INSOMNIA

Insomnia is characterized by difficulty falling asleep, difficulty maintaining sleep, and/or waking up too early (and not being able to fall back asleep). Prolonged insomnia symptoms interfere with daily activities and lead to serious health consequences.

What Is Insomnia?

Insomnia is a common type of sleep disorder. People with this disorder have difficulty falling asleep, difficulty maintaining sleep, and/or waking up too early (and not being able to fall back asleep). Prolonged insomnia symptoms interfere with daily activities and lead to serious health consequences.

Insomnia can be classified based on how long symptoms appear and persist:

  • Acute insomnia (also called adjustment or short-term insomnia): Is a short-term insomnia condition with symptoms lasting fewer than 3 months. This type of insomnia often occurs due to stressful life events, such as job loss, the death of a loved one, health problems, or other disturbing traumatic events. Typically, acute insomnia can resolve when the stressor subsides and/or the individual adjusts to the stressor. For example, when a person is first diagnosed with a serious illness, he or she may have difficulty sleeping for several weeks, after which the condition gradually subsides until the person accepts this fact.

  • Chronic insomnia (also called long-term insomnia): Is a long-term insomnia condition, characterized by a longer duration and more persistent than acute insomnia disorder. Specifically, insomnia symptoms will last 3 months or longer. Chronic insomnia may subside or become more severe over time.

Symptoms And Diagnosis

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Text Revision (DSM-5 TR), characteristic manifestations of insomnia include:

  1. Difficulty falling asleep (In children, this may manifest as difficulty initiating sleep without caregiver intervention)

  2. Difficulty maintaining sleep: characterized by frequent awakenings or problems returning to sleep afterward (In children, this may manifest as difficulty returning to sleep without caregiver intervention)

  3. Early morning awakening with the inability to return to sleep

Insomnia causes clinically significant distress or impairment in social, occupational, educational, academic, behavioral, or other important areas of functioning.

Besides, to diagnose insomnia, the following conditions are needed:

  • The sleep difficulty occurs at least 3 nights per week

  • The sleep difficulty is present for at least 3 months

  • The sleep difficulty occurs despite adequate opportunity for sleeping

  • Insomnia is not better explained by and does not occur exclusively during another sleep-wake disorder (such as narcolepsy, a breathing-related sleep disorder, a circadian rhythm sleep-wake disorder, or parasomnia)

  • Insomnia is not attributable to the physiological effects of a substance (such as a drug of abuse, or a medication)

  • Coexisting mental disorders and medical conditions do not adequately explain the predominant complaint of insomnia (however, comorbid disorders may be present).

WARNING: The symptoms listed are for reference only. If you suspect that you have insomnia, see a psychologist for an accurate diagnosis.

Risk Factors For Insomnia

Age

Insomnia can occur in anyone, but the risk of this disorder increases with age. Older adults tend to have more challenges maintaining sleep than youngsters, reducing total sleep time and quality of sleep.

Genetic

Genetic factors are believed to be one of the causes of insomnia. Besides, genes may also affect whether a person is a deep or light sleeper.

Physiologic

Insomnia is more common in women than in men due to hormonal changes that occur during pregnancy or menopause. Physiological changes along with symptoms of mood disorders, sleep-disordered breathing, and vasomotor symptoms seriously disrupt sleep.

Lifestyle

Some unhealthy lifestyle habits can raise the risk of sleep problems, such as:

  • Unstable living hours, affecting the body's biological clock;

  • Repeatedly interrupted sleep, such as waking up often to care for a baby;

  • Taking long naps during the day;

  • Lack of physical activity during the day;

  • Use of caffeine, nicotine, alcohol, or recreational drugs;

  • Watching TV or using electronic devices near sleep time.

Environment or occupation

Some environmental factors can disturb the biological clock, leading to insomnia:

  • Work night shift;

  • Noise or light at night;

  • Uncomfortably high or low temperatures;

  • Traveling frequently to countries with different time zones.

Stress

Mental health problems, especially anxiety and depression, can affect sleep. Stress or worrying about school, work, relationships, money, or the passing away of a loved one all increase the risk of insomnia.

Additionally, people with insomnia may have thoughts and concerns about whether they are getting enough sleep (which can be indicated by frequently checking the clock). This can also increase the risk of insomnia or make it worse.

