Insomnia

How can insomnia manifest itself?

A person may notice:

difficulty falling asleep after going to bed;

you have to wait a long time for sleep to set in;

sleep is often interrupted at night;

after waking up it is difficult to fall asleep again;

awakening occurs much earlier than the desired time;

sleep seems shallow or restless;

in the morning there is no feeling of recovery;

anxiety appears about the upcoming sleep;

Fatigue, drowsiness, irritability, or difficulty concentrating during the day.

One person may have only one of these signs, while another may have several at the same time.

What is important to know

Insomnia can occur with severe or prolonged stress, anxiety, depression, chronic pain and some other mental and physical illnesses.

Sleep can also be affected by irregular schedules, shift work, the use of caffeine, alcohol and other substances, certain medications, and the habit of spending a lot of time in bed without sleep.

Sometimes nighttime problems are caused by other sleep disorders, such as restless legs syndrome or sleep-disordered breathing.

With depression, sleep can change in different ways: some people have difficulty falling asleep, while others wake up frequently during the night or very early in the morning. Therefore, sleep disturbance is important to evaluate along with mood, energy levels, and other symptoms.

What to pay attention to

How long have you had sleep problems and how many nights per week do they occur?

What exactly has changed: falling asleep, the number of night awakenings, the time of waking up in the morning, or the quality of sleep.

How much time do you usually spend in bed and how much of it do you actually sleep?

Do you feel restored after sleep?

Have daytime sleepiness, fatigue, irritability, or difficulty concentrating.

Whether there is a depressed mood, anxiety, loss of interest, or unusual changes in energy levels.

Do you experience snoring, sleep apnea, discomfort, or the need to move your legs?

Whether caffeine, alcohol, nicotine or other substances are used in the evening.

Whether insomnia began after a new medication was prescribed or its dosage was changed.

Is the sleep disorder due to pain, illness, stress, or a change in routine?

What can help

It is helpful to maintain relatively constant wake-up and sleep times, avoid prolonged stays in bed during the day, and create a restful environment for nighttime rest.

If sleep doesn't come for a long time, it's usually better to get up briefly and do a quiet activity and return to bed when you feel sleepy again, rather than spend hours trying to force yourself to sleep.

It is also worth paying attention to the use of caffeine, alcohol and other substances that can affect sleep.

For chronic insomnia, one of the leading modern treatments is cognitive behavioural therapy for insomnia (CBT-I). It includes not only recommendations on “sleep hygiene”, but also work with routine, behaviour and anxious expectations associated with sleep.

You should not regularly take sleeping pills on your own or increase their dosage without consulting a doctor.

When to ask for help

Contact your doctor if sleep problems persist for several weeks, occur regularly, or noticeably affect your performance, mood, concentration, or quality of life.

Consultation is especially important if insomnia is accompanied by severe anxiety, depressed mood, chronic pain, severe snoring, sleep apnea, or severe daytime sleepiness.

If your need for sleep has sharply decreased and you are experiencing unusually high energy, rapid speech or thinking, impulsivity, or a noticeable change in behaviour, evaluation by a specialist is also necessary.