The Health Impacts of Insomnia
The health impact of insomnia. Insomnia is a sleep disorder characterized by poor sleep quality. The average adult has experienced some form of insomnia during his life. And depending on how often this happens, it may be sign of a more serious sleep disorder.
Symptoms of Insomnia
People that suffer from insomnia express difficulties:
- Going to sleep at night
- Waking often in the middle of the night and having trouble going back to sleep
- Waking up too early, and being unable to fall back asleep
- Feeling as if sleep was not refreshing (non-restorative)
- Experiencing excessive daytime sleepiness
- General lack of energy
- Difficulty concentrating
- Mood and behavioral changes (irritability, aggression, impulsivity)
- Difficulty concentrating
- Forgetfulness
- Decreased performance at work or school
- Troubles in personal and professional relationships
- Having accidents, at work or while driving
- Decreased quality of life
- Depression
Types of Insomnia
Classifying insomnia depends on two different factors:
- Duration (how long it typically lasts and how often it occurs)
- The underlying cause (if it’s directly linked to other health conditions)
Insomnia is classified as one of two different types:
Acute Insomnia
Acute insomnia is experiencing sleep loss over a short period of time. It can last anywhere from one night to a few weeks. Causes of acute insomnia include:
- Anxiety (tension, worry, overwhelming responsibilities, over stimulation)
- Chronic Stress
- Receiving bad news
- Life circumstances
- Jet lag
- Shift-work
- Illness
- Emotional or physical discomfort
- Exposure to environmental factors (noise, light, temperature)
- Consumption of stimulants (nicotine, caffeine, alcohol)
- Poor sleep hygiene practices
- Medications (like those taken for colds, nasal allergies, high blood pressure, heart disease, thyroid disease, birth control, asthma, and depression)
Chronic Insomnia
Chronic insomnia involves experiencing symptoms of poor sleep for longer than a month, and on 3 or more nights per week. Causes of chronic insomnia include:
- Pain
- Nasal/sinus allergies
- Gastrointestinal problems
- Hypothyroidism (and other endocrine problems)
- Neurological conditions (like Parkinson’s disease)
- Chronic pain
- Arthritis
- Asthma
- Sleep apnea
- Restless leg syndrome (RLS)
- Narcolepsy
- Circadian rhythm disorders
- Depression (insomnia can cause depression and vice versa)
Causes of Insomnia
Psychiatric and medical conditions, unhealthy sleep habits, consumption of some substances, or some biological factors, are the causes of insomnia. More recently, insomnia is thought of as the brain’s inability to balance the sleep and a wake cycles. When one is turned on, the other is turned off. A problem with either part of this cycle. The many causes of insomnia are also classified into two categories:
- Primary Insomnia (not directly related to a medical condition)
- Secondary Insomnia (associated with an existing medical or psychiatric condition).
In addition, insomnia may only be a symptom of a greater, underlying sleep disorder, such as:
- Restless legs syndrome (RLS)—a neurological condition in which a person has an uncomfortable sensation of needing to move his or her legs. An estimated 10 percent of the population has restless legs syndrome.
- Sleep apnea—when a person’s airway becomes either partially, or completely obstructed while sleeping. This inability to breathe causes a drop in oxygen that will make a person wake up repeatedly throughout the night.
- Narcolepsy—a sleep disorder that involves excessive, uncontrollable daytime sleepiness. A dysfunction of the brain mechanism that controls sleeping and waking. No cure exists, but a combination of treatments can help minimize the symptoms.
- Circadian rhythm sleep disorders—the human body has an internal, biological clock that regulates the 24-hour sleep-wake cycle, known as the circadian rhythm. Light is the primary cue that influences circadian rhythm.
When circadian rhythms are disrupted they can cause insomnia, depression, bipolar disorder, and seasonal affective disorder (SAD). - Delayed sleep phase disorder—a condition where your biological clock gets delayed. As a result, you go to sleep and wake up much later than what would be considered normal. This disorder makes it difficult to keep normal hours—to make it to morning classes, get the kids to school on time, or keep a 9-to-5 job. It is most common in teenagers, but they eventually grow out of it. Treatments include light therapy and chronotherapy.
