Guide to Insomnia: Symptoms, Causes and Latest Treatments
Written by
Reviewed by
Dr. Ai Nhi Bui
Having trouble sleeping or getting to sleep? You’re not alone. A recent report investigating the prevalence of insomnia in Australia shows that almost 60% of adult Australians regularly experience at least one chronic sleep symptom that affects their ability to live a happy and healthy life. Researchers also found that 14.8% of respondents showed symptoms that could result in a clinical insomnia diagnosis. Suffering from insomnia is more common than you might think.
Think you might have insomnia? Let’s explore the ins-and-outs of this condition and how you can get the treatment you need, because no one should have to put up with sleepless nights.
Table of Contents:
What is insomnia?
Symptoms of insomnia
Why you need quality sleep to function
Common causes of insomnia
How insomnia is diagnosed
Treating insomnia
Accessing insomnia treatment online
Frequently asked questions about insomnia
What is insomnia?
Insomnia is a condition characterised by regularly having difficulty falling asleep and staying asleep. It can present in several patterns; some may initially have trouble getting to sleep, and others may find that even if they can fall asleep, they may wake up several times or struggle to get back to sleep. It can also affect daytime function.
Are there different types of insomnia?
When you start researching insomnia, you’ll probably come across online discussions of different ways to describe the condition, including:
Stress-related insomnia
Transient insomnia
Primary insomnia
Acute insomnia
Sleep maintenance insomnia
Comorbid insomnia
Onset insomnia
However, in the medical field, the above classifications are now considered to be outdated. According to the Australian Journal of General Practice, there are currently two separate classification symptoms for sleep disorders in Australia: ICSD-3 and DSM-5. So when you are assessed and diagnosed by a doctor, they will more than likely refer to these.
Symptoms of insomnia
Insomnia symptoms and signs may include:
Difficulty falling asleep
Waking up during the night
Waking too early
Not feeling well-rested after sleep
Being tired or sleeping during the day
Irritability, anxiety or depression
Ongoing worries about sleep
Errors, accidents and difficulty paying attention
The bottom line is, when you have insomnia, the quantity and quality of sleep is often so bad that it negatively affects your day-to-day life.
Why is sleep important?
Sleep is an important restorative process that your body needs in order to maintain optimal function. In fact, it’s just as important as maintaining a healthy diet and exercising.
When you fall asleep, your body doesn’t simply “shut down;” it’s an active period where processing, restoration and strengthening occurs. The reason why this happens and why our bodies “sleep” for so long is still a mystery. But, scientists and medical professionals do know that sleep is vital for maintaining health and wellbeing.
Poor sleep quality has been linked to:
Increased weight gain and obesity
An imbalance of appetite regulating hormones, which can result in overeating
Impaired brain function and physical performance
A greater risk of heart attack, stroke and type-2 diabetes
Depression
Increased inflammation
An inability to recognise important social cues and process emotional information
Insomnia causes
If you’re suffering from insomnia, there can be many reasons as to why. Sometimes insomnia can be the primary problem, and sometimes it can be associated with other problems.
Wondering what could be the cause of your insomnia? Here are some of the most common reasons below.
Medications that cause sleeping problems
There are a bunch of medications that can impact the quality and quantity of your sleep. These can include some:
Antidepressants
Blood pressure and heart drugs
Asthma medication
Antihistamines
Cold and flu medications
Pain relievers
In addition, there are weight-loss products out there which may contain stimulants such as caffeine, which is known for disrupting sleep.
Insomnia caused by depression, stress or anxiety
If you’re suffering from depression, stress or anxiety, you’re at higher risk for suffering from insomnia.
Stress can cause a profound reaction in the body. It’s no wonder that concerns about study, work, health, finances and relationships can keep you up at night. In addition, traumatic life events like the loss of a loved one, separation or losing your job can also lead to insomnia.
Chronic pain and trouble sleeping
Insomnia can co-occur with a wide range of chronic pain conditions. If you’re a chronic sufferer of conditions such as back pain, fibromyalgia, migraines or orofacial pain, you are more likely to experience problems falling and staying asleep.
Studies show that approximately 20% of people living with chronic pain also experience at least one symptom of insomnia compared to 7.4% of people who live without chronic pain.
Menopause and insomnia
Menopause is another common cause of insomnia. When your body goes through menopause, it experiences things like hormone changes and hot flashes, which can both affect the quality of your sleep. In addition, the medications used to treat menopause could also be a causal factor.
Another sleep disorder
Sometimes insomnia is caused by another sleep disorder. Sleep apnea, which affects up to 20% of people, causes breathing lapses and sleep interruptions, can be a cause of insomnia. In addition, Restless Leg Syndrome and abnormal sleeping behaviours such as nightmares, sleepwalking and sleep paralysis can also be contributing factors.
Discomfort due to the increasing size of the abdominal region
Frequent urination throughout the night
Back pain
Heartburn
Anxiety
Hormonal changes
You may also find you’re having problems falling asleep due to an interruption to your circadian rhythms. This can be the result of things like shift work or jetlag.
Whatever the cause of your sleeping problems, it’s important to speak to a doctor if you’re experiencing symptoms. Your doctor will help you understand what the underlying issues are so that you can treat the problem as soon as possible.
Diagnosing insomnia
There’s no “one test” to diagnose insomnia. Doctors will use a variety of tools along with your medical history to make a diagnosis. This might involve asking a patient questions about their lifestyle, symptoms and sleeping habits. Sometimes your doctor will require further investigation which might include sending you for blood tests or referring you to a sleep specialist to undergo a sleep study.
