Insomnia: Understanding and Overcoming Sleep Difficulties
Insomnia is a common sleep disorder characterised by difficulties initiating and maintaining sleep. It can manifest as problems falling asleep at the start of the night, waking up multiple times, or waking up earlier than intended without being able to return to sleep. According to a study by SingHealth, 13.7% of older adults aged 60 and above reported experiencing sleeplessness, highlighting how widespread this issue is in Singapore and beyond. While occasional sleeplessness is common, chronic insomnia can have severe consequences on health, mood, productivity, and quality of life.
Symptoms
Insomnia manifests through a range of symptoms that affect both nighttime rest and daytime functioning. The disorder often creates a cycle of sleeplessness and worry, where concern about poor sleep further exacerbates the problem.
- Difficulty falling asleep at night
- Waking up during the night and struggling to return to sleep
- Waking up too early in the morning
- Not feeling refreshed after a full night’s sleep
- Daytime tiredness, low energy, or persistent sleepiness
- Irritability, depression or anxiety
- Difficulty concentrating, paying attention, or remembering details
- Increased risk of mistakes, accidents, or reduced work performance
- Ongoing worries about sleep, creating anticipatory stress at bedtime
Many individuals with insomnia report lying awake in bed for long periods, feeling anxious about not being able to sleep. Over time, the bed itself becomes associated with stress rather than rest, reinforcing the disorder.
Common Causes of Insomnia
Insomnia rarely arises without cause. A combination of lifestyle factors, medical conditions, and psychological challenges can contribute to its onset and persistence.
- Stress: Concerns about work, school, finances, or family issues keep the mind active and prevent relaxation.
- Travel or Work Schedule: Jet lag from traveling across time zones or irregular shifts can disrupt the body’s circadian rhythm.
- Poor Sleep Habits: Irregular bedtime schedules, late-night screen use, excessive napping, or stimulating activities before bed can prevent quality rest.
- Eating Before Bed: Heavy meals before bedtime may cause discomfort, indigestion, or heartburn, disrupting sleep.
- Mental Health Disorders: Anxiety and depression are strongly linked with sleeplessness, often creating a cycle where each condition worsens the other.
- Medication: Certain prescription drugs, including some antidepressants, steroids, and stimulants, may interfere with sleep.
- Sleep Disorders: Conditions like sleep apnea or restless legs syndrome directly disrupt the sleep cycle.
- Substances: Caffeine, nicotine, and alcohol affect the brain’s sleep mechanisms and reduce sleep quality.
Understanding the root causes is essential, as treatment for insomnia often begins with identifying and addressing these contributing factors.
Risk Factors
While anyone can experience sleeplessness, some groups are more vulnerable than others:
- Hormonal changes during menstrual cycles, menopause, or pregnancy
- Older age, as sleep patterns and health conditions shift with time
- Existing mental or physical health disorders, such as chronic pain or depression
- Stressful life events, including bereavement, job loss, or major transitions
- Irregular sleep schedules due to lifestyle or occupational demands
These factors may not directly cause insomnia, but they increase the likelihood that normal sleep patterns will be disrupted.
Prevention
While not all cases of insomnia are preventable, adopting good sleep hygiene can significantly reduce risk and improve sleep quality. Lifestyle adjustments often serve as the first line of defence against chronic sleep difficulties.
- Maintain a consistent sleep and wake schedule, even on weekends
- Engage in regular physical activity during the day
- Consult your doctor if prescribed medications may affect sleep
- Avoid long or late naps that interfere with nighttime rest
- Limit caffeine, alcohol, and nicotine intake, especially in the evening
- Refrain from consuming heavy meals and excessive liquids before bed
- Optimise your sleep environment: keep the bedroom dark, cool, and quiet
- Create a calming bedtime ritual such as meditation, reading, or listening to music
These small yet consistent changes often prevent occasional sleeplessness from developing into chronic insomnia.
Treatment
When insomnia persists, professional treatment can help restore healthy sleep patterns. One of the most effective and well-researched approaches is Cognitive-Behavioural Therapy for Insomnia (CBT-I).
✽ Cognitive-Behavioural Therapy for Insomnia (CBT-I)
Cognitive therapy: This method helps reframe distorted beliefs about sleep and manage anxiety associated with bedtime. It may include constructive worry exercises and guided imagery to calm the mind.
Behavioural therapy: This involves practical strategies such as stimulus control (using the bed only for sleep), sleep restriction techniques, and relaxation exercises like progressive muscle relaxation and deep breathing.
Research consistently supports the efficacy of CBT-I. Unlike medication, which may provide temporary relief, CBT-I addresses the root causes of insomnia by modifying thought patterns and behaviours. As such, it often leads to lasting improvements in sleep quality and overall wellbeing.
In some cases, short-term use of medication may be prescribed, but most experts recommend therapy as the primary treatment due to its long-term effectiveness and absence of side effects.
When to Seek Professional Help
If insomnia occurs more than three times a week and lasts for over three months, or if it significantly impacts daily functioning, it is advisable to seek help from a healthcare professional. Untreated insomnia increases the risk of developing depression, anxiety disorders, cardiovascular issues, and weakened immune function.
We recommend This Video to those who wants to learn more about Insomnia.
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