Insomnia (Sleeping Pills)

Insomnia

What is insomnia?

Insomnia is a problem characterised by having difficulty sleeping. Most people experience insomnia at some point in their lives, even if only in the very short term, and often it can be resolved simply by changing your sleeping habits. However, for some people it can be a serious long term problem that has a long lasting detrimental impact on your life. There are several types and severities of insomnia and each type can require a different solution. Symptoms of insomnia include:

• Finding it hard to get to sleep, even late into the night
• Waking up multiple times in the night and having difficulty getting back to sleep
• Waking up early and being unable to get back to sleep
• Feeling tired after waking up and throughout the day
• Not being able to nap in the day even if you feel tired
• Being so tired in the day that you become irritable and have difficulty concentrating

Around half a third of people have mild insomnia at any one point in time. It affects women around twice as much as men, and is more likely to be a problem the older you are. Your insomnia can be better assessed if you know what kind of insomnia you have: primary or secondary, and acute or chronic.

What is primary insomnia?

Primary insomnia is called such because it is a problem in its own right, not a side effect or symptom of another illness. This type of insomnia can be caused by problems such as poor sleeping habits (sometimes known as bad sleep hygiene), too much light or noise in your sleeping space, or consuming stimulants too close to sleeping which means the body is more likely to stay awake.

What is secondary insomnia?

In comparison, secondary insomnia is where your insomnia is caused as a side effect to another illness or a medication you are taking. Illnesses that can cause insomnia can be either physical, such as arthritic pain or heartburn, or mental health conditions such as depression or anxiety.

What is acute insomnia?

Acute insomnia is better known as short term insomnia, and is, quite simply, where the problem doesn’t last as long, sometimes only a few days or weeks. This type of insomnia can most usually be cured by fixing your sleeping habits, though it may be caused by short term problems such as exams, deadlines, short term work stress or grief, such as after the death of a loved one. Although it can be difficult, and when it comes to stress, can seem to only make the issue worse, it is a short term problem with no long term health impacts.

What is chronic insomnia?

When you experience insomnia for more than four weeks, it becomes known as long term, or chronic, insomnia. This is when you should consider seeing your GP as the repercussions it can have on your daily life can reach into the dangerous territory. It can not only impact on your health and well being, but make activities such as driving dangerous when you are severely tired, and the stress, irritably and lack of concentration it can lead to can be damaging to your career and close relationships.

How much sleep should I be getting?

The amount of sleep you need depends greatly on both your age and your lifestyle, and individual needs may vary. The NHS recommends that toddlers and babies get 12 to 17 hours’ sleep a day (even though it may seem like they’re never asleep), children usually require 9 to 13 hours’ sleep, and adults tend to need 7 to 9 hours’ sleep. However, the quality of the sleep you get is just as, if not arguably more, important than the amount of sleep you get. As a general rule, 6 hours’ of unbroken, deep sleep is far better for you than 9 hours’ sleep where you are only sleeping lightly and waking frequently, which might happen if you are in a noisy or light environment, for example if you work night shifts and need to sleep during the day in a busy house. However, not everyone’s requirements are the same, and you may find you need more or less sleep than average. You may need more sleep at night if you have a particularly exhausting job, or less sleep if you are inclined to nap during the day.

When you wake up can be just as important as the quality and amount of sleep you get. We sleep in cycles of around 45 minutes and waking up in the middle of one of these cycles can leave you feeling groggy and less refreshed than if you’d woken up at the end of one. Try not to set your alarm on weekends, and see if waking up naturally at the end of a sleep cycle leaves you feeling less tired the next day. Finding out under what conditions you sleep best and how much sleep you need is a valuable investment and can have a huge impact on your life.

What causes insomnia?

There are dozens of factors which can cause insomnia, and the trigger will affect the severity of the problem. Some causes of insomnia include (but are not limited to):

• Environmental factors which make your sleeping conditions unsuitable, such as too much light, noise, or an uncomfortable mattress
• Long term stress, anxiety or depression
• Other mental health disorders such as PTSD (post traumatic stress disorder), bipolar disorder, schizophrenia, OCD (obsessive compulsive disorder), dementia or ADHD (attention deficit hyperactive disorder).
• Stimulants such as alcohol, caffeine or nicotine
• A disruption to your usual sleep pattern, such as working night shifts or suffering from jet lag
• Short term grief or stress, caused by factors such as moving house, pressure at work, or going through a divorce
• Severe pain from causes such as arthritis, dental pain, period pain, migraine
• Certain medications such as some antidepressants, epilepsy medications and steroid medications
• Some neurological conditions
• Heart disease
• Nocturnal sleeping disorders

This is not an exhaustive list of causes of insomnia, and if you speak to your GP about the problems you are having, they may diagnose the cause as something not covered in the above list.

