Insomnia and Sleep Disorders

What is insomnia?

We understand the importance of sleep and how low quality and insufficient sleep negatively affects our lives, but what if we can’t sleep? And what about the feeling of being tired even after a full night of sleep?

Insomnia is the sleep disorder most of us might experience at some time; it is the feeling that you haven’t had enough sleep because you couldn’t get to sleep in the first place, woke up frequently during the night or woke up early. You will also wake up feeling tired, sluggish and unrefreshed – furthermore, you will probably discover that you have problems functioning during the day too.

You may have primary insomnia if you show any of these symptoms^{15 16 17}:

• Your main complaint is difficulty falling or staying asleep, or feeling unrefreshed the next day after a night’s sleep, for at least one month or more;

• Your sleep disturbance (or the daytime sleepiness that results from it) is worrying you, hindering your day-to-day activities, or affecting your social relationships;

• Your sleep disturbance is not linked to other sleeping problems such as narcolepsy, sleep apnea, circadian rhythm sleep disorder (such as being jet lagged or blind), or a parasomnia;

• Your sleep disturbance is not linked to mental health problems like depression or anxiety;

• Your sleep disturbance is not a side effect of medication, substance abuse like alcohol or illegal street drugs, or an underlying medical condition such as pain

Use our Self Diagnosis Test to find out whether you have sleep disorders.

As we age, our need for sleep reduces as our sleep patterns naturally change. Older and elderly people can find that they sleep earlier in the evening and wake much earlier the next morning than in their 20s or 30s. In fact the highest level of insomnia happens in people aged 65 years and over.

There are 2 types of insomnia¹⁴:

• Primary insomnia when your sleep problems have no known physical (pain), emotional (depression, anxiety), chemical (another medication), or environmental (noise at night) causes
• Secondary insomnia happens when your sleep problems are caused by one of the factors detailed above

Many studies now refer to “insomnia” per se or “comorbid insomnia” rather than “primary” or “secondary” insomnia thus acknowledging the stand alone importance of this condition to morbidity.
Insomnia can be transient lasting less than a fortnight; short-term lasting less than three weeks, or chronic lasting more than three weeks.

Transient or short-term insomnia is often linked to something that’s happening in your life, such as anxiety or stress about something in your life, and once that situation is sorted out, the insomnia often passes. Examples might be preparing for an exam, waiting for test results, or starting new medication. In some people, the short-term insomnia triggers concerns about getting to sleep and this can contribute to chronic insomnia.
Chronic insomnia can be a primary disorder or secondary to another medical condition.
It is estimated that primary insomnia, defined as insomnia with no other obvious underlying condition as its cause, affects up to 10% of the general population, increasing to up to 25% in the elderly¹.

How Quality of Sleep relates to insomnia^{3 4 18 19}

Traditionally insomnia has been diagnosed on the basis of quantity of sleep:

• Sleep latency (time taken to get to sleep)

• Sleep duration (length of time spent asleep)

While it is important not to ignore quantity of sleep, surveys show that poor Quality of Sleep has a greater negative impact on health, well-being and satisfaction with life than the quantity of sleep a person gets. Individual need for sleep differs but it is quality of that sleep which results in alertness, improved functioning the following day and better Quality of Life.

How does insomnia affect a person’s health?

Insomnia is not just a problem of the night, leaving the sufferer tired in the morning. A number of surveys have shown that leaving insomnia untreated may affect the sufferer in the long-term, with severe impact on general health, well-being and Quality of Life^{5 6 7 8 9}. These insomnia patients are at a higher risk of developing hypertension, cardiovascular morbidity such as heart attacks and stroke, dementia and obesity.

Insomnia that affects normal functioning can be harmful to daily life, with poor alertness and efficiency raising the risk of vehicle or occupational accidents⁷. Nearly 50% of lorry drivers admit to falling asleep at the wheel^{10 11}.

In the untreated patient, insomnia can also affect work performance. There can be a change in character and a drop in quality of work, which may be misinterpreted as laziness or lack of motivation. Increased absenteeism from work results in reduced productivity and is also uneconomical for the employer. Eventually, if the disorder remains untreated, this may even lead to reduced job prospects and loss of employment¹².

Furthermore, directly or indirectly, disrupted sleep can also have a negative effect on family life and relationships by affecting a person’s mood and the way in which they are able to perform daily activities and interact socially¹². Insomnia may create irritability or a change in mood that damages relations between couples. Family and friends may refuse to accept sleep-related disorders as illnesses and attribute sleepiness to boredom, laziness or psychological problems¹³. This can leave patients feeling misunderstood and unsupported by those closest to them. Studies have shown that people with insomnia suffer from more symptoms of hypertension (high blood pressure), anxiety and depression than people without insomnia^{2 3}.

Clinical studies show us that poor Quality of Sleep negatively corresponds with measures of health, well-being and satisfaction¹.