Insomnia has two layers—trouble falling asleep and trouble staying asleep. In general, people experience transient bouts of insomnia throughout their lives. The causes vary, such as stress and worries, too much caffeine or too much stimulation close to bedtime. Trouble arises when insomnia takes on long-term status. Insomniacs can spend weeks, months or years battling this frustrating and debilitating condition. The current Medical Diagnosis and Treatment text lists causes and treatments for those suffering from extended insomnia.
Organic Causes
A strong psychiatric component exists in many cases. The manic phase of bipolar disease may cause insomnia. However, people in the manic state stay awake because of a surge in energy that comes from the illness. Depression and anxiety play a strong role as well. Delirium and dementia also affect sleeping habits.
Alcohol
Ironically, a method that people choose to help them go to sleep actually perpetuates their insomnia. The effects of alcohol calm a person and induce short-term drowsiness. While this seems to work on falling asleep, the alcohol dehydrates the body and causes discomfort that awakens the person a couple of hours after falling asleep and continually throughout the night. The disruption of the normal sleep cycle negatively affects energy, mood and coping mechanisms during the day. Alcohol decreases REM sleep, a level of sleep that repairs tissue and restores restfulness.
Nicotine and Caffeine
Heavy smoking causes difficulty falling asleep. A pack of cigarettes a day or more interrupts sleep and results in less actual sleep time from too much nicotine. Another stimulant, caffeine, which is found in coffee, tea, soft drinks, chocolate and energy drinks, also keep the body from the relaxed state that induces sleep and interrupts normal sleeping patterns. Amphetamines act the same way in the body. Formulated to treat attention disorders and narcolepsy, these drugs have also made it to the illegal drug market. Their use and abuse contribute to sleep disturbances.
Sedative-Hypnotics
The benzodiazepines commonly prescribed to treat insomnia belong to the sedative group. They serve to relax the body and create a dreamy effect. According to the Diagnostic and Statistical Manual of Mental Disorders, these and other drugs used to promote sleep work in getting the insomniac to fall asleep but cause trouble awakening. They also produce tolerance, dependence and severe withdrawal while worsening the state of rehabilitative sleep. Insomniacs should use caution using these for sleep.
Other Causes
Persistent insomnia may result from medical conditions or medications. Conditions like pain, respiratory disease, gastrointestinal problems and cardiac arrhythmias break up a night's rest. Prescribed medications such as steroids and drugs that affect the nervous system cause restlessness and insomnia.
References
- Current Medical Diagnosis and Treatment; Stephen J. McPhee and Maxine A. Papadakis; 2010
- Diagnostic and Statistical Manual of Mental Disorders, 4th Edition; American Psychiatric Association; 2000
