Insomnia

What is insomnia? https://youtu.be/j5Sl8LyI7k8

Insomnia is a sleep disorder characterised by difficulties initiating and/ or maintaining sleep. According to a study by SingHealth, 13.7% of older adults aged 60 and above reported experiencing insomnia.

 

Symptoms of insomnia 

  • Difficulty falling asleep at night
  • Waking up during the night
  • Waking up too early
  • Not feeling well-rested after a night's sleep
  • Daytime tiredness or sleepiness
  • Irritability, depression or anxiety
  • Difficulty paying attention, focusing on tasks or remembering
  • Increased errors or accidents
  • Ongoing worries about sleep

 

Common causes of insomnia:

  • Stress: concerns about work, school, health, finances or family can keep your mind active
  • Travel or work schedule: Jet lag from traveling across time zones or working late/ early shifts can disrupt your internal body clock
  • Poor sleep habits: Irregular bedtime schedule, frequent naps in the day, stimulating activities before bed, and uncomfortable sleep environment makes it difficult to fall sleep
  • Eating excessively before bed: Physical discomfort may result from lying down after eating too much. Heartburn and backflow of acid from the stomach may also keep you awake.
  • Mental health disorders: Anxiety disorders and depression may implicate insomnia 
  • Medication: Side effects of some prescription drugs may be affected sleep 
  • Sleep-related disorders: Sleep apnea impairs breathing periodically during sleep which interrupts sleep. Restless legs syndrome causes one to move their legs during sleep which may be distracting. 
  • Caffeine, nicotine and alcohol: Drinking caffeinated drinks, smoking cigarettes and consuming too much alcohol affects sleep quality

 

Risk factors 

  • Hormonal shifts during menstrual cycle, menopause, and pregnancy
  • Old age causes changes in sleep patterns and health 
  • Existing mental or physical disorders
  • Stressful periods
  • Irregular sleep schedule

 

Prevention

  • Maintain a regular sleep schedule
  • Regular physical activity in the day
  • Check if your medications contribute to insomnia
  • Avoid or limit naps in the day
  • Limit caffeine and alcohol intake, and avoid smoking
  • Refrain from consuming large meals and beverages before bedtime
  • Make your bedroom comfortable and only use it for sleep
  • Create a relaxing bedtime ritual, such as taking a warm bath, reading or listening to soft music

 

Treatment 

  • Cognitive-Behavioural Therapy for Insomnia (CBT-I) 
    • Cognitive Therapy reframes cognitive distortions about sleep and stressful situations. Clients are also taught skills to manage anxiety related to sleep and strategies to calm your mind through constructive worrying and guided imagery. 
    • Behavioural Therapy comprise of behavioural strategies to improve sleep quality. Clients are also taught relaxation techniques like muscle relaxation and deep breathing exercises. 

 

Research has consistently supported the efficacy of CBT-I as it addresses both the underlying beliefs and teaches helpful strategies to mitigate effects of insomnia. As such, CBT-I helps in ensuring healthy sleep patterns with lasting benefits.

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