The most frequent causes of insomnia

Insomnia is widespread at all ages. Among the causes, bad habits and the consumption of substances such as alcohol and caffeine, as well as factors of a medical and psychological nature.

Waking up in the middle of the night, sleeping in fits and starts, or having trouble falling asleep. They are signs of the presence of a sleep disorder, a universal experience that can protect our brain and health in general.

However, sleep can be threatened by several factors, internal and external to the body: stress, nutrition, consumption of substances such as alcohol and caffeine, use of certain drugs and the presence of diseases.

The main sleep disorders are insomnia (difficulty falling asleep or staying asleep throughout the night) and excessive daytime sleepiness, which involves the tendency to fall asleep during the day with repercussions on work and road safety.

“By definition, insomnia is a condition in which the person has difficulty initiating or maintaining sleep,” explains Liborio Parrino, Director of the Postgraduate School of Neurology and the Center for Sleep Medicine at the University of Parma.

“However, to be defined as a disease, it must also lead to daytime consequences such as fatigue, drowsiness, nervousness, irritability, difficulty concentrating, memory loss, headaches. Insomnia is therefore considered a 24-hour disease, a negative experience that has an impact on the quality of both night and day life.

Insomnia suffers from 10% of the population regardless of any other characteristic; We speak of chronic insomnia when the difficulties remain for more than three months and occur repeatedly during the week.

Insomnia and sleep

Sleep performs important functions for the body, including psycho-physical recovery and the preservation of energy and memory. In addition, it interacts with the nervous, endocrine and immune systems, which in turn condition the quality and quantity of sleep.

«The number of hours of sleep needed by each individual varies according to age, but from the age of 18 onwards you should not sleep less than seven hours,” says Parrino. “The current trend, however, is to think of sleep as an “optional” or a waste of time, when in fact it is one of the most important activities in life and for which our brain is programmed. A recent study conducted on animal brain tissue, in fact, has shown that in the absence of stimuli the brain is naturally led to sleep. In addition, lost sleep can not be recovered and, in general, you sleep too little; This also concerns young people and children.”

Insomnia can take various forms: difficulty falling asleep, more frequent in adolescents and young adults, and difficulty keeping asleep, more typical of the elderly.

Aging involves, due to the decrease in the production of growth hormone, a physiological change in the structure of sleep: the time spent in deep sleep decreases and more frequent awakenings occur. For this reason, in the morning it is not uncommon for you to feel less rested, despite having spent many hours in bed. In addition, older people usually spend less time outdoors; Less exposure to sunlight decreases the production of melatonin, a hormone involved in regulating the sleep-wake rhythm.

Precisely because sleep is a “non-negotiable” experience, its deficiency entails, in the long term, important health effects and increases the risk of developing obesity, diabetes, hypertension, anxiety, alcohol abuse.

“According to some studies – explains Parrino – those who sleep less than five hours a night, at least three times a week and for a period of even six or seven months, are at high risk of developing hypertension and cardiovascular disease. Getting less sleep than necessary or having poor quality sleep also affects glucose metabolism and insulin secretion, leading to a higher risk of developing type 2 diabetes.

Not only that, according to other studies the effects of lack of sleep also affect the central nervous system: people with insomnia have cognitive deficits in the areas of attention and memory, as well as signs of emotional lability.

Causes of insomnia

It is important to try to understand what can cause difficulties to sleep well and sufficiently: physical, psychological or environmental factors, such as a bedroom that is too hot or noisy.

Possible causes of a medical nature can be represented by allergic rhinitis, gastrointestinal disorders (gastroesophageal reflux), endocrine problems (hyperthyroidism), arthritis and other osteoarticular diseases, asthma, chronic pain, up to Parkinson’s disease . In some cases, therefore, these are conditions that in themselves determine insomnia, in others it is their symptoms that cause a malaise that interferes with sleep.

Two particular conditions that can cause sleep disturbances are restless legs syndrome and obstructive apnea. In the first case it is a neurological disorder for which the person has the continuous need to move his legs, especially in the phase between wakefulness and sleep, making it difficult to fall asleep.

Obstructive apnea, on the other hand, causes a temporary interruption of breathing, with a drop in oxygen levels, and leads to brief and repeated awakenings during the night.

Insomnia can also occur during periods of intense stress, due for example to events such as job loss or hospitalization. Incorrect eating habits, practicing brain-stimulating activities (such as the use of computers and technological devices), the habit of taking a nap during the day or taking certain medications also interfere with the regularity of the sleep-wake rhythm.

Among the causes of insomnia, those of a psychological nature play a central role. In fact, there is a two-way link between insomnia and depression, conditions that feed off each other.

“Those who do not sleep well have a very high risk of developing depression. But the opposite is also true, that is, the depressed person complains of poor quality sleep» explains Parrino. “In essence, insomnia can be a symptom of depressive syndrome. Sometimes, however, poorly treated and untreated chronic insomnia can, within 1-2 years, give rise to depression.

About 80% of patients with major depression report symptoms related to insomnia. Conversely, 40% of chronic insomniacs suffer from a psychiatric pathology, most often a mood disorder.

Even prolonged anxiety states (tension, tendency to ruminate on the past or excessive concern for the future), when they become part of one’s life pattern, interfere with sleep causing difficulty falling asleep or nocturnal awakenings.

Insomnia and hormones

During sleep, the body secretes hormones that act on the mechanisms that regulate appetite and metabolism.

Lack of sleep, for example, modifies insulin secretion, leading those who sleep less than 6-7 hours per night to a higher risk of developing diabetes. Insulin is also associated with stimulating the consumption of caloric foods.

In addition, in those suffering from insomnia the release of cortisol, also known as the stress hormone, is prolonged and increases the risk of hypertension.

On the contrary, during the night, thanks to regular rest, blood pressure levels are lowered to allow the circulatory system to rest.

“Circadian rhythms are the basis of life – says Parrino – and their alteration, interfering with hormonal fluctuations that regulate metabolism, increases the likelihood of developing metabolic diseases. Modern civilization forces to domesticate sleep making it less natural: before the advent of the industrial age, sleep followed natural rhythms, the trend of the seasons and light, and it was normal to sleep as needed and on several occasions. Today the experience of sleep has been contracted and concentrated in a single “block”, a situation that is still unnatural».

Remedies for insomnia

To promote the well-being of the body it is essential to respect the so-called sleep hygiene rulesGoing to bed at the same time, avoiding work or using technological tools before going to sleep, controlling the consumption of caffeine and exciting drinks, practicing regular physical activity (not in the evening), are measures that can improve the quantity and quality of sleep.

Nutrition and the use of substances such as alcohol or caffeine can also affect sleep, and are therefore to be kept under control. Alcohol has a sedative effect, but can cause sleep disruption and early awakenings. Caffeine, on the other hand, has a stimulating effect and remains in circulation for up to eight hours; It is therefore advisable to avoid excessive consumption in the afternoon-evening hours.

Nicotine also has negative implications on the sleep-wake rhythm, disturbs the natural biorhythm by altering the circadian rhythm, increases the risk of sleep apnea and is an antagonist of deep sleep,” explains Parrino. “For this reason, smokers are more prone to insomnia, a fact that becomes even more evident in women over 50. Some studies have shown that in smokers the duration of “light” sleep is longer than in non-smokers, with problems falling asleep, more frequent awakenings during the night and morning fatigue.

If the adoption of specific measures does not lead to positive results, it is advisable to contact a doctor for personalized advice. The treatment of insomnia is generally based, depending on the case, on the administration of hypnotic drugs and / or on the adoption of cognitive behavioral strategies.

Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.

The blog covers a wide range of topics related to health and wellness, with articles organized into several categories.

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