A Guide to Insomnia: Why Can’t I Fall Asleep?

In India, a land where chai culture reigns and work-life balance is often skewed, sleeplessness is becoming increasingly common. From overburdened professionals in bustling metros to students burning the midnight oil, insomnia is a growing concern. While pulling an occasional all-nighter might seem harmless, chronic insomnia can lead to serious health issues. Here’s an in-depth look at insomnia including its symptoms, causes, and ways to prevent it.

What is insomnia?

Insomnia is a sleep disorder characterised by difficulty falling asleep, staying asleep, or waking up too early and being unable to fall back asleep. It can affect both the quantity and quality of sleep, leaving individuals feeling tired, irritable, and unable to function optimally during the day. Insomnia can be short-term (acute) or long-lasting (chronic), and its severity ranges from mild to severe.

A research study in South India revealed that 18.6% of healthy adults visiting a tertiary care hospital experienced insomnia. Another study in India found a 15.4% prevalence rate of insomnia overall. The condition was significantly more common among individuals with chronic physical ailments (28.1%) compared to those without such conditions (10.9%).

Types of insomnia 

Experts typically classify insomnia into two main categories based on duration and causes:

By duration:

• Acute insomnia: This is a short-term condition often triggered by stress or a specific event. It typically lasts for a few days to weeks.

• Chronic insomnia: Also called insomnia disorder, this is a long-term condition where sleep difficulties occur at least three times a week for three months or longer.

By cause:

• Primary insomnia: This occurs independently, with no apparent link to other health issues or conditions.

• Secondary insomnia: This arises as a symptom of another issue, such as a medical condition (like asthma or arthritis), mental health disorders (like depression or anxiety), medication use, or lifestyle factors.

This classification helps in diagnosing the condition accurately and tailoring the treatment effectively.

Causes of insomnia

The exact causes of insomnia aren’t fully understood, but experts believe it results from a combination of factors. Some of these factors might directly cause insomnia, while others may contribute to or exacerbate the condition. Research is ongoing to better understand how and why insomnia occurs.

Here are some key factors associated with insomnia:

1. Family history (genetics): Insomnia and other sleep-related issues often run in families, suggesting a genetic component. Specific inherited traits or predispositions may affect sleep patterns.
   
   
2. Brain activity and chemistry: People with insomnia may experience heightened brain activity, making it harder to relax and fall asleep. Differences in brain chemistry and signalling pathways that regulate sleep could also play a role.
   
   
3. Medical conditions: Physical health issues, both temporary (like infections or injuries) and chronic (such as acid reflux, chronic pain, or neurological disorders like Parkinson’s disease), can interfere with sleep. Disruptions to the body’s circadian rhythm — its internal sleep/wake cycle — are also significant contributors.
   
   
4. Mental health conditions: Insomnia is closely linked to mental health disorders like anxiety, depression, and PTSD. Studies indicate that about 50% of people with chronic insomnia also have at least one coexisting mental health condition.
   
   
5. Life circumstances: Stressful events, such as job loss, financial difficulties, or personal loss, often contribute to insomnia. While these factors might not directly cause insomnia, they can disrupt sleep patterns and make the condition more likely.
   
   
6. Life changes: Temporary changes like jet lag, sleeping in unfamiliar settings, or adjusting to a new work schedule (e.g., shift work) can disrupt sleep. Long-term life changes, such as moving or starting a new job, can also impact sleep routines.
   
   
7. Sleep habits and routine: Poor sleep hygiene, such as irregular sleep schedules, excessive caffeine consumption, or frequent naps, can significantly contribute to insomnia. Practices like using electronic devices before bedtime can also interfere with the body’s ability to relax and transition into sleep.

Understanding and addressing these factors can help one manage insomnia and improve sleep quality. For persistent or severe insomnia, consulting a healthcare professional is crucial for identifying underlying causes and exploring effective treatments.

Insomnia risk factors

Insomnia is more likely to occur in individuals with certain traits or circumstances, such as:

• Light sleepers: Those who wake easily due to minor disturbances

• Alcohol use: Alcohol can disrupt sleep patterns, especially when consumed close to bedtime.

• Unsafe living conditions: People living in unsafe environments, including situations involving violence or abuse, are at greater risk due to heightened stress and anxiety.

• Sleep-related fears or anxieties: Individuals with conditions like nocturnal panic attacks or nightmare disorder may develop a fear of sleep, which can lead to insomnia.

Understanding these factors can help one identify risks and guide targeted interventions for better sleep health.

Symptoms of insomnia

In addition to sleep disturbances, insomnia can lead to several physical, emotional, and cognitive issues, including:

• Daytime fatigue or excessive sleepiness: Feeling tired or drowsy throughout the day

• Mood changes: Increased irritability, depression, or heightened anxiety

• Low energy or motivation: Difficulty engaging in activities due to exhaustion

• Impaired focus: Trouble concentrating, poor decision-making, and memory lapses

• Coordination problems: Reduced motor skills that may result in errors or accidents

• Frustration about sleep: Preoccupation with the inability to sleep, leading to further stress

• Reduced productivity: Poor performance in work settings

• Social challenges: Difficulty maintaining relationships, working effectively, or studying due to tiredness and irritability.

