Insomnia

“Innocent sleep. Sleep that soothes away all our worries. Sleep that puts each day to rest. Sleep that relieves the weary labourer and heals hurt minds. Sleep, the main course in life’s feast, and the most nourishing,” so wrote William Shakespeare in his play, Macbeth. Still an accurate observation of how important sleep is for the human body, over four hundred years later.

For some lucky people, sleep comes easily and quickly. They sleep deeply and soundly for six to eight hours, and wake refreshed each morning, ready to tackle their new day. For others, heading to bed can be something to be afraid of because, for them, getting to sleep, staying asleep, or having a nourishing sleep can be a battle.

World Sleep Day is on 17 March 2023, with the World Sleep Society hoping to raise awareness of sleep health among researchers, healthcare workers, patients and the public. The theme for 2023 is understanding how essential sleep is for our overall health. Just like regular exercise, good quality sleep is vital to maintaining good mental, physical and social health.

The benefits of good quality sleep are felt through our entire body. Sleep supports memory and learning, and clears waste from our brain. It supports our immune system, helping remove viruses and bacteria from our body. It is vital for a healthy cardiovascular system, maintains our bodies by repairing and recycling old cells and helps to maintain our energy levels.

On the other hand, poor sleep is associated with diabetes, coronary artery disease and cardiovascular mortality. It decreases our immune response and makes us more susceptible to infections that further impact our quality of sleep. It can impair safe driving by decreasing our reaction times, and impairing our cognitive abilities to the same extent as if we were intoxicated. After a bad night sleep, we can experience low mood and energy levels and have less ability to concentrate. Bad sleep can become a vicious cycle of worrying about how bad it was, making it even harder to fall or stay asleep.

Insomnia is the term given when a person struggles to fall asleep and/or stay asleep with no obvious reason, and is the most common sleep disorder. It can be due to an underlying health condition such as asthma, heart disease, diabetes or pregnancy, but most often behind insomnia is emotional stress, anxiety or depression. Insomnia can be acute or chronic.

There is hope – insomnia is treatable, and it can get better. If your inability to sleep has gone on longer than a couple of weeks, it is important to go to your doctor. They will treat any underlying physical or mental health conditions. Good sleep hygiene is very important to establishing bedtime routines. Aim to go to bed at the same time each night (including weekends), have relaxing bedtime rituals (like a warm bath or shower, yoga, stretching or meditation). Avoid cigarettes, alcohol and caffeine in the evenings. Get some sunlight in your eyes each day before 11am, and exercise in the morning or the middle of the day. Avoid computers, cellphones and bright lights one to two hours before bed as this can delay the release of our sleep-promoting hormone, melatonin. Make sure your bedroom is cool, quiet, dark and comfortable.

Cognitive Behaviour Therapy (CBT) is a therapy that can help to manage anxiety, calm a busy mind and get on top of negative thoughts that interfere with sleep. CBT can be done via your doctor, sleep therapists or online.

If lifestyle changes and CBT measures are not successful, a course of medication may be prescribed. These medicines are effective for short-term only but are not ideal for long-term use due to safety and efficacy concerns and their addiction potential. Sedatives and hypnotics such as temazepam and zopiclone can be used. Melatonin is a brain hormone that induces sleep and can be helpful in re-establishing sleeping patterns. Some sedating antidepressants such as amitriptyline are useful to treat insomnia coinciding with depression.

Insomnia is not something you have to put up with. Simple lifestyle measures may be enough, but don’t hesitate to seek further help as everyone deserves a decent night’s rest!

This blog provides general information and discussion about medicine, health and related subjects. The information contained in the blog and in any linked mate­ri­als, are not intended nor implied to be a substitute for professional medical advice.