What is insomnia?

In everyday language, insomnia can refer to difficulty getting to sleep, staying asleep or waking up too early. It can also refer to not getting enough quality sleep, and feeling unrefreshed the next day. Insomnia is very common, and over a third to nearly half of the population will experience a few nights of poor sleep from time to time.

 

Acute insomnia

If sleep is disturbed up to a few weeks, it is called short-term or acute insomnia. Acute insomnia is most often caused by a stressful situation or significant change in life circumstances, such as having an important work project due, changing jobs, travelling overseas, or experiencing a medial illness. In general, sleep problems resolve once the stressful situation passes and most people will not require treatment or intervention. During these times, it can be helpful to follow some general guidelines for healthy sleep, to prevent these short bouts of insomnia developing into a more serious sleep problem. You can download a SHORT GUIDE TO BETTER SLEEP, a free booklet full of tips about how to improve sleep during a period of insomnia.

Girl with insomnia

Chronic Insomnia

For around 5-10% of the population sleep problems can occur as often as 3 or more nights a week and persist for months, or even years. When insomnia becomes chronic, lasting more than three months, a health professional may diagnose an Insomnia Disorder if certain clinical criteria are met. Click here for the clinical criteria for an insomnia disorder.

If you are experiencing chronic insomnia it is very important that you see you GP for a medical assessment. Your GP will help you decide if you need to meet with a sleep specialist, a mental health professional, or whether a self-help approach would be suitable.

Short term consequences

If you haven’t sleep well for a few nights you’ll know the feeling of fatigue and sleepiness that can occur in the days that follow. Other common effects of poor sleep include:

  • reduced mental alertness and ability to concentrate
  • poorer short-term memory
  • changes in mood, such as feeling down, more irritably or anxious
  • changes in perspective, such as a greater tendency towards negative thinking
  • a greater tendency to make mistakes or errors
  • slower reaction times, which can increase the risk of accidents or injuries.
Feeling stressed
Tired guy

Long term consequences

The consequences of long term disturbed sleep can be more serious, as it can negatively affect your physical and mental health.  Some of these long-term consequences of poor sleep can include:

  • increased weight gain (if you are tired, you may be less likely to exercise, and may choose higher energy food such as sugars and carbohydrates for an immediate energy boost)
  • increased risk of high blood pressure
  • increase risk of Type 2 diabetes
  • increase risk of depression and anxiety disorders

What are the causes insomnia?

Insomnia is generally not caused by a single factor, it is caused by a combination of factors.

Some things might predispose you to insomnia in adulthood, such as having a family history of sleep problems, of having sleep problems childhood.

Other factors that would increase your risk of developing insomnia include things like: leading a busy lifestyle, consuming high levels of caffeine, or experiencing mental or physical health problems. Also, women tend to develop insomnia more often than men, and your risk also increases with age.

Major life events (such as changing jobs, becoming unwell, becoming a parent) are common triggers of a sleep problem. Then once a sleep problem begins, worry about not sleeping (and the associated stress and hyperarousal) sets off a vicious cycle that can cause insomnia to persist.

You can learn more about the causes of insomnia in this video.

Girl suffering from stress

IMPORTANT NOTE:   If you have experienced disturbed sleep for more than 2 weeks and do not know the cause of the insomnia, it is recommended that you see your GP for an assessment and medical check-up. This information is not a substitute for proper assessment and treatment with a suitably qualified health professional.

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If you’re experiencing chronic insomnia the first step is to see your GP for an assessment and medical check-up. As mentioned earlier, your GP will help you decide if you need to meet with a sleep specialist, a mental health professional, or whether a self-help approach would be suitable, such as accessing reading material or online programs to help you learn to sleep better.

Despite the recognition that insomnia disorder is caused by physical and psychological factors, 90% of patients with insomnia who visit their GP’s will only be prescribed sleeping pills. Medication only addresses part of the problem, and does very little to prevent insomnia occurring again in the future.

To overcome insomnia in the long term, and prevent it reoccurring, it is important to understand the underlying causes of your sleep problems, and address these holistically. This means, learning a range of skills to address lifestyle factors that contribute to insomnia, reducing behaviours that interfere with sleep, reducing stress and anxiety levels, and changing the way you think about sleep.

There are two non-drug treatment approaches to improve sleep that have been well supported with scientific research: Cognitive behaviour therapy for insomnia (CBTi) and Mindfulness based therapy for insomnia (MBTi).

What treatments are available for insomnia?

Cognitive Behaviour Therapy for Insomnia (CBTi)

The first is called Cognitive-behavioral therapy for insomnia (CBTi), which addresses the physical and the mental aspects of insomnia and helps people to make the behavioral changes needed to sleep better.

CBTi strategies include avoiding activities that interfere with sleep (sleep hygiene and stimulus control), increasing sleep quality with a sleep schedule program (sleep consolidation), managing sleeplessness at night, relaxation training, and creating a healthy mind-set for sleep (cognitive restructuring).

You can learn more about CBTi here.

Mindfulness based therapy for Insomnia (MBTi)

The second approach is a more recent development in the psychological treatment for insomnia, called mindfulness based therapy for insomnia (MBTi). Mindfulness is an awareness that comes from paying attention to the present moment, with an open mind and non-judging attitude. It is letting go of thinking about past or future situations, to be present in the here and now, facing life as it is. Mindfulness training provides skills to help people relax, quieten and calm and overactive mind, reduce hyperarousal, and respond to insomnia with confidence and clarity.

For some further details on mindfulness click here and also have a look at our blogs: How does mindfulness help overcome insomnia? and Mindfulness and sleep. A doctor's perspective.

Mindfulness and sleep

Mindfulness can improve sleep in several ways. Firstly, when practiced at night, it assists in breaking the vicious cycle of insomnia by guiding attention away from unhelpful thinking and worrying about not sleeping, to focus on the natural flow of the breath. The aim is not not to induce sleep, but to cultivate patience and trust that sleep will come in its own time.

Secondly, practicing meditation while lying in bed can be very relaxing and restful, restoring energy to the body and mind for the following day.

A third benefit of mindfulness practice is that it reduces stress and anxiety in daily life. Regular practice helps to relax the mind and body, and teaches us how to regulate and calm our emotions so we are less reactive when faced with challenging situations. These skills can increase our capacity to deal with the problems we face in our lives.

Man meditating

And finally, with greater awareness of our thoughts, feelings, and body sensations, you can respond better to the body’s need for rest, a healthy diet, and exercise, to maintain a healthy and balanced lifestyle. It follows that when daily stress is low and health is optimal, you’ll experience better sleep.

An online course to improve sleep and overcome insomnia

A Mindful Way offers an online program to help you sleep better and overcome insomnia. The six-week course teaches you everything you need to know about sleep and takes you step by step through the proven strategies to help improve the quality of your sleep and spend less time awake in bed.

The course is taught through a series of video lessons and practical exercises presented by Dr Giselle Withers, a clinical psychologist with a background in sleep psychology. From the comfort of your own home, you’ll have access to the gold standard treatment approach for insomnia.