Causes of insomnia and tips for improving it
What is insomnia? Discover the true nature of sleepless nights
I can't fall asleep even when I get into bed at night.
Before I knew it, it was late at night and only the light from my smartphone was illuminating the room.
Many people have experienced a night when they want to sleep but can't.
It may not just be a lack of sleep, but a sign of insomnia .
Definition and main types of insomnia
Insomnia is a condition in which, despite having sufficient opportunity to sleep, one has difficulty falling asleep or maintaining sleep, which interferes with daytime physical and mental functioning (ICSD-3 criteria).
There are four main types:
Difficulty falling asleep : It takes a long time to fall asleep (approximately 30 minutes or more)
Waking up multiple times during the night
Early morning awakening : Waking up earlier than expected and not being able to fall back asleep
・Deep sleep disorder : Feeling of fatigue persists even after sleeping
According to international definitions, chronic insomnia is diagnosed when sleeplessness occurs at least three times a week for more than three months .
The difference between lack of sleep and
Sleep deprivation refers to a temporary lack of sleep.
On the other hand, insomnia is a sleep disorder in which you cannot sleep even when you have time to sleep .
In other words, the problem is not the amount of time, but the ability to sleep (quality of sleep) .
Although short sleep duration may not be a problem if it does not interfere with daytime performance, long-term sleep deprivation has been reported to increase health risks (AASM, 2021).
The main causes of insomnia
There is no single cause of insomnia.
When the balance between mind, body, and environment is disrupted, your sleep rhythm is also disrupted.
Here are five major causes.
1. Psychological factors such as stress, anxiety, and depression <br data-end="920" data-start="917">Stress from work or relationships, or anxiety about the future, makes it difficult for the brain's "rest switch" to be turned on.
At this time, the sympathetic nervous system becomes dominant, and body temperature and heart rate do not decrease, making it difficult to fall asleep.
For chronic cases, cognitive behavioral therapy (CBT-I) is recommended worldwide as the most effective treatment.
② Blue light from smartphones and PCs <br data-end="1079" data-start="1076">Blue light suppresses the secretion of the sleep hormone "melatonin" and delays the body clock.
Avoid using your smartphone or PC one hour before going to bed and focus on detoxing with light.
In addition to using night mode, it's also important to lower the brightness and keep your distance.
3. Caffeine, alcohol, and smoking. Caffeine intake after the afternoon can delay sleep onset and reduce deep sleep. In particular, if the total amount is close to 400 mg, the effects may persist even 12 hours before bedtime.
Alcohol may seem to help you fall asleep easier, but it actually makes your sleep shallower and increases the chances of you waking up during the night.
Smoking (nicotine) has a strong stimulating effect and increases the risk of difficulty falling asleep.
4. Physical illness or effects of medication <br data-end="1381" data-start="1378">There may be underlying illnesses such as hyperthyroidism, asthma, chronic pain, and depression.
Insomnia can also occur as a side effect of antidepressants and antihypertensive medications.
It is important to consult with your doctor to determine the cause.
⑤ Changes in sleep due to aging <br data-end="1499" data-start="1496">As we age, deep non-REM sleep tends to decrease and we tend to wake up more often during the night.
This is a natural change, and can be improved by adjusting your lifestyle, such as by getting some morning light and exercising during the day.
The more you feel like you have to sleep, the less likely you are to fall asleep.
The more you think, "If I don't go to bed early, tomorrow will be tough," the more your brain will become awake.
This phenomenon is called "sleep onset anxiety."
Sleep begins when the parasympathetic nervous system, which is the nerve that relaxes you, becomes dominant.
Deep breathing, meditation, and gentle stretching can help induce natural sleepiness.
The first step to improving insomnia: Reviewing your lifestyle habits
"Morning light" and "evening habits" to regulate your sleep rhythm
・Open the curtains as soon as you wake up in the morning and let in sunlight. ・Go to bed at the same time every night. ・Limit your naps to 20-30 minutes (avoid taking naps late at night).
It helps reset your body clock and induces natural sleepiness.
Optimizing your bedroom environment
Use soft, warm lighting and adjust the room temperature to around 20-23°C, or a temperature that feels slightly cool and comfortable to you.
A gradual drop in core body temperature makes it easier to fall asleep.
It is best to adjust it to suit the season and your constitution.
If noise bothers you, consider white noise, and when it comes to bedding, make sure it fits comfortably and gently supports your body.
Diet and Sleep: Nutrients that Help You Sleep
Food helps to lay the foundation for good sleep.
Consuming certain nutrients has been shown to support the pathways for melatonin and serotonin production.
・Banana: Tryptophan (a component of the sleep hormone)
・Almonds: Magnesium (suppresses nervous excitement)
Cherry: Melatonin (may help regulate sleep rhythms)
・Salmon and tofu: Vitamin B6 (supports tryptophan metabolism)
*Effects vary from person to person.
*Regular eating habits, not just the foods mentioned above, are said to have a positive effect on sleep.
When to consult an expert
If you experience insomnia three or more times a week for more than three months, or if it continues for more than two weeks and severely interferes with your daytime sleep, consult a specialist.
Diagnosis is primarily made using a medical interview and sleep diary.
A PSG is primarily performed when other sleep disorders, such as sleep apnea, are suspected.
Treatment and self-care concepts
Rather than relying solely on medication, re-education of daily routines is the key to long-term improvement.
Under your doctor's supervision, you may be able to gradually reduce your medication.
First, start by adjusting your lifestyle and stress management.
Frequently Asked Questions (FAQ)
Q1. Will insomnia go away if left untreated?
Temporary insomnia may improve on its own, but if it becomes chronic, treatment is required.
Q2. Will I be able to fall asleep quickly if I stop using my smartphone?
It is effective, but results vary from person to person.
It is also important to reset your body clock by exposing yourself to sunlight in the morning.
Q3. Are sleeping pills safe?
It is safe when used properly under the supervision of a doctor. Consult your doctor if you plan on using it for a long period of time.
Q4. Is drinking before bed bad for sleep?
Yes, alcohol can make your sleep shallower and more likely to wake you up during the night.
Q5. Is it okay if I don't get enough sleep?
While this isn't a problem as long as it doesn't interfere with daytime performance, chronic short sleep poses health risks.
Q6. What do you do at the sleep clinic?
Evaluation will be based mainly on sleep diaries, actigraphy, and interviews, and tests will be performed as necessary.
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summary
I can't fall asleep even when I get into bed at night.
Before I knew it, it was late at night and only the light from my smartphone was illuminating the room...
Many people have experienced nights when they want to sleep but can't.
It's not just lack of sleep, it could be insomnia .
Sleepless nights are a sign that your mind and body are asking for help.
Don't rush, start by gradually adjusting your daily routine.
References
American Academy of Sleep Medicine. International Classification of Sleep Disorders, 3rd Ed. (2023 update).
Riemann D et al. Cognitive Behavioral Therapy for Insomnia. Lancet Psychiatry, 2021.
Cajochen C et al. Evening exposure to blue light and melatonin suppression. J Clin Endocrinol Metab, 2005.
Drake C et al. Caffeine effects on sleep: meta-analysis. Sleep Med Rev, 2013.
Roehrs T & Roth T. Alcohol and sleep. Alcohol Res, 2018.
Inagawa K et al. Glycine ingestion improves subjective sleep quality. Sleep Biol Rhythms, 2006.
Howatson G et al. Effect of tart cherry juice on sleep. Eur J Nutr, 2012.