Insomnia’s Impact on Depression
Insomnia can be caused by underlying psychiatric conditions such as depression. In turn, insomnia can bring on changes in mood, as well as shifts in hormones and physiology which can lead to depression. Sleep problems may, in fact, represent a symptom of depression.
It’s important to know that symptoms of depression and insomnia can be linked, and one can make the other worse.
Insomnia’s Impact on Anxiety
Most adults have experienced insomnia because they feel worried or nervous on a regular basis. The symptoms of general anxiety can make it difficult to sleep. Anxiety is associated with onset insomnia (trouble falling asleep), and maintenance insomnia (waking up during the night and not being able to return to sleep).
When this happens frequently one might start to feel anxiousness, dread, or panic at just the prospect of not sleeping. This is how anxiety and insomnia feed each other and become a negative cycle.
Lifestyle and Insomnia
Insomnia can be triggered or perpetuated by unhealthy behaviors. Unhealthy lifestyles can create insomnia, or they can worsen insomnia by another cause.
Examples of how certain lifestyle behaviors can lead to insomnia are:
- Working in the evenings: it can make it hard to unwind right before bedtime, and it’s well known that the blue light from screens causes disruptions in normal brain functions.
- Napping during the day: naps can be helpful for the few, but for most they make it more difficult to sleep at night.
- Sleeping in: it can confuse your body’s internal clock.
- Working irregular hours/shifts: an ever-changing schedule does not make a good routine which can also confuse your body’s internal clock.
Food’s Impact on Insomnia
Some eating and drinking habits can bring about insomnia. Alcohol is a sedative and may disrupt your sleep cycle. Caffeine is a stimulant, it’s fine in moderation, but excessive consumption can cause insomnia. Caffeine can stay in your system for as long as eight hours, so it is ill advised to drink it close to bedtime.
A 2005 National Sleep Foundation poll found that people who drank 4+ caffeinated drinks in a day were more likely to experience at least one symptom of insomnia, compared to those who drank 0-1 caffeinated drink.
Nicotine is also a stimulant, so it is ill advised to use tobacco products close to bedtime. The use of tobacco products in general is hazardous to one’s health. Heavy meals too close to bedtime will disrupt a natural sleep cycle by affecting R.E.M. sleep (the dreaming cycle).
Insomnia and Brain Health
In some cases, insomnia may be caused by some neurotransmitters in the brain that are responsible for patterns of sleep and wakefulness making some people biologically prone to insomnia without any identifiable cause.
Self Help
Many sleep disorders you can improve on your own. Simply by improving your daytime habits, sticking to a consistent sleep schedule, getting regular exercise, limiting intake of caffeine, alcohol, and nicotine, and managing stress.
Develop a relaxing bedtime routine to prepare mind and body for sleep. Make your bedroom quiet, dark, and cool, avoid heavy meals close to bedtime, take a warm bath, read, or listen to soothing music, and limit screen time.
Always try to get back to sleep if you wake up in the middle of the night. If you’re having trouble, try focusing on your breathing, meditating, or practicing any other relaxation technique.
Charlene Gamaldo, M.D., medical director of Johns Hopkins Center for Sleep at Howard County General Hospital advises on the natural ways to make adjustments to your sleeping habits.
Six Tips for Better Sleep
Drink Up
Warm milk, chamomile tea and tart cherry juice. Warm milk has long been believed to be associated with chemicals that simulate the effects of tryptophan on the brain. This is a chemical building block for the substance serotonin, which is involved in the sleep-wake transition. Chamomile tea is believed to have flavonoids that interact with benzodiazepine receptors in the brain that are involved in the sleep-wake transition but does not contain caffeine. Lastly, tart cherry juice could support melatonin production.
