Why do I have insomnia? [What else could be going on?]

Insomnia can be defined an as inability to sleep or habitual sleeplessness. If this has been ongoing for at least 3 nights a week for a month or more, it is known as chronic insomnia. Lack of sleep is going to lead to the question ‘Why do I have insomnia?’ which will be explored in this article.

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Difficulty sleeping can be the result of a wide range of reasons. Many of these can be effectively treated, if the reasons are correctly diagnosed.

In an earlier article we considered the basics including the sleeping environment, lifestyle habits and sleep preparation. In many cases’ there are simple adjustments that can be applied to help achieve a better night’s sleep.

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In some circumstances, however, factors such as the presence of a sleeping disorder; stress, anxiety or depression; and/or other health conditions may be a significant reason for a lack of optimal sleep.

Sleep disorders – there are many of them!

According to Michael J Breus, PhD (The Sleep Doctor), there are at least 88 different types of sleep disorder.

Many people suffer with a sleep disorder that can adversely affect their health, but are either unaware they have the disorder, or have not sought treatment for a condition that can be substantially alleviated.

It is recommended you seek medical advice if your sleep problems become an ongoing pattern and/or if you find yourself not refreshed after a night’s sleep, and prone to excessive sleepiness during the day.

Some of the most common sleep disorders include:

  • Sleep apnoea: this is a condition where breathing repeatedly stops during sleep. As muscles relax the airways block or become significantly reduced, causing breathing to be interrupted. The sleeper is often unaware they have this condition but can be alerted to it by other family members advising symptoms such as snoring, restlessness, gasping, etc during the night.
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According to the Sleep Health Foundation sleep apnoea leads to an increased risk of cardiovascular disease, high blood pressure, stroke and irregular heartbeat. They advise there is strong evidence linking sleep apnoea to premature death and increased risk of motor vehicle accidents.

For more detail about sleep apnoea, recommendations and options for treatment, refer to the Sleep Health Foundation and their fact sheets. Further details about some other sleep disorders may also be found there.

  • Insomnia: This can include symptoms such as finding it difficult to fall asleep; to sleep long enough, or continual waking throughout the night and then taking a long time to get back to sleep again.

Older people and women are more at risk, however insomnia can affect anyone and most people experience insomnia at some point in their lives.

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  • Bruxism: This occurs when sleepers grind or gnash their teeth at night.

Bruxism may not be severe or require treatment, however in other circumstances it can lead to permanent teeth damage. The Mayo Clinic lists symptoms such as worn tooth enamel, chipped teeth, increased tooth sensitivity, damage on the inside of the cheek, an aching jaw and headaches.

Sleepers may have no awareness that they grind their teeth, but it can be a cause of sleep disruption.

  • REM (Rapid Eye Movement) Sleep Behaviour Disorder: this disorder leads to people acting out their dreams.

When a person without this disorder enters the REM sleep phase, their brain activity resembles the waking state, but this is accompanied by rapid eye movements and virtual muscle paralysis. The muscle paralysis does not occur in someone with this disorder when they enter the REM stage. This means the sufferer is able to physically act out their dreams which can include behaviour such as kicking, yelling, punching, etc.

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Refer to the WebMD for more information on the causes of REM Sleep Behaviour Disorder.

  • Nightmares and night terrors: These happen more commonly in children and can be upsetting for both the person and those witnessing the incidents. Nightmares are often recalled in the morning, whereas night terrors commonly are not.

Nightmares in particular can lead to anxiety for the child that affects their thoughts about bedtime. Parents can be shaken witnessing either nightmares or night terrors in their child. The Alaska Sleep Clinic has published a helpful article around managing incidents for children.

  • Restless Legs Syndrome: this is accompanied by a need to move the legs to relieve discomfort, and also affects sufferers during the day.

The Brain Foundation advises that one in twenty people will suffer from restless leg syndrome at some time. Definitive causes are not clear yet, but there appears to be a link to low iron levels and a number of chronic diseases such as kidney failure, diabetes and Parkinson’s disease.

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  • Shift work sleep disorder: as the name suggests, this disorder is commonly suffered by shift workers as a result of their work schedules disrupting their natural circadian rhythms.

This can result in difficulty sleeping, and impacts alertness when the sufferer needs to be awake and/or is ‘on the job’. A similar problem is occurring for someone suffering jet lag, however this ordinarily resolves over a relatively short period.

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The Cleveland Clinic advises that people suffering from this disorder are more prone to accidents and workplace errors, moodiness, poor coping skills and other health related problems. They may also have increased risk of drug and alcohol dependency.

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  • Narcolepsy: this disorder is associated with excessive drowsiness and a lack of energy.

It occurs as a result of the part of the brain which controls falling asleep not functioning correctly, with multiple daytime naps lasting anywhere from a few minutes to an hour or more.

Stress, Anxiety and Depression can affect quality of sleep

Have you even gone to bed feel really exhausted, but finding it impossible to turn off your mind?

A stressed, anxious or depressed mind, worrying about matters (sometimes even mundane matters!), makes it really hard to sleep. It can then turn into worry about not being able to sleep which is a downward spiral!

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Other health problems can contribute to sleeplessness

Sleeplessness may be a result of other health issues that the sufferer has.

This may include arthritis, asthma, cancer, heartburn or any condition causing pain that leads to an inability to sleep.

In some cases’ medication or other substances such as alcohol, may also be the culprit.

Until these other problems are resolved, it may be difficult to restore optimal sleep patterns.

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If good sleep cannot be restored by implementing strategies such as those outlined in the previous article relating to your sleeping environment, lifestyle habits and preparation before sleep, you may be impacted by one or more conditions such as those outlined above.

Further investigation with a medical professional is recommended if you suspect untreated issues such as those considered above. Most can be effectively treated, and will make a big difference towards ensuring optimal ongoing health and well-being.

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