What is insomnia?
Insomnia is said to be present when you regularly find it hard to fall asleep or stay asleep. It has several patterns. You may have trouble getting to sleep initially. Or even if you can fall asleep, you might not be able to stay asleep for as long as you would like. Also you may wake up during the night and not be able to go back to sleep for a long time. Many people have two of the above problems, or even all three. Because of these, you might feel tired during the day.
What causes insomnia?
Insomnia has many causes which can include:
- Some medicines and drugs e.g. asthma or blood pressure medication, caffeine, alcohol or smoking.
- Chronic pain and other uncomfortable illnesses
- Stress at work or in your personal life
- A friend or loved one passing away
- Anxiety and worrying, including worrying about not getting enough sleep
- Another sleep problem (see Ten Common Sleep disorders)
- Sometimes there is no clear cause for insomnia, in which case it is called primary insomnia
How common is insomnia?
Most people have experienced insomnia symptoms at some time of their lives. At any given time around 10% of people have at least mild insomnia.
Who is at risk?
Older people with poor health have a higher risk. Also women have twice the rates compared to men. This may be related to higher rates of anxiety and depression, which can be associated with insomnia. Shift workers have a higher risk too.
How does it affect people?
You might feel that it's harder to focus and remember things. But most people think their memory is worse than it really is. The same goes for concentration. Your risk of a traffic accident or other injury may be higher (see Drowsy Driving). You may be more emotional and a lack of sleep can cause depressed mood. Some people feel sleepy during the day, but this can be caused by many things (see Excessive Daytime Sleepiness).
How is it treated?
This depends on what is causing the insomnia.
- If poor sleep habits are the cause then these need to be improved (see Good Sleep Habits).
- If your sleep habits seem to be okay but you are still having problems then you may need more specialist help. Cognitive-behavioural therapy for insomnia (CBT-I) has been shown to be more effective in the medium and long term than sleeping tablets. (See the information under the final three sub-headings for treatment services.)
- Stress, depression and anxiety are best treated by specialists, but taking steps to improve your sleep can also help with these.
- Sometimes sleep specialists will suggest a sleep study to be sure they understand what may be causing the poor sleep and also check for sleep apnoea.
What about sleeping pills?
If you only take them occasionally, sleeping pills can get you a good night’s sleep. However, if you take them often, you will get used to them and they will stop working as effectively. Also, they can be habit-forming and it can then become difficult to stop taking them.
Where and when should you seek help?
If you are having ongoing trouble sleeping, persistent problems with mood, restlessness in bed, severe snoring or wakening unrefreshed, make sure that you go and see your doctor. Your GP can refer you to a sleep specialist or psychologist.
Is there online help available?
Yes, on-line, low cost, sleep improvement programs are available, such as:
A Mindful Way (www.amindfulway.com.au) – This is an Australian 6-week digital online self-help program, that teaches mindfulness and cognitive-behavioural skills for sleep improvement at a cost. A Monash University randomised control pilot study showed completion of the program led to significant improvement in measures of insomnia.
THIS WAY UP – This free online program provides practical strategies to help deal with ongoing sleep disturbances. These strategies are based on CBT-I and delivered via 4-lesson program.
Sleep Better without Drugs – This Australian program consists of a book and an audio tape. It was first developed and tested in Australia in the 1990s by psychologist Dr David Morawetz and subsequently updated
Sleepio – An on-line program developed and tested in the UK by the insomnia researcher and clinician, Professor Colin Espie.
Somryst – This online program was developed by the University of Virginia, USA and tested in several countries, including Australia.
(Note: The Sleep Health Foundation does not endorse programs or products and the above list is provided for information only.)