Irshaad Ebrahim (Medical Director of The London Sleep Centre) gives expert video advice on: What is insomnia?; What happens to people who suffer insomnia, over time?; How many people suffer from insomnia? and more...
What is insomnia?
Insomnia refers to a condition, which may be a short term condition or a long term condition where there is an inability to initiate sleep - the opposite to <a href="http://www.videojug.com/interview/hypersomnia-2">hypersomnia</a>. In other words difficulty falling asleep or there may be difficulty maintaining sleep where people get up frequently after falling asleep or they have the problem of waking too early. It is usually considered as part of the diagnosis to have not enough sleep. In other words a reduced amount of sleep in order to have a diagnosis of insomnia and also to have symptoms during the day after having a night of insomnia. Insomnia may be classified as being acute which is a short term problem. And this is frequently associated with stressful life events or other forms of stress. Or insomnia may be chronic where it is becomes an established pattern of poor sleep over a long period of time.
What happens to people who suffer insomnia, over time?
If someone has chronic insomnia then they become vulnerable to other problems. Most commonly they become vulnerable to symptoms of daytime tiredness, fatigue, and daytime sleepiness because of this chronic sleep loss, not unlike suffers of <a href="http://www.videojug.com/interview/the-effects-of-sleep-deprivation-2">sleep deprivation</a>. They also become more vulnerable to depression and to anxiety disorder. They also become vulnerable to infections and the immune system seem to suffer for this.
How many people suffer from insomnia?
There is some debate about the exact prevalence of insomnia. But it seems to vary between 1 in 10 to 1 in 20 people have insomnia on any given night.
Can insomnia be dangerous?
There is now increasing evidence that chronic insomnia, particularly long-term sleep disruption can lead to abnormalities in the immune system, and therefore lead to people getting more infections and inflammations, and may also be related to a shorter lifespan.
What factors can cause insomnia?
Insomnia can be classified as either primary or secondary. Primary insomnia refers to insomnia that has no identifiable medical cause. In other words, life stress, whether its minor or major. Any series of events made to set off one bad night, which would then result in a series of bad nights, and then maybe months and even years of bad nights because one establishes a dysfunctional pattern of sleeping. That is called primary insomnia. Secondary insomnia, as its name implies, is secondary to something else. It may be a medical condition such as a heart condition or a vascular condition or an inflammatory condition such as arthritis that could be affecting your sleep at night. There could be another sleep disorder for example, sleep apnea, where ones's breathing stops during sleep that may cause insomnia.
Is insomnia hereditary?
Primary insomnia is thought to be hereditary, in that people in those particular families have learned how to adjust to a bad night's sleep, or have certain coping mechanisms that may encourage the onset of insomnia. So what we find quite frequently is, when we speak to people, or when I have patients who have got insomnia, and I ask them about their family history, they frequently say, "Well, my mom's a bad sleeper and always has been a bad sleeper. But like my mom, I'm a big worrier, too."
Can insomnia cause other disorders?
The relationship between insomnia and other disorders is quite complex. Insomnia can be secondary to other disorders. For example, in depression one frequently finds in people with depression; an early-morning-waking type of insomnia. People with anxiety disorders, who tend to worry excessively, tend to have a sleep initiating type of insomnia, where they can't fall asleep, and they lie in bed spending hours worrying about things. Having said that, long-term insomnia can result in disruption of the serotonin mechanisms in the brain. And this, in turn, can then lead on to symptoms of anxiety and depression. So it's a bit like the chicken and egg—what came first?
Are there any tips to help people deal with insomnia at home?
There are several tips called ‘good sleep hygiene' that are important to follow if one has a problem of insomnia. The first instant having a regular sleep time and a regular get-out-of-bed time is very important. Once you are consistent with the sleep time and the get-out-of-bed time, not only during the weekdays but on weekends too. Living a healthy lifestyle, not smoking, not drinking excess of alcohol, particularly not drinking alcohol prior to bed time, exercising regularly, exercising at the right time, it's not healthy to exercise after 6pm in the evening, it's healthier to exercise during the day, exercising in the evening can lead to excess of stimulation, and therefore hyper arouse the individual and result in the irrelevant system being overdrive and hence difficulty in falling asleep. Caffeine is important in the sense that it should not be consumed after 2pm in the afternoon and one should restrict one caffeine intake to a maximum of 2 to 3 cups of coffee in the earlier part of the day. The environment is important. Having a comfortable bed with not too soft or not too firm mattress, a well ventilated room between 21 to 24 degrees centigrade and also having adequate nutritional and food intake prior to bed. We have a list of other sleep tips on our website www.londonsleepcentre.com
Does insomnia affect women more than men?
The ratio of men to women is quite significant in people with insomnia. There's almost a nine times more prevalence of women with a problem with insomnia compared to men. There are a variety of reasons for this, one being that women tend to seek help more frequently than men do in terms of health related complaints. Secondly, some people believe that there may be an increased vulnerability in women to developing insomnia. The specific answers to this are not actually available right now, but there are research projects underway to answer this question.