Insomnia: Why You Can't Sleep and What Affects Sleep

Insomnia is when you regularly can't fall asleep, wake up several times a night, or feel drained in the morning. One bad night is not yet insomnia.

What Insomnia Is

We speak of insomnia when sleep problems recur. You take a long time to fall asleep, lie awake, wake up early and can't fall asleep again. After waking up there is no feeling of rest. During the day you are tired and irritable, and it's hard to concentrate. Even a daytime nap doesn't come, although your eyes are closing.

Short-term insomnia lasts less than three months. If it lasts longer, it is long-term insomnia. In the classification of sleep disorders, episodic, short-term, and chronic are distinguished. The need for sleep is individual: adults usually need 7–9 hours, children — 9–13, infants — 12–17. Constant daytime fatigue means that sleep is most likely insufficient.

Why You Can't Sleep

The most common causes:

• stress, anxiety, or depression;
• noise, a room that is too warm or too cold, an uncomfortable bed;
• alcohol, caffeine, and nicotine;
• illicit substances such as cocaine or ecstasy;
• changing time zones and shift work.

In healthy people, short-term insomnia happens after worry. In people with increased nervous system excitability, worry disrupts sleep more deeply and for longer.

There can be physiological causes — hormonal changes, most often in the postpartum and perimenopausal periods.

Consequences of Sleep Deprivation

Sleep deprivation takes away a resource you can't borrow with coffee. During the day, attention drops, it's harder to concentrate, and irritability builds up.

What Affects Sleep

Insomnia usually improves when you change sleep habits. The blue light of screens before bed stimulates the brain. If needed, a doctor offers cognitive behavioral therapy — in person or online.

When Insomnia Is a Symptom of Another Illness

Insomnia often accompanies other conditions. It may be anxiety, depression, or panic disorder. Insomnia can be caused by Alzheimer's and Parkinson's disease, restless legs syndrome, an overactive thyroid, and menopause. Sleep is disrupted by pain, sleepwalking, snoring and pauses in breathing during sleep, attacks of daytime sleepiness anywhere, as well as nightmares or night terrors, especially in children. Sleep disorders are divided into primary and secondary — those that are a symptom of other illnesses. Distinguishing primary sleep disorders from those related to psychopathology is difficult.

Long-term insomnia occurs with infectious and heart diseases, with neuroses and depression. Sleep disturbances are observed in arthritis, allergies, coronary heart disease, and prostate hypertrophy. Sleep is also changed by some medications: antidepressants, psychostimulants, antihypertensive and hormonal drugs, and certain antibiotics. Sleep disturbances can even be caused by eye drops with beta-blockers and nasal drops with sympathomimetics. Therefore, it's better to ask your doctor directly about your regular medications.

In older age, insomnia manifests as difficulty falling asleep, frequent nighttime awakenings with a feeling of light sleep, early morning awakening, and a feeling of being "worn out." Depressed patients are characterized by difficulty falling asleep, early awakenings, and a lack of feeling of sleep.

Who to See About Sleep

See a family doctor — if changing habits hasn't helped, sleep problems have lasted for months, or insomnia prevents you from coping with everyday tasks. The doctor will look for the cause and may refer you to a sleep clinic if there are signs of another disorder, such as apnea. Sleeping pills have serious side effects and can cause dependence; they are prescribed only for a few days or weeks in very severe insomnia when other methods haven't helped.

Call 103 or 112 immediately if there are signs of a life-threatening condition: a serious traffic accident, stroke, or heart attack. Do not drive to the emergency department yourself — ask someone to take you or call an ambulance.

This article is for reference and does not replace a doctor's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer