What is insomnia?

Sleep plays a vital part in our physical and mental wellbeing. It provides a much-needed restoration to our bodies, helps to consolidate our memories and be more productive. A good night’s sleep can also make us feel more energised and positive about life in general.

Many people struggle to get a good night’s sleep. They may wake up several times during the night or not be able to fall asleep. Some find themselves lying awake all night, waking up too early, not being able to go back to sleep, or regularly feeling tired after waking up. What often comes after that is the lack of energy, feeling tired and irritable (but finding it hard to nap during the day), feeling down and finding it difficult to concentrate. Although these experiences are quite common, if taking place regularly over a prolonged period, they may suggest problems with insomnia.

Is insomnia a mental illness?

Insomnia, also known as sleeplessness, is a sleep disorder in which people have trouble sleeping. Insomnia is not a mental illness, but it can be one of the symptoms of a mental illness, such as depression or anxiety. Insomnia can also directly impact our mental well-being and cause us to feel down, anxious, irritable, or confused. Sometimes, especially after an extended period of sleep deprivation, people can become manic or start to hallucinate (seeing or hearing things that other people can’t). Insomnia can also negatively impact our self-esteem, relationships with others, or our ability to hold down a job.

What causes insomnia?

 There are many causes of insomnia, which include:

  • stress, anxiety or depression
  • nightmares (especially if they relate to a traumatic event)
  • noise
  • a room that’s too hot or cold
  • uncomfortable beds
  • alcohol, caffeine or nicotine
  • recreational drugs like cocaine or ecstasy
  • jet lag
  • shift work
  • very warm or very cold weather conditions

Some physical illnesses, such as chronic pain (of any kind), heart disease or restless leg syndrome, and certain medications, can also cause insomnia, including schizophrenia, bipolar disorder, Alzheimer’s disease, or Parkinson’s disease medication.

What are the treatments for insomnia?

Insomnia usually gets better by changing your sleeping habits. Some of the things you can do include:

  • Going to bed and waking up at the same time every day – you must stick to the time you wake up, regardless of how much you slept the night before.
  • Relaxing at least 1 hour before bed – for example, take a bath, read a book or listen to music; put your phone away and try not to watch TV as this can make it harder for your brain to ‘switch off’ due to bright light.
  • Making sure your bedroom is dark and quiet – use thick curtains, blinds, an eye mask or earplugs.
  • Exercising regularly during the day and avoiding exercise in the evening (at least 4 hours before bed)
  • Making sure your mattress, pillows, and covers are comfortable.
  • Reducing caffeine and alcohol intake – have your last caffeinated drink no later than 6 hours before bedtime.
  • Avoiding eating a big meal late at night.
  • Avoiding naps during the day.

However, if you still find it difficult to get ‘proper’ sleep after making changes to your lifestyle and/or your environment, your GP may prescribe you some medication for a few days or suggest you try Cognitive Behavioural Therapy (CBT) for Insomnia. CBT for Insomnia can be more effective in the long run as you learn skills to overcome the difficulties associated with falling asleep, and it has fewer side effects.

Cognitive Behavioural Therapy is a talking therapy that focuses on the relationship between our thoughts and behaviours and their impact on each other. If you decide to try CBT for Insomnia, your therapist will help you recognize and change beliefs and behaviours that affect your ability to sleep. Some of the techniques that your therapist may cover include:

  • Thought challenging
  • Keeping a sleep diary
  • Relaxation strategies (e.g. progressive muscle relaxation)
  • Sleep restriction therapy (SRT) – reduces the time you spend lying in bed awake by eliminating naps and forcing you to stay up beyond your normal bedtime.
  • Learning to remain passively awake, also known as “paradoxical intention”, letting go of worrying about not being able to go to sleep and making no effort to sleep may help you to unwind and fall asleep.
  • Teaching you about sleep hygiene.
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