Do you suffer from insomnia?

Do you suffer from insomnia?

Are you routinely struggling to fall asleep each night? Even after a long, exhausting day?

Do you find yourself awake in the night and just can’t get back to sleep?

Do you worry about just the “thought” of going to bed each night?

Are sleeping pills no longer doing the job?

Is your career or personal life suffering because of lack of sleep?

Icon showing 40% of Canadians suffering from insomnia

Did you know?

According to Statistics Canada, about 40% of the population is living with a sleep disorder, insomnia being the most prevalent.

What is Insomnia?

Insomnia is the most common sleep disorder, affecting approximately 10% of adults chronically and 25% of adults acutely. This condition prevents you from getting enough sleep to feel rested and leaves you yawning all day.

Insomnia can take many forms. Some people have trouble falling asleep, which is defined as spending more than 20 to 30 minutes in bed before falling asleep. Others wake up frequently and cannot fall back to sleep. Insomnia can be acute (short term) or chronic (long term). Chronic insomnia can be diagnosed if your problem occurs at least three nights a week for at least three months.

  • Stress
  • Worry
  • Anxiety
  • Depression
  • Substances and Medicines
  • Irregular schedule during the day
  • Menopause
  • Respiratory problems
  • Bad sleeping habits, caffeine and alcohol
  • Jet lag
  • Pain caused by arthritis or other health conditions
  • Sleep apnea or restless legs syndrome
  • Watching TV or screens late at night

Insomnia is a sleep disorder in which you cannot fall asleep even if you want to, or you cannot stay asleep long enough. It is generally defined as taking longer than 15 minutes to fall asleep (initial insomnia) waking up at night and being unable to go back to sleep after periods of 30 minutes or more during the night (maintenance insomnia) waking up early at night without being able to go back to sleep (terminal insomnia) more than 3 times a week.

Acute insomnia can afflict you for just a few days or become a chronic condition, robbing you of rest for months or even years.

Talk to your doctor about Cognitive behavioural therapy for insomnia. CBT-I is an effective treatment for chronic sleep problems and is usually recommended as the first line of treatment. From there, you will probably be advised to make certain lifestyle changes (such as exercising more and improving your diet).

If your insomnia is being caused by sleep apnea, CPAP therapy can help.

Finally, in some cases, physicians can recommend medications to help with insomnia.

  • Difficulty falling asleep
  • Waking up intermittently during night
  • Waking up prematurely
  • Tiredness on waking and drowsiness during the day
  • Irritability and trouble concentrating
  • Headache
  • Decreased alertness and performance
  • Insomnia can disappear and can be treated in several ways:
  • Treatment of the condition that caused it (e.g. depression, anxiety, sleep apnea or other)
  • Improved sleep hygiene
  • Behavioural modification CBT (cognitive behavioural therapy)
  • Taking medication

Hormonal imbalance is a major cause of insomnia for women.

It is generally defined as taking more than 15 minutes to fall asleep, being awake and unable to surrender after periods of 30 minutes or more during the night and/or sleeping less than five hours per night.

Using Cognitive Behavioural Therapy (CBT) instead of sleeping pills. CBT aims to change your thought pattern and approach to sleep and your habits before bed.

By adopting better sleep hygiene:

  • Don’t watch TV or eat in bed
  • Make sure your bedroom is cool and dark
  • Don’t take naps during the day
  • Avoid consuming caffeine (in drinks or food) in the afternoon

No, insomnia is not a mental illness.

People who suffer from insomnia often have an overactive brain due to stress and anxiety.

The activity of the nervous system causes a rise in body temperature even though it must drop to be able to fall asleep. High levels of cortisol, adrenaline, and noradrenaline make the heart beat faster, making the transition from deep sleep to light sleep more difficult.

Finally, brain activity related to the sympathetic nervous system, in insomniac patients, doesn’t decrease in the part of the brain related to emotions (the amygdala) and memory (the hippocampus):

We see the same scenario for the basic functions of the brainstem, all staying stubbornly awake to stand guard. Meanwhile, the thalamus, the brain’s sensory barrier that must close for sleep to occur, remains active and available for use in patients with insomnia.

Foods rich in tryptophan:

  • Eggs
  • Walnuts, almonds and hazelnuts
  • Dairy products
  • Certain grains and starches
  • Lentils, chickpeas
  • Meat and fish
  • Bananas

Some tips to help you sleep better:

  • Avoid caffeine after 4 p.m.
  • Play sports or try to exercise at least 20 mins a day (such as going for a walk after dinner)
  • Ban screens before bedtime
  • Sleep in complete darkness and in a cool room

Icon of drugs/pills with a slash through them

Avoid Sleeping Pills

Sleeping pills may be helpful as a short-term treatment but research shows that there are better solutions. Moreover, individuals taking OTC medications may develop an addiction which can result in reduced alertness, fatigue, and depression.

Treatment

At Apnea Health, we encourage the use of Cognitive Behavioral Therapy (CBT) instead of sleeping pills. CBT aims to change the way you think about and approach sleep, and your habits of going to bed and getting to sleep.

This type of therapy can help you control or eliminate negative thoughts and worries that keep you awake, and helps you develop good sleep habits and avoid behaviors that keep you from sleeping well. With over 40% of Canadians suffering from poor sleep, there are plenty of marketing products and gimmicks around, but evidence proves that CBT is the only treatment which has consistently be shown to improve sleep in 80% of those who try it.

Sleep is just as important as good nutrition or exercising.
Charles Morin – President of The World Sleep Society

Effects of Insomnia

Weight Gain

During sleep our bodies produce a number of hormones including leptins: an appetite-controlling hormone. If we don’t get enough sleep our body will decrease the production of that hormone and therefore, we’re at greater risk to become overweight.

Heart Disease

Blood pressure also decreases when we sleep but disorders such as insomnia or sleep apnea put more strain on the heart thus leading to hypertension. A 2015 statement from the American Heart Association found that short sleep duration was associated with a higher risk of hypertension and of coronary heart disease.

Mental Health

In a 2016 meta-analysis, insomnia was associated with a higher risk of depression. In a 2017 review, researchers found that several studies point to a link between sleep deprivation and more amyloid-beta protein accumulating in the brain; a key factor in the development of Alzheimer’s disease. Although clinical trials haven’t yet proven that sleep deprivation causes dementia or Alzheimer’s, this might be one potential consequence of sleep disruption.

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30-70% of patients who consult for insomnia have sleep apnea

There are many factors that can contribute to insomnia and some may be symptoms or side effects of another underlying problem.

  • Breathing disorders: asthma or heart failure
  • Psychological conditions such as financial or emotional stress, anxiety and depression
  • Neurological disorders: Alzheimer’s or Parkinson’s disease
  • Pain conditions: arthritis and headache
  • Gastrointestinal disorders: heartburn, GERD
  • Menopause
  • Substances, such as caffeine, tobacco or alchohol
  • Sleep disorders: restless legs syndrome or sleep apnea

It’s this last cause which is by and large often the culprit. Studies report that between 30 and 70% of of insomnia patients also suffer from sleep apnea1.

The first step in assessing someone for insomnia is to rule out apnea.

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