Sleeplessness

Insomnia – What is it?

One of the most common misconceptions about insomnia is that it is simply about not being able to “get to sleep”.

This is one type of insomnia (Sleep Onset insomnia). But just as troubling for many people are problems with waking during the night, waking up too early or poor quality sleep. This is called Sleep Maintenance insomnia.

Insomnia is the second most common medical complaint with up to 40 percent of people reporting trouble with sleeping in any one year, and 10% experiencing it frequently. ¹

Why is it so common? Researchers believe we sleep 1 hour less on average than 100 years ago. Stress is a major cause, with the increased demands of everyday life – longer working hours, shift work and family pressures. Some medical conditions can cause insomnia. Various sleep disorders, such as sleep apnoea (prolonged breathing pauses during sleep) or restless legs syndrome often produce sleeping difficulty.

Other causes of poor sleep include back pain, medications (such as blood pressure tablets), alcohol and stimulants like nicotine and caffeine.

Insomnia is almost twice as common in women as in men (especially around menopause), and becomes more frequent as we age.

Affects of insomnia include lack of energy, irritability, poor performance at work, memory difficulties, concentration problems and increased risk of car accidents due to fatigue.

Sleep Disorders Australia recommends seeking advice from your GP if sleeplessness has gone on for more than a few weeks.

What can be done?

Establishing the cause

Address the underlying cause of the insomnia first: is it medical, environmental, psychological? Often assistance with stress management and relaxation can be more helpful than medication.

For many people it is a combination of factors – some physical, some emotional. Remember insomnia is a symptom, not a disease. Treat the cause and the symptom often disappears.

Diet and Lifestyle

While there is no particular “diet” for insomnia, avoiding caffeine and sugar can help, as they are nervous system stimulants. Eating a large meal before bedtime is not recommended because the digestive process can keep you awake. And while drinking alcohol may help you drop off to sleep, it is the enemy of satisfying sleep – alcohol disrupts the REM sleep pattern.

Be careful using medications such as cold and flu tablets and nasal sprays which can contain stimulants like psudoephedrine.

Exercise and meditation also help some people – in particular, those with stress related insomnia. Relaxing, mind-body classes such as yoga and tai chi are effective, as are walking, swimming and outdoor activities. Some community centres and clinics hold stress management classes – see your local council for details.

Sleeping tablets

An estimated $40 million is spent on pharmaceuticals for sleeping disorders each year in Australia.²

Benzodiazepine or diazepam drugs (such as Temazepam or Valium) are still the most commonly prescribed, however these have a potential for dependence, withdrawal symptoms and other side effects, such as decreased daytime performance.

Many experts believe they are counter-productive for long term use, causing a phenomenon known as “rebound insomnia” – meaning it takes longer to fall asleep after ceasing to take the drugs.

Sleep Disorders Australia warns benzodiazepines may assist in some cases of short term insomnia but “lose their effectiveness after a few weeks and may not be appropriate for more than four weeks”.³