Insomnia: When you can’t fall asleep
Insomnia is characterized by frequent and persistent difficulty initiating or sustaining sleep - even when you are experiencing favorable circumstances and opportunities that typically facilitate sleep.
There are three types of insomnia:
Difficulty going to sleep
Difficulty staying asleep
Difficulty going to sleep and staying asleep
Insomnia is affected by a combination of factors summarized as the “3 P’s of Insomnia.”
Predisposing factors: A variety of factors can impact how easy it is for an individual to fall and stay asleep. A genetic predisposition (family history of insomnia), chronic pain, chronic mood/affective disorders, sleep-disordered breathing (sleep apnea), bladder dysfunction, and shift work are all predisposing factors that impact an individual’s ability to fall and stay asleep.
Precipitating factors: Changes in an individual’s life can trigger the onset or worsening of insomnia. These factors include stressful life events, changes in routine, and intense emotional experiences (positive and negative). Cognitive and behavioral interventions can mitigate the intensity of these triggers.
Perpetuating factors: Repetitive behaviors or conditions can also increase the difficulty of falling and staying asleep. Inadequate sleep hygiene, environmental factors, and even negative concepts of insomnia can hinder the ability to fall asleep. Treatment options include cognitive and behavioral therapy, modifications to sleep hygiene, mindfulness activities, and medications.
The 3 P’s of Insomnia
To meet the criteria for chronic insomnia, symptoms must occur at least three times per week for at least three months.
Facts about insomnia…
Anyone can suffer from insomnia at any age. Up to 33% of adults experience insomnia at least intermittently. It’s estimated that up to 40% of children and teenagers experience insomnia.
Insomnia can reduce life expectancy and increase the risk of cardiovascular events, compromised immunity, obesity, diabetes, seizures, and asthma.
Disorders such as restless leg syndrome, pain, acute stress, sleep apnea, and side effects of certain medications can mimic or contribute to insomnia.
Insomnia can also be a symptom of another disorder such as depression, anxiety, and substance abuse.
Treatment for Insomnia
Once the factors that are contributing to the individual’s insomnia are identified, a treatment plan is established that usually contains the following elements:
Cognitive and Behavioral Therapy
Triggers are identified and skills are taught to mitigate their intensity
Medication
While the individual develops skills to mitigate the intensity of the factors that are impacting their ability to sleep, medication can be prescribed to help the individual fall asleep.
Sleep hygiene and mindfulness activities
Habits are developed and skills are taught that position the individual to more easily fall asleep.
Treatment of underlying conditions
Ensuring that underlying conditions that impact insomnia such as sleep apnea, anxiety, side effects of medication, and substance abuse are being properly addressed is an important part of successfully treating insomnia.
At the Keeton Clinic, we provide relief for insomnia. Contact us today and start experiencing restful and restorative sleep.
Much of this information is taken directly from a Provider Fact Sheep on Insomnia created by The American Academy of Sleep Medicine.