Health Problems Due To Insomnia

Insomnia disorders can make it difficult for individuals to concentrate or think clearly. People with insomnia may feel irritable, sad, and unrested or have headaches. Prolonged insomnia can seriously affect your health - increasing the risk of respiratory, cardiovascular, inflammatory, or metabolic problems. The body's immune system can also be weakened if a person regularly lacks sleep. Besides, chronic insomnia disorder can lead to mental health problems such as anxiety, depression, or even suicidal thoughts.

Coping With Insomnia

In addition to using medication to deal with medical symptoms (in extreme cases), psychological intervention helps individuals identify and learn how to manage the factors that cause their insomnia. Among them, Cognitive Behavioral Therapy for Insomnia (CBT-I) is the most effective and commonly used psychological treatment method to treat insomnia disorder. CBT-I includes the following techniques:

Stimulus Control Therapy

Many people often spend time in bed doing other activities, such as reading books, watching movies, playing games, etc. This can stimulate the brain and make it more difficult for individuals to fall asleep. Furthermore, using bedtime for other activities can reduce the connection the brain makes between bed and sleep. Therefore, in Stimulus Control Therapy, the individual is encouraged to use the bed only for sleeping and to limit other activities (sex being the exception).

Sleep Restriction Therapy

Sleep Restriction Therapy aids individuals in establishing rigorous bedtime and awakening routines to reduce the duration of wakefulness while in bed. For instance, if someone typically spends 8 hours in bed but only sleeps for 6 of those hours, they would adhere to a schedule of allocating 6 hours for sleep and waking at a designated time, even if they feel inclined to sleep longer. Gradually, as sleep quality improves, the duration of time spent in bed is extended.

Practicing Helpful Ways Of Thinking

As mentioned above, worrying about being unable to sleep can make sleeping even more difficult for individuals. Cognitive Therapy helps them identify these unhelpful thoughts and seek out more helpful ways to understand sleep and cope with sleep-related stress.

Learning Relaxation Skills

Individuals will be guided and practice a variety of techniques to help calm the mind and body. Certain techniques such as muscle relaxation and deep breathing combined with guided imagery (focusing the mind on positive, soothing images) are used to reduce stress and anxiety that interfere with sleep.

Practicing Sleep Hygiene

Sleep hygiene is healthy behaviors or habits that help increase the length and quality of sleep. People can practice sleep hygiene by redecorating the bedroom to make it a more comfortable space to sleep in; reducing brain-stimulating activities before bed (such as using electronic devices); and improving a range of lifestyle factors to support sleep (such as diet changes and exercise).

Some Tips To Help You Improve Sleep Quality

  • Limit your intake of coffee, tea, and other caffeinated beverages in the afternoon and evening

  • Limit drinking alcohol and alcoholic beverages before going to bed

  • Limit or stop smoking with your doctor's help. Trying to stop smoking suddenly and using a nicotine replacement patch can affect your sleep

  • Get up at a regular time, even if you had trouble sleeping the night before

  • Exercise regularly, but avoid exercising right before bed

  • Avoid using electronic devices such as computers, TVs, smartphones, e-readers, or tablets at least one to two hours before bed

  • Avoid doing important work that requires intense concentration in the evening

  • Practice relaxation or mindfulness techniques when getting ready for bed to help calm the mind and body and promote rest even when you're not sleeping. Gently focusing on your breathing as you inhale and exhale can be a simple and helpful technique

  • Only use your bed for sleep (or sexual activity) instead of meeting deadlines, eating, or surfing TikTok

  • Make sure your bedroom is quiet and dark during sleep time

  • Make sure your bedroom has a comfortable temperature - not too cold or too warm

  • Try not to worry about whether you'll sleep well or not, or what will happen if you don't

If you feel you are having symptoms of insomnia, go to a medical facility for a timely examination and diagnosis, or contact the Vietnam - France Psychology Institute via Hotline: 0979.158.463 for specific advice. Early intervention is key to improving health and quality of life.

References:

[1] What Is Insomnia?. https://www.verywellmind.com/what-is-insomnia-5088915#toc-causes

[2] What Is Insomnia?. https://www.nhlbi.nih.gov/health/insomnia

[3] Women and insomnia. https://pubmed.ncbi.nlm.nih.gov/15457811/

[4] Insomnia. https://psychology.org.au/for-the-public/psychology-topics/insomnia

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VIETNAM - FRANCE PSYCHOLOGY INSTITUTE

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