Coping with Insomnia

It has been estimated that between 10% and 20% of the general population experience insomnia which can be defined as a difficulty falling asleep and remaining asleep.

Researchers have found that twice as many females complain of insomnia compared to males. The elderly are also more likely to be affected than the young, introverts more than extroverts.

There are many causes of insomnia. It is well known that excitement, fear, worry, tension or anger can rob us of a good night’s rest. Painful physical ailments, malignant tumours, arthritis, stomach ulcers and the like often cause sleep to be disturbed. Smokers are frequently awakened by coughing as are their sleeping partners. People suffering from cardiac or lung conditions may also have their sleep interrupted by breathlessness.

Individuals who abuse alcohol or tranquilizers will also experience insomnia. Although such substances have a sedative effect, regular use will cause the body to develop tolerance to these after a period of time. This means that the same amount of drinks or drugs will no longer produce the same sedative effect. Thus, a habitual drinker may have to drink more in order to enjoy uninterrupted sleep.

Night shift workers may experience insomnia for a night or two after changing to the day shift. Long distance travellers, especially those who travel across time zones, are prone to suffer from “jet lag” e.g. waking up in the middle of the night or feeling very sleepy during the day. This is due to a disruption of the sleeping-waking rhythm.

People suffering from psychiatric disorders such as anxiety neurosis, depressive illness and mania may also experience insomnia.

However, a person with insomnia may not necessarily suffer from a psychiatric or physical problem. In about 15% of cases examined, no cause for insomnia can be found.

Regardless of the causes of the insomnia, it is prudent to adopt good sleeping habits:

  • Try to go to bed at the same time and wake up at the same time every day.
  • Exercise regularly but avoid strenuous physical exertion just before sleeping.
  • Ensure that the bedroom is well ventilated and reasonably quiet.
  • A warm milky drink before going to bed can help induce sleep.
  • Some light reading may help a person unwind after a hectic day.
  • Listening to soothing music prior to bedtime may be helpful.

The following should be avoided:

  • Naps during the afternoons or early morning.
  • Drinking coffee, tea and certain cola drinks in the evenings. These contain caffeine which is a stimulant.
  • Cigarette smoking in the evenings. Although some find smoking relaxing, it has been found that the nicotine in cigarettes can stimulate the brain and disturb sleep. It is also known that heavy smokers often develop chest ailments e.g. bronchitis (smoker’s cough) which can seriously disrupt sleep.
  • Working, eating or engaging in any mentally stimulating activity in the bedroom.
  • Regular consumption of alcohol and/or sleeping tablets.
  • A heavy carbohydrate meal prior to bedtime.

If, despite having good sleeping habits, you still experience insomnia, professional help should be sought. One’s general practitioner or outpatient clinic doctor can help treat insomnia by identifying and treating the underlying cause(s). If physical conditions are the cause of the insomnia, then treatment of the underlying disorder should alleviate the sleep problem.

Very often sleeping tablets are prescribed to induce sleep. Although these may bring about the much needed sleep, the regular use of hypnotics will lead to a problem of dependence. Stopping such medication suddenly will cause a recurrence of insomnia as well as nightmares. Hence, it may be wise to gradually reduce the dosage of sleep medication under medical supervision.

Some forms of anti-depressant medication may have sedative properties and may be useful if the insomnia is related to a depressive condition.

Psychological methods such as learning how to cope with anxiety and tension during the day can help improve sleep at night. Doing relaxing activities such as listening to soothing music, practising relaxation exercises, meditation or yoga etc. prior to sleeping may also be helpful. The more relaxed a person is, the easier it will be for him to fall asleep.

If a traveller is to arrive at a destination at night, he should try to sleep after arriving but avoid caffeinated drinks while on board the aircraft. If he is to arrive during the day, he should try to remain awake and out in the sunlight until night fall. This will help him adjust to the new time zone more quickly. Some travellers try to get as much sleep as possible on board the aircraft prior to arriving at their destination during the day, claiming to feel more refreshed. Sometimes it may be necessary to take a sleeping tablet during the flight or after landing in order to induce sleep at the appropriate times.

Insomnia is a fairly common problem in society. The causative factors are many and varied. Anxiety, worry, stress and tension are the common enemies of sound sleep. Treatment of insomnia involves tackling the underlying causes.

Very often, non-pharmacological methods such as counselling, adhering to a sensible regular routine of sleep and waking, or the avoidance of stimulants, will resolve the problem. The prolonged use of hypnotics and/or alcohol to promote sleep is discouraged.