Learn about the types and causes of insomnia and how to tackle them

Insomnia is the inability to fall asleep and stay asleep. People who suffer from this disorder sleep for fewer hours and have poor quality sleep. This impacts directly on their quality of life and can affect their personal and working relations.

What are the causes of this problem?

• Primary causes. These are related to bad resting habits, psychological problems such as moving house, shift work, travel to different time zones, advanced age, very long naps, heavy meals, drug consumption such as hormones, anti-cholinergics, anti-hypertensives, antidepressants, bronchodilators…etc, or stimulants such as caffeine, theines, spicy substances…etc. Other primary causes can be pain, depression, anxiety and worry.
• Secondary causes. When there is an underlying disease affecting sleep, such as cardiovascular, lung, gastrointestinal, hormonal or neurological diseases, or when environmental causes such as extreme temperatures prevent deep sleep.

Are there different types of insomnia?

Depending on its duration, we would say:

• If it happens in a short and specific period, usually caused by a situation of stress, pain, or change in habits, or by taking medication, or by another specific problem.
• Chronic When it lasts longer and has consequences in the patient’s daily life.

To reach a diagnosis, particularly in serious cases when the patient does not rest enough, there are numerous techniques which will measure sleep patterns. Symptoms of anxiety, depression, underlying diseases, drug interference or problem habits are explored and tests are carried out  for possible apnoea (interruptions in breathing) which interrupt the patient’s sleep.

Is there any treatment?

There are two types of treatment. Sleep re-education or behavioural therapy is always tried first, to try to create resting habits which will promote and restore deep sleep before reaching the stage when drugs are needed when it’s not possible to fall asleep, or when this is weak and difficult.

Remember that to sleep well it’s necessary to:

• Have an early light dinner for good digestion before bedtime.
• Avoid caffeine, theines, alcohol, and tobacco, as they stimulate the nervous system.
• Increase intake of foods with tryptophan or magnesium which induces sleep,such as dairy, eggs, honey, banana, cereals, dried fruit or chamomile,
• Establish a time routine.
• Sleep in a bedroom without noise,quite dark and with a temperature no more than 21 degrees.
• Don’t nap for more than 20 minutes.
• Don’t watch television or use the computer in bed.
• Take regular exercise, but at least two hours before bedtime.

The most commonly used drugs for psychological causes are the anxiolytics or anti-depressants, or hypnotics if the causes are physical. They always have to be prescribed by a doctor and the instructions must be followed to the letter, as they can lead to dependency. On no account must any drug of this type be taken without prior consultation with the doctor.

Techniques such as relaxation, meditation, yoga, tai-chi,or pilates can be a great help in getting rid of tension, being more receptive, and stimulating the secretion of melatonin, which helps to regulate sleep cycles.