Exercise
Physical activity can improve sleep. It’s known that moderate aerobic exercise boosts the amount of nourishing slow wave (deep) sleep you get. But, because aerobic exercise also releases endorphins (chemicals that keep you awake), you must time it right. It can also raise core body temperature signaling the body it’s time to get up.
Take Melatonin
Melatonin is a hormone that is released in the brain about four hours before our usual bedtime. It’s triggered by the body’s response to reduced light exposure at night. Exposure to unnatural light —whether it’s from your phone, laptop or TV prevents the release of melatonin. Luckily, melatonin is available in pill form as an over-the-counter supplement.
Keep Cool
The ideal temperature for your thermostat should be lower than 68 degrees. Keep the bedroom as cool as possible and wear cotton or breathable fabrics to bed.
Bundle Up
Simultaneously, keep the ambient temperature low but your body temperature warm, by sleeping under soft, warm blankets (think something like a cocoon).
Go Dark
Shut off all tech and lights. If you have the urge to go at night, don’t flick on the lights. Keep a small flashlight by your bedside, because it offers less visual disruption. Even invest in black-out shades for your bedroom windows.
Natural Sleep Aids
Good sleep starts with proper nutrition, regular exercise, and good sleep practices and habits. There may be times where those aren’t sufficient enough. If you require a little extra help to get a good night’s sleep, these are nine sleep-promoting over-the-counter supplements to try.
| Sleep Aid | Description | The Science |
|---|---|---|
| Melatonin | Melatonin is a hormone your body produces naturally, which signals your brain that it’s time to sleep. | This hormone’s cycle of production and release is influenced by time of day (exposure to natural light) — melatonin levels naturally rise in the evening and fall in the morning. Melatonin supplements have become a popular sleeping aid as it appears to reduce the time needed to fall asleep and increases the total amount of sleep time. Several studies even report that melatonin improves daytime sleep quality and duration, which is beneficial for shift workers. A small dose (3–10 mg) before bedtime is enough to induce sleepiness. Melatonin supplements are safe when used for short-term bouts of insomnia, but little is known about its long-term use. |
| Valerian Root | Valerian is an herb native to Asia and Europe. Its root is commonly used as a natural treatment for symptoms of anxiety, depression and menopause. | Valerian root is also one of the most commonly used sleep-promoting herbal supplements in the US and Europe. Recent user reviews reported that 300–900 mg of valerian taken right before bedtime improved sleep quality. Short-term intake of valerian root is safe for adults, with minor, infrequent side effects such as dizziness. However, little is known about its long-term use, or its use by pregnant or lactating women. |
| Magnesium | Magnesium is a mineral involved in hundreds of processes in the human body, and is important for brain function and heart health. | Studies show that magnesium’s relaxing effect may be partly due to its ability to regulate the production of melatonin. Same studies also report that insufficient levels of magnesium in your body may be linked to insomnia. Magnesium also appears to increase brain levels of gamma-aminobutyric acid (GABA), a brain messenger with calming effects. One study gave 46 elderly adult participants 500 mg of magnesium or a placebo daily for eight weeks. Those in the magnesium group benefited from better sleep. Moreover, this group also had higher blood levels of melatonin and renin, two hormones that regulate sleep. In another, smaller study, elderly adult participants given a supplement containing 225 mg of magnesium, 5 mg of melatonin, and 11.25 mg of zinc slept better than those given a placebo. |
| Lavender | Lavender is an herb that can be found on almost all continents. It produces purple flowers that, when dried, have a variety of health and beauty uses, as well as medicinal properties. | Lavender’s soothing natural fragrance is believed to enhance sleep. Simply smelling lavender essential oil for 30 minutes before sleep is enough to improve the quality of sleep. This effect is especially strong in females and children. One small study with elderly participants reports that lavender aromatherapy is as effective as conventional sleep medications, with fewer, if any, side effects. Another study gave 221 patients suffering from anxiety, either an 80 mg lavender oil supplement, or a placebo per day. By the end of the 10-week study, the lavender group experienced 14–24% greater improvements in the quality and duration of sleep, without any unpleasant side effects. Though lavender aromatherapy is safe, the intake of lavender supplements is not recommended since it has been linked to nausea and stomach pain. |