All of the above will help your doctor investigate what’s causing you to suffer from poor sleep. This information will also help your doctor to formulate the right treatment plan for you.
Treating insomnia
Insomnia may go away without prescribed treatment, but if you find that it’s persisting, it’s time to speak to your doctor to find out what could be causing or contributing to the problem.
From practicing healthy sleep habits through to medications and addressing underlying causes, there are plenty of ways to treat insomnia.
Cognitive Behavioural Therapy (CBT) for insomnia
A treatment for insomnia that is often recommended by doctors is CBT. This is generally a range of techniques that addresses thoughts and behaviours around sleep.
CBT for insomnia will usually involve:
Stimulus control - which involves getting out of bed and leaving the room to doing something else non-stimulating until you feel sleepy again
Sleep restriction - matching the time you spend in bed more closely with how much sleep you’re actually getting
Relaxation training - managing stress and anxiety techniques with relaxation and meditation techniques
Cognitive therapy - challenging beliefs about sleep that people with insomnia may develop over time
Sleep hygiene - ensuring your body, mind and environment are ready for sleep
Following a sleep routine and only going to bed when you actually feel sleepy
Avoiding daytime naps
Improving your sleep environment through temperature regulation, making sure your room is dark, reducing noise and not using any smartphones, tablets or TVs in the hour before bed
In addition to following a healthy diet and exercising regularly, it’s also important to avoid things like cigarettes, alcohol, drugs and caffeine. Avoiding caffeine, energy drinks and alcohol close to bedtime, or fluids that can cause frequent urination during the night, is also a good sleep hygiene practice.
Treating insomnia with sleep medication
If you are suffering from insomnia, and other methods haven’t helped, your doctor may prescribe a medication for temporary use. Long-term medication use for insomnia is discouraged as sleeping pills can be habit-forming and cause other adverse side-effects, including excessive drowsiness, agitation, sleepwalking and more.
If you’re a chronic insomnia sufferer, your doctor will work to address the underlying cause of your insomnia to come up with a manageable long-term treatment strategy.
How to get insomnia treatment and medications online
If you are having trouble sleeping, you can use Rosemary to access an online doctor and get treatment for insomnia online. Simply fill out a doctor-curated online assessment, a licensed Australian doctor will review within hours and, if suitable, prescribe a personalised treatment plan. All medications prescribed are shipped anywhere in Australia with free delivery. All 100% online and text-based so you can get the care you need whenever, wherever.
Frequently asked questions about insomnia
How long does insomnia last?
Insomnia can be acute (short-term) or chronic (long-term), but how long it lasts will depend on the cause and severity of your condition. Insomnia can also come and go, where you might experience periods where you have no sleep problems.
What are the long-term effects of insomnia?
There are many long-term effects of insomnia. An ongoing lack of sleep has been linked to conditions such as hypertension, cardiovascular disease, strokes, diabetes, obesity, depression and anxiety, weakened immune systems and more.
Is it possible to access over-the-counter sleep medication?
Some drugs used to treat insomnia are available over the counter, and it’s not uncommon for patients to use these over-the-counter ‘sleep-aids’ as a first-line treatment before seeking assistance and medical review from a doctor.
However, addressing any underlying causes is key. Management of insomnia is two-fold: it should treat the symptom, while at the same time, investigate and treat the cause.
Is meditation for insomnia recommended?
Meditation and other relaxation techniques have been shown to increase sleep time, improve the quality of sleep and make it easier to fall and stay asleep. There are a number of meditation apps and courses on the market that you may find useful. You may even find a guided sleep meditation playlist helpful. If you are considering meditation or other relaxation techniques to improve your sleep, speak to your doctor.
Can online doctors prescribe sleeping pills?
Yes, you can access licensed Australian doctors through Rosemary Health to get a prescription for sleeping medication.
The process is fairly simple. Fill out a questionnaire to see if you qualify for a prescription, and once reviewed by a doctor, your sleeping medication will be shipped to you.
Note: While Rosemary doctors can help to identify a treatment plan for you, we don’t prescribe habit-forming sleeping drugs like benzodiazepines and hypnotics, as these are known to cause adverse side effects. However, we do offer effective sleep treatments that are personalised to your needs.
Does insomnia get worse as you get older?
According to current diagnostic criteria, insomnia is more common in older Australians. As we age, our sleep patterns start to change, resulting in a larger delay between going to bed and the onset of sleep - this causes sleep quality to suffer. The older we get, the more likely we are to suffer from other health conditions that may be underlying causes of insomnia. It’s also more likely we will be on medications that can increase the risk of insomnia.
Is there an insomnia cure?
Causes of insomnia are varied, so there is no single cure. However, many people see improvement by addressing underlying causes and lifestyle changes.
What are some common natural remedies for sleep?
The best way to treat insomnia naturally without medication is all about lifestyle changes. As we’ve outlined above, these include exercise, healthy eating, sleep hygiene and CBT.
FRACGP, MB.BS (University of Sydney), B.Med Sc (University of NSW)
Dr. Bui is a General Practitioner based in Sydney. She is a member of the Royal Australian College of General Practitioners, and is all about providing excellent healthcare to all Australians. She is passionate about the future of health, and provides training to the next generation of highly skilled GPs through on-the-job clinical supervision.
Dr Jo Santos
FRACGP, MB.BS (University of Sydney)
Dr. Santos is a highly respected General Practitioner based in Sydney. From volunteering as a doctor in remote parts of the Philippines, through to providing on-the-job clinical training to the next generation of Australian GPs, it is clear to see that Dr. Santos is passionate about contributing to healthier communities.
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