What is Insomnia and What Can I Do About It?

Insomnia just means you're not able to sleep, right? Not quite!

Though this is what many people may first think of when they hear insomnia, it's actually not that straightforward. Let's break down what insomnia really is.

What are the signs of insomnia?

According to the DSM-5, which is published by the American Psychological Association and is basically an encyclopedia all known mental diseases and disorders, insomnia means:

  1. It's hard to

    a. fall asleep - you lie in bed awake for a long time, even though you want to sleep b. stay asleep - you wake up often and/or can't fall back asleep after waking up c. sleep enough - you wake up earlier than you want to and can't go back to sleep

  2. Not getting the sleep you need affects you during work/school/everyday life by

    a. Making it hard to focus b. Making your mood worse c. Making you anxious or worried

  3. The above issues occur 3 or more times a week

If the things listed above seem to describe you, there is a chance you have insomnia. Depending on long it happens for, insomnia is classified differently:

Acute (Short Term) Insomnia - The symptoms lasted less than three months
Chronic (Long Term) Insomnia  - The symptoms lasted more than three months

What causes insomnia?

There are many things that can cause insomnia, which are shown in detail in the following figure:

Epidemiology of insomnia: what we know and what we still need to learn - Figure 3

There are three categories:

Primary - no identifiable cause
Secondary - insomnia is the result of a separate medical problem
Self induced - insomnia is caused by a particular behavior or lifestyle

The easiest way to figure out which of these might be causing your insomnia is to talk to your doctor, who may request a polysomnogram, or sleep test. Polysomnogram might sound intense, but is just a simple test which requires you to spend one night sleeping in a lab, and measures things like your heart rate and brain activity while you are asleep.

Is insomnia a disease?

Insomnia is classified as a sleep disorder. A disorder is different from a disease, and it's important to know the difference because each one requires a different approach in order to get better. In fact some disorders, including insomnia, can be caused by diseases.

A disease is your body is responding to a change, like the strep bacteria giving someone a sore throat or a lack of insulin meaning someone has diabetes. A disorder, on the other hand, just means a function of the body--- like sleep--- isn't happening the way it should. 

Is there a cure for insomnia?

The short answer is yes, there are ways to cure insomnia, but the way to do it may not be what you're imagining.

With most diseases, getting rid of or treating whatever is causing the problem is the important thing, which is why medicines like antibiotics will cure strep throat. They kill off the bacteria that are causing the problem, and the person is cured.

Curing insomnia, which is a disorder, is a bit different. Though the cause is still something to consider, the way to cure a disorder is to make the function work properly. Unfortunately, there aren't really any medicines that can fix insomnia the way antibiotics fix a sore throat.

Don't worry though! Even though there's no magic bullet, there are still ways to get rid of insomnia for good.

How can I get rid of insomnia?

The European Sleep Research Society reviewed all the research comparing insomnia treatments from 1966 to 2016, everything from taking sleeping pills to getting more exercise, even acupuncture. After analyzing the findings and taking into account the quality of the evidence behind it, they then gave recommendations and notes on each treatment.

Proven Methods: These methods were all shown to have evidence behind them, and are considered to be proven treatments and therapies for insomnia

Non-proven Methods: Acupuncture, aromatherapy, foot reflexology, homeopathy, meditative movement, moxibustion and yoga are not recommended for the treatment of insomnia due to a lack of evidence.

Citations 

https://www.psychiatry.org/psychiatrists/practice/dsm https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t36/ https://www.sciencedirect.com/science/article/pii/S1087079202901863 https://amastyleinsider.com/2011/11/21/condition-disease-disorder/ https://onlinelibrary.wiley.com/doi/full/10.1111/jsr.12594