| Passion Flower | Passion flower, also known as Passiflora incarnata or maypop, is a popular herbal remedy for insomnia. | The species of passion flower linked to sleep improvements are native to North America. They are also currently cultivated in Europe, Asia, Africa and Australia. Passion flower’s sleep-promoting effects have been demonstrated in animal studies. Its effects in humans depend on the form consumed. One study in humans compared the effects of a passion flower tea to those of a placebo tea made from parsley leaves. Participants drank each tea about one hour before bed every day for one week, with one week break between the two teas. Each tea bag was allowed to steep for 10 minutes. At the end of the three-week study, participants rated their sleep quality around 5% higher following the week drinking passion flower tea compared to the week drinking parsley tea. Another study compared the effects of a 1.2-gram passion flower supplement, conventional sleeping pills, and a placebo. Researchers found no difference between the passion flower supplements and the placebo. Passion flower intake is safe for adults, but it seems that passion flower provides more benefits in tea form than as a supplement. |
| Glycine | Glycine is an amino acid that plays an important role in the nervous system. | Glycine is an amino acid that plays an important role in the nervous system. The Science The exact mechanism of how it works is unknown, but glycine is thought to act by lowering body temperature at bedtime, signaling that it’s time to sleep. In one study, participants suffering from poor sleep consumed either 3 grams of glycine, or a placebo immediately before bedtime. In the study, researchers also took measurements of brain waves, heart rate and breathing while participants slept. Participants in the glycine group fell asleep faster and reported feeling less fatigued, more lively, and clear-headed the next morning. You can also consume glycine by eating foods rich in this nutrient, like bone broth, meat, eggs, poultry, fish, beans, spinach, kale, cabbage, and fruits like bananas and kiwis. Glycine is also available in pill form, or as a powder that can be diluted in water. It’s safe when taking fewer than 31 grams per day. |
| Tryptophan | Tryptophan is an α-amino acid used in the biosynthesis of proteins. Tryptophan contains an α-amino group, an α-carboxylic acid group, and a side chain indole, it’s considered a non-polar aromatic amino acid. | The human body does not create it, it can only come from external sources like foods. One study reports that doses as low as 1 gram per day of this essential amino acid may help improve sleep quality and help you fall asleep faster. |
| Ginkgo Biloba | Ginkgo biloba, commonly known as ginkgo or gingko, also known as the maidenhair tree, is the only living species in the division Ginkgophyta, all others are extinct. It is a very old species, some fossils date back 270 million years. | Consuming 250 mg of this natural herb 30–60 minutes before bed has been known to help reduce stress, enhance relaxation, and promote sleep. |
| L-Theanine | Theanine, also known as L-γ-glutamylethylamide and N⁵-ethyl-L-glutamine, is an amino acid analogue of the proteinogenic amino acids L-glutamate and L-glutamine. | It is found primarily in particular plant and fungal species. Consuming a daily supplement containing 200–400 mg of this amino acid may help improve sleep and relaxation. |
| Kava | Kava or kava kava is a crop of the Pacific Islands. The name “kava” is from the Tongan and Marquesan languages, it means “bitter”; other names for kava include ʻawa, ʻava, yaqona, sakau, seka, and malok (or malogu). | Kava is another plant that has been linked to improved sleep. It originates from the South Pacific islands and its root is traditionally prepared as a tea, although it can also be consumed in supplement form. However, due to low-quality production or adulteration, kava use has been linked to severe liver damage. Therefore it’s best to buy only supplements that have passed rigorous certification standards by a reputable organization. |
These supplements might be helpful in promoting restful sleep, but should not replace good sleep practices, proper nutrition, and regular exercise. It’s best to take them in combination with good sleep habits. If you are interested in trying these, you can usually find them in health food stores, and some drug stores. It’s best to always shop locally.