What treatments are available?

Often, insomnia can be eased or cured by making lifestyle changes, and when you speak to your GP, this will be the first advice that they give you. Practising good sleeping habits, which may also be referred to as “good sleep hygiene” can help to clear up a lot of your problems. Even if you are not suffering from insomnia, taking the following advice may help you to sleep better and therefore leave you feeling more productive and focussed in the daytime. Good sleep hygiene involves:

• Set regular times for going to bed at night and getting up in the morning, even if you find it hard to fall asleep at that time at first. Over time, this routine will teach your body when to start winding down ready for sleep
• Try relaxation techniques before bedtime, such as listening to calming music, reading a light fiction book, taking a bath or meditating
• Avoid using your phone, laptop or watching TV in the hour or two before sleeping as the blue light that the screen emits keeps your mind awake and can stop you sleeping or disrupt your sleep. If you need to use your phone or laptop, set the screen to night mode, or use an app or extension which makes the screen slightly more yellow to counteract the blue light. You can also get tinted glasses to prevent this problem, but avoidance is always best for a good night’s sleep
• Make sure your bedroom is the best sleep environment it can be. Invest in thick blackout curtains, earplugs and an eye mask if you think environmental issues may be causing your sleep disturbances. Some people find gentle noise, such as a fan or nature sounds, helps them to sleep
• Avoid factors which may stimulate your brain before going to sleep. These include things such as caffeine, alcohol and nicotine, plus heavy meals and exercise four hours before bed. A light snack may help you sleep and prevent you waking up from hunger, but a heavy meal can impair your sleep
• Avoid napping during the day
• Keep a pen and paper by your bed, and writing down anything that’s on your mind that may be worrying you. This is also helpful if you wake up in the night and have something on your mind
• Take light exercise in the day
• Avoid using your bedroom for anything other than sleep or sex
• Avoid watching the clock as it will make you more worried about how long you have been awake
• Turn your phone off so you know you cannot be disturbed

Keep a sleep diary with a brief account of what you did that day and any factors in your lifestyle which may be affecting your sleep, and see if there are any triggers which are causing your disturbances.

Speaking to a GP

You should make an appointment to speak to your GP about your sleep problems when they begin to impact your day to day life, or when they have been going on for more than 4 weeks (and it becomes chronic insomnia). Your doctor will first try to rule out any underlying problems, such as a long term sleep disorder, or a mental health disorder than may require treating in its own right and once fixed, resolve your insomnia.

Cognitive Behavioural Therapy (CBT)

Some people find that cognitive behavioural therapy with a trained sleep therapist can help to resolve sleep problems. This is especially relevant if you know your insomnia to be caused by a mental health disorder such as depression or anxiety. If you associate sleeping with fear, stress or panic, a professional sleep therapist can help you to break this line of thinking and cure your insomnia

Medication

Your doctor may be reluctant to prescribe medication as a first solution to insomnia, and will probably recommend improving your sleeping habits or other non medicinal solutions first. This isn’t because they don’t want to help, but because using sleeping tablets of any kind can have side effects. Often, sleeping tablets can leave you tired the next morning, which can make driving or using machinery dangerous. Sleeping tablets can also solve the issue in the short term, but can mask a bigger issue that may crop up again later when you stop taking them. It is always better to treat the cause than to mask the problem. Finally, taking sleeping tablets for too long can lead to both tolerance and dependence. This means it takes more of the drug for you to get to sleep, and make it near impossible for you to sleep without it. If this happens, you have an addiction on your hands as well as the initial problem of insomnia.

However, there are several types of medication that can be used in the short term to manage insomnia, but they should not be taken for more than a few weeks at a time.

From Doctor-4-U, you can buy both slow release and fast acting sleeping tablets. Slow release tablets, such as Circadin, are effective several hours after taking as the chemical is released into your bloodstream, and generally have a lower chance of addiction. They help you to sleep more easily by altering the melatonin in your brain.

You can also buy fast acting sleeping tablets such as Zolpidem, better known as the brand name Ambien. This gets to work quicker and has its effect by increasing the sedative effect of chemicals in the brain so you fall asleep fast.