituals. You can develop your own rituals to remind your body that it’s getting close to bedtime. Some people find it helpful to do relaxing stretching exercises or breathing exercises for 15 minutes before bedtime, or to sit quietly with an herbal tea.

9) Ban the clock. Many people who struggle with sleep difficulties tend to look at the clock excessively. Frequently checking the clock at night can awaken and trigger haunting thoughts: “how late!”, “I’ll never get to sleep…” or” “I only have 5 hours of sleep left, this is terrible”

10) Exercise. Regular exercise is a good idea for a good night’s sleep, but try not to do strenuous exercise 4 hours before bedtime.

11) Eat healthy. A good, balanced diet will help you sleep well. Some people believe that an empty stomach before bed makes it harder to fall asleep, so have a light snack, but not a hearty meal. Some recommend foods containing tryptophan, which acts as a natural sleep inducer, such as pumpkin seeds or soy products.

12) Adequate space. It is very important that your bed and bedroom are quiet and comfortable for sleeping. A cooler room temperature is best. Make sure you have curtains or an eye mask to minimize morning light.

13) Maintain the same daily routine. Even if you sleep poorly at night and are tired, it’s important to try to stick to your original daily schedule. Don’t avoid activities because you feel tired. This can reinforce insomnia.

Insomnia, insomnia affect our functioning

In addition to the ways mentioned above, you can overcome insomnia by working on your negative thoughts and interpretations. Research shows that negative thinking is linked to negative emotions and behavior, so healthy thinking is a very important part of healthy sleep. However, when the problem becomes chronic and we can’t manage on our own, we can use medication for insomnia. Sleep medications are used to relieve the symptoms of insomnia, that is, difficulty falling asleep or maintaining sleep. However, this type of treatment often works for a short time. There is also a risk that continuous use of sleeping pills can lead to addiction. In addition to using drug treatment, it is worth considering taking psychotherapy. A diagnosis of insomnia will help rule out or confirm other co-occurring problems. Cognitive-behavioral therapy (CBT) is an effective approach to work with insomnia, but also other difficult sleep experiences such as nightmares. Insomnia-focused CBT aims to help identify and change certain unhelpful thoughts and interpretations, thereby reducing anxiety. The therapy also aims to identify and modify behaviors that may be perpetuating our problems and to help introduce more helpful sleep habits.

If you’re hesitant about whether the sleep problems you’re experiencing are just a temporary hassle or a deeper problem, get in touch with us – online psychotherapy.