Treatments for Insomnia
Acute insomnia often requires no treatment and symptoms usually go away on their own or can be cured by practicing better sleep habits. Oftentimes, treatment for secondary insomnia requires treating the underlying medical/psychiatric condition at its root cause.
Cognitive and Behavioral Therapy
Cognitive and behavioral approaches may be taken to help a person change behaviors that are causing insomnia. Other approaches help promote better sleep practices including relaxation and meditation techniques, breathing exercises, limiting the bedroom to sleep and sex only, and keeping a regular sleep/wake schedule.
Medical Treatments
There are over-the-counter and prescription sleep aids available to help with symptoms of insomnia. Typical prescription medications include benzodiazepine hypnotics, non-benzodiazepine hypnotics, and melatonin receptor agonists. If a sleep disorder is the underlying cause, a sleep study may be necessary to diagnose and treat that sleep disorder.
Sleep Disorders
It’s normal to occasionally experience sleep difficulties, however, it is not normal to have problems getting to sleep, to wake up feeling exhausted, or to feel sleepy during the day on a regular basis.
In order to stay healthy quality sleep is an absolute necessity. Falling into a negative sleep cycle can take a serious toll on your mood, energy, efficiency, and ability to handle stress. Ignoring sleep disorders can damage your physical health and lead to weight gain, car accidents, impaired job performance, memory problems, and strained relationships.
Even if you’ve struggled with insomnia in the past, you can still learn better sleep habits. You can start by tracking your symptoms and sleep patterns, so you can identify the underlying causes of your insomnia. Then, you can find ways to improve your sleep by making healthy changes to your daytime habits and bedtime routine.
Track Your Symptoms
The first step to overcoming a sleep disorder is identifying and carefully tracking your symptoms and sleep patterns. Keep a sleep diary. A sleep diary can pinpoint day and nighttime habits that may contribute to insomnia. It’s important to include as much detail as possible. A sleep diary should include:
- bedtimes and wake times
- total sleep hours and quality of sleep
- time spent awake
- activities performed while awake
- types and amount of foods, liquids, caffeine, and alcohol consumed that day
- moods and emotions experienced before bed
- drugs or medications taken, including dose and timing
When it’s time to call a doctor
If you’ve tried a variety of self-help remedies without success, schedule an appointment with a sleep specialist or ask your family doctor for a referral to a sleep clinic.
Sources:
Alaska Sleep Education Center
Insomnia Facts: Symptoms, Causes, & Treatment of Poor Quality Sleep
https://www.alaskasleep.com/blog/insomnia-facts-symptoms-causes-treatment-poor-quality-sleep
Posted by Jennifer Hines, on Jul 17, 2018
National Sleep Foundation
Insomnia
https://www.sleepfoundation.org/articles/what-are-facts-about-insomnia
What Causes Insomnia?
HelpGuide.org – Your trusted guide to mental health & wellness
https://www.helpguide.org/articles/sleep/sleep-disorders-and-problems.htm
Authors: Melinda Smith, M.A., Lawrence Robinson, and Robert Segal, M.A. Last updated: November 2019
Cedars-Sinai Blog
Myths and Facts About a Good Night’s Sleep
https://www.cedars-sinai.org/blog/sleep-myths.html
David Scott, PhD, Cedars-Sinai Pain Center, Apr 30, 2019
9 Natural Sleep Aids That Are Backed by Science
https://www.healthline.com/nutrition/sleep-aids
https://www.ncbi.nlm.nih.gov/pmc/articles/
https://www.ncbi.nlm.nih.gov/books/NBK19961/
https://www.ncbi.nlm.nih.gov/pubmed/
Natural Sleep Aids: Home Remedies to Help You Sleep
The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System
https://www.hopkinsmedicine.org/health/wellness-and-prevention/natural-sleep-aids-home-remedies-to-help-you-sleep
Charlene Gamaldo, M.D., medical director of Johns Hopkins Center for Sleep at Howard County General Hospital