Sleeplessness: Introduction

What is sleeplessness?

Sleeplessness (Insomnia) is a sleep disorder in which a person has difficulty in falling asleep or experiences poor sleep. It can involve any or all of the following:

Difficulty in falling asleep:

you are trying to sleep but you just can't get any sleep. You may try counting sheep, reading a book, tossing about in bed or just anything but nothing seems to put you to sleep.

Difficulty in staying asleep:

you experience frequent breaks in the sleep at night due to any reason and then face difficulty in going back to sleep again.

Waking up too early in the morning and then not being able to get back to sleep again.

Unrefreshed feeling on waking up from sleep; feeling as if one has not slept at all at night.

Sleeplessness (Insomnia) can be of 3 types:

Transient Insomnia:

Transient insomnia may last from 1 night to a few nights. It is usually mild and does not severely hamper a person's ability to function during the daytime. It passes off after a few days and the person functions normally.

Short-term Insomnia:

This type of insomnia may last for anywhere between a few nights to a month. This usually affects the daytime functions of a person though it may not be very severe. Usually some kind of irritability and tiredness may occur due to short term insomnia.

Chronic Insomnia:

This is the most debilitating amongst all the types of insomnia. It lasts for more than a month and may extend upto many months or even longer. It severely affects the mental capacities of an individual, his concentration, mood, task handling, etc.

Consequences of sleeplessness:

These may vary from person to person and include some or all of the following in varying intensities:

• Impaired concentration for work
• Difficulty in memorizing minor daily tasks
• Irritability
• Mood swings
• Anxiety
• Depression
• Accident proneness
• Fatigue
• Inability to handle stressful situations effectively

In the long run, sleeplessness can also be the trigger for many gastro-intestinal disorders such as Irritable Bowel Syndrome, frequent heartburn, frequent indigestion, etc. Long term insomnia can also increase the risk for developing Hypertension and Diabetes (Type II).

Sleeplessness and its Causes

Some of the common causes of sleeplessness are as follows:

• Inappropriate sleeping environment such as: too hot or too cold bedroom, bed being too hard or too soft, noisy place, poor ventilation, change of sleeping place, mosquitoes, etc
• Anxiety: Worrying about various things such as work, appointments, family or work stress, etc.
• Depression, grief, etc
• Emotional excitement (Euphoria)
• Mood disorders
• Too much of caffeine intake especially during the later part of the day (e.g. Strong coffee, cola, etc).
• Sedentary lifestyle: When you have not worked enough during the daytime, your mind might be tired, but your body may not be tired, thus causing difficulty in sleeping
• Hormonal changes: Around the time of menses, Pregnancy (especially during 1st trimester)
• Overeating
• Jet lag
• Working in shifts
• Systemic disorders such as Asthma, Hyperthyroidism, duodenal ulcers, arthritis, Diabetes, GERD, etc
• Night urination frequency (due to diabetes, prostate enlargement, urinary infection, etc)
• Alcohol withdrawal
• Dehydration
• Chronic pain (due to any cause): E.g.: Osteoarthritis, trauma, leg cramps, etc
• Itching (due to any skin disorder, allergy, etc)

There are a large number of drugs that can causes sleeplessness. Few of them have been mentioned below. Please note however that this list is not exhaustive:

• Bronchodilators such as theophylline
• Certain anticonvulsants such as Phenytoin
• Nasal decongestants
• Certain anti-depressants
• Levodopa
• Steroids
• Estrogen drugs
• Cocaine
• Thyroid hormones
• Nicotine
• Amphetamine group of drugs