Recognising these symptoms is crucial for diagnosing insomnia and finding effective treatments.

What does chronic insomnia feel like?

Living with chronic insomnia often feels like being trapped in a relentless cycle of sleepless nights and weary days. Despite feeling exhausted, falling asleep becomes a nightly struggle, and when sleep does come, it is often light and broken. People with chronic insomnia frequently wake up feeling unrefreshed, as though they haven’t slept at all, no matter how long they were in bed. This ongoing sleep deprivation can lead to a foggy mind, low energy, mood swings, and a sense of detachment from daily life. It’s more than just a bad night’s sleep; it becomes an ongoing challenge that affects both physical health and emotional well-being.

Home remedies for insomnia

Sleepless nights can be exhausting, but natural home remedies for insomnia may offer relief. Below are listed remedies to help you sleep more soundly.

Establish a consistent sleep schedule

Going to bed and waking up at the same time every day helps regulate your internal body clock. Over time, this consistency signals your brain when it’s time to wind down and when to wake up.

Create a calming bedtime routine

Engaging in relaxing activities before bed, such as reading, taking a warm bath, or listening to soft music, can prepare your body and mind for sleep.

Limit screen time before bed

The blue light emitted from phones, tablets, and computers can suppress melatonin production, the hormone responsible for sleep. Aim to switch off screens at least an hour before bedtime.

Try herbal teas

Chamomile, tulsi, and lemon teas are known for their calming effects and can promote relaxation and drowsiness before bed.

Insomnia during pregnancy

Pregnancy often leads to sleep disturbances caused by physical discomfort, hormonal changes, and emotional stress. Fortunately, there are several safe and effective home remedies for insomnia during pregnancy that can help expectant mothers get the rest they need.

• Support your body with pillows: Use pregnancy pillows to support your back and legs for a more comfortable sleeping position.

• Take short naps: If you're tired during the day, a 20-30 minute nap can provide relief without interfering with night-time sleep.

• Practise gentle yoga or stretching: Prenatal yoga can ease body tension and promote relaxation.

• Hydrate earlier in the day: Reducing fluid intake a few hours before bed can minimise night-time trips to the washroom.

Complications of insomnia

When insomnia becomes severe or persists for a long time, it can result in sleep deprivation. This lack of restorative sleep can have significant consequences, both immediate and long-term.

Immediate risks:

• Daytime drowsiness: Increased risk of accidents, particularly while driving or performing tasks requiring full alertness and focus.

Long-term health risks:

Sleep deprivation can increase the likelihood of developing or worsening the following conditions:

• Mental health disorders: Conditions such as depression and anxiety can arise or intensify due to chronic insomnia.

• Cardiovascular issues: Higher risk of high blood pressure (hypertension), heart attack, and stroke

• Metabolic disorders: Insomnia can contribute to the development of type 2 diabetes and obesity.

• Sleep-related conditions: Higher likelihood of developing or worsening obstructive sleep apnoea

• Neurological and psychological concerns: Prolonged insomnia can exacerbate conditions involving psychosis or other severe mental health disorders.

How can I prevent insomnia?

While not all causes of insomnia are preventable — especially those stemming from underlying medical or psychological conditions — there are ways to improve your sleep quality and reduce the chances of developing sleep difficulties. Certain strategies, like maintaining good sleep hygiene and managing stress, can significantly lower the risk of insomnia.

Sweet dreams

Insomnia can significantly impact your quality of life, but understanding its causes and symptoms is the first step toward finding relief. Whether it’s through lifestyle adjustments, natural remedies, or medical intervention, effective management of insomnia is possible. For persistent or severe symptoms, consult a healthcare professional to explore treatment options.

Frequently Asked Questions

1. How common is insomnia?

Insomnia affects about 10%-30% of the population at any given time, with chronic insomnia affecting 6%-10%.

2. How do I stop my insomnia?

Improving sleep hygiene, managing stress, and consulting a doctor for cognitive behavioural therapy or medications can help.

3. Can insomnia be cured?

While there’s no one-size-fits-all cure, many cases can be managed or resolved with appropriate treatment and lifestyle changes.

4. What is the best natural remedy for insomnia?

Chamomile tea, lavender oil, and mindfulness meditation are popular natural remedies for better sleep.

5. What foods help insomnia?

Foods rich in tryptophan (like turkey, bananas, and nuts), magnesium (like spinach and almonds), and melatonin (like cherries) can promote sleep.

6. Is there a home remedy drink for insomnia?

A warm glass of milk with honey, chamomile tea, or tart cherry juice can help improve sleep quality.