What is insomnia?

1st June 2022

A 2012 study found that 1 in 14 people in South Africa, over the age of 15, experiences insomnia. That’s 7.1% of the South African population.

What is Insomnia?
Insomnia is ­a sleep disorder that causes difficulty in falling asleep and/or staying asleep. The condition can be acute (short term) and last a few days to a few weeks and then go away. Or it can be long term (chronic), meaning you encounter sleep problems at least 3 nights a week for 3 months or more.

If you have insomnia, you may also worry about being able to sleep, causing anxiety and stress, which will make it harder to fall asleep.

Causes of Insomnia
Firstly, there are two types of insomnia.

Primary insomnia isn’t linked to any other health condition, and can be brought on by a variety of reasons including:

• Major life changing events such as divorce, death of a loved one,
• Your environment such as noise or temperature
• Disruptions to your routine such as travel including jet lag, new work shifts

Secondary causes of insomnia, which mean you have difficulty falling asleep because of an existing health condition, include:

• Other sleep disorders such as sleep apnea or restless leg syndrome
• Pregnancy
• Pain or discomfort
• Mental health issues such as depression and anxiety
• Neurological disorders such as Alzheimer’s or Parkinson’s disease
• Use of substances such as alcohol and tobacco

Is Insomnia a Serious Problem?
It can be if it interferes with your life quality and health. Getting enough sleep (between 7-9 hours) per night is an important part of living a healthy lifestyle.

Insomnia can affect you mentally and physically, which can make you feel tired, depressed, and irritable. Chronic insomnia can also interfere with your day-to-day performance, making it hard to concentrate, perform tasks efficiently and have a negative effect on memory, all of which could hinder your career progression. If you have a physically demanding job, or drive a lot, it can also slow reaction times when driving or operating machinery and put you at higher risk of injury.

"Insomnia can affect you mentally and physically, which can make you feel tired, depressed, and irritable."

Also, if you don’t get enough sleep on a regular basis, you’re at increased risk of diseases such as diabetes, heart disease and high blood pressure.

Is There a Cure or Treatment?
In some instances, insomnia can’t be prevented or avoided. For secondary causes of insomnia, you’ll need to address the conditions or health problems that are keeping you awake. However, there are several good sleep habits, also called sleep hygiene, which can help with acute insomnia.

Lifestyle changes:

• Go to bed around the same time and wake up around the same time every day.
• Keep your room dark and cool so as not to disrupt sleep or hinder it.
• Avoid watching TV or using your phone or other electronic devices in the bedroom, at least one hour before bed.
• Get regular exercise but not too close to bedtime.
• Follow a wind-down sleep routine such as reading a book or having a hot bath.
• Avoid large meals and alcohol 2-3 hours before bedtime, and caffeinated beverages 4-6 hours before bedtime.
• If you tend to lie awake and worry about things, make a to-do list before you go to bed. This may help you put your concerns aside for the night.

Supplements to Aid Sleep
The two most popular sleep aids are melatonin and valerian.
Melatonin has been shown to quicken time to sleep, and have modest benefits on sleep duration and quality, but it can cause daytime drowsiness in some cases. 

Valerian contains small amounts of GABA, a sleep-promoting neurotransmitter, and some studies have shown that valerian can improve sleep. However, other studies have found no difference in sleep when taking valerian compared with a placebo.

Talk to your doctor before trying one of these products or any other OTC medications.

Prescription Medication
In some cases, your doctor may prescribe you medication for chronic insomnia. This is a temporary solution, and not a cure for insomnia. Common prescription medicines include sedatives such as benzodiazepines (e.g. Valium, Xanax, Klonopin, Ativan). They help with falling asleep initially but tend to reduce the amount of deeper sleep. They are not recommended for long-term use and can have serious side effects.

Cognitive Behavioural Therapy (CBT)
CBT for insomnia can help you change the things you do that make insomnia worse and learn what you can do to promote sleep, such as minimizing napping during the day, relaxation training, breathing exercises, and good sleep hygiene. For some patients, CBT is more effective than medications.

While this treatment has demonstrated impressive efficacy in treating insomnia, it doesn’t always work right away. It also involves a lot of input and work. You will have to keep a sleep diary for a few weeks to monitor progress and have at least four sessions to get you on the right track. Face-to-face treatments of at least four sessions seem to be more effective than self-help interventions or face-to-face interventions with fewer sessions.

It is important to understand the cause of your insomnia before deciding on a course of action. However, developing and maintaining good sleep habits is always a good idea, regardless of the cause of your condition. Give yourself the best possible chance of getting 7-9 hours sleep a night and remember, it takes time for any new habit to stick, so be consistent.

If insomnia, or any other sleep disorder is causing you distress or affecting your quality of life, seek help from a doctor or other appropriate medical professional.