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Insomnia

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Please note that all content on this website (including, but not limited to, copy, images, commentary, advice, tips, hints, guides, observations) is provided as an informational resource only. It is not a substitute for correct and accurate diagnosis, or recommendation, or treatment by a medical professional. Please ensure that you obtain proper guidance from your GP, or another medical professional. The information provided on this website does not create any patient-medical expert relationship and must not be used in any way as a substitute for such.

Getting enough sleep is not a luxury, but a necessity. A good night’s sleep is restorative and is essential to keep the body in good health.

A person needs around 7 to 9 hours of sleep per day. The National Health Service (NHS) defines insomnia as a – type of sleep disorder, during which a person has difficulty falling asleep, or maintaining sleep.

While insomnia is usually trivialized, research shows that untreated insomnia is associated with serious health problems such as hypertension, congestive heart failure and diabetes.

What Causes Insomnia?

Every person has a sleep-wake cycle, which scientists refer to as the circadian rhythm. The human body depends significantly on this sleep-wake cycle to know when exactly it should start telling the brain to start releasing melatonin – a sleep-inducing chemical. Melatonin, also known as the ‘sleep hormone’, is a chemical secreted by the pineal gland and is released in the presence of darkness.

Additionally, the mind also needs to calm down, so that the body can prepare for sleep. The brain areas that need to calm down include the hypothalamus, hippocampus, amygdala, and the cortex.

Unfortunately, sometimes due to stressors, such as receiving bad news, the brain enters a state of hyperarousal. This means that stress causes an activation of the cognitive and emotional processes occurring inside the body during sleep hours. This hyper aroused state is very similar to the feelings one experiences when subject to a frightening situation, such as coming across a tiger on the road!

It is impossible to relax when one’s mind is rushing with fearful thoughts and your heart is pounding rapidly. Insomnia is quite similar.

During insomnia, the hypothalamus, hippocampus, amygdala and cortex are very active. Insomnia can also occur secondary to a delayed secretion of melatonin.

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Acute Insomnia 

Acute insomnia can be defined as a short period of sleep difficulty. Acute insomnia usually occurs secondary to a stressful event, such as receiving bad news, a traumatic event, sudden changes in one’s sleep schedule, or even due to certain medications, such as antidepressants and antihypertensives. Acute insomnia lasts for less than three months.

Chronic Insomnia

Chronic insomnia can be defined as a type of sleep difficulty occurring over at least three nights every week, lasting for at least three months. Chronic insomnia is generally caused by depression, anxiety disorder, or chronic stress. Depending on the classification system, chronic insomnia can sometimes be referred to as comorbid insomnia.

Comorbid Insomnia

In comorbid insomnia, the term ‘comorbid’ stands for other conditions. This type of insomnia occurs in combination with other conditions, most frequently psychiatric disorders, such as anxiety and depression. Sleep apnea and pain can also contribute to comorbid insomnia.

Onset Insomnia

Sleep onset insomnia, also known as acute onset, refers to a type of insomnia in which the person has difficulty falling asleep, rather than maintaining sleep. Onset insomnia can be caused by short-term stressors, or poor sleep hygiene, such as a noisy environment, taking stimulants before sleep, eating a large meal, or even excessive exposure to light at bedtime.

Maintenance Insomnia

In maintenance insomnia, a person has difficulty to maintain an undisturbed sleep. He, or she, may suddenly wake up in the middle of the night and find it difficult to get back to sleep again.

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It is useful to think of insomnia as a manifestation of another problem. The symptoms of insomnia can vary from person-to-person. The most common symptoms of insomnia are described below:

  • Waking up early and being unable to fall asleep again
  • Non-restorative and poor-quality sleep
  • Trouble falling asleep
  • Waking up several times at night
  • Fatigue and sleepiness during the day
  • Poor concentration
  • Mood swings
  • Feeling irritable most of the time.

Since it can be quite common to have some degree of sleeplessness, putting a clear diagnosis of insomnia can be difficult. To demarcate the ‘‘common sleeplessness’’ from insomnia, health experts use well-defined criteria known as the DSM-V. A simplified version of the DSM-V criteria is below:

  • Major sleep difficulties including difficulty initiating sleep, difficulty maintaining sleep, and early awakening with difficulty to get back to sleep.
  • Sleep difficulties for at least three nights per week over at least three months.

The NHS also provides a convenient online sleep self-assessment tool to help determine if one suffers from insomnia and what can be done about it.

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Getting a good night’s sleep is not as simple as it seems. Once your body’s internal sleep clock gets used to a few hours of sleep, it becomes more challenging to reset that clock to its natural state again. However, it is not impossible. All you need to do is to follow a proper set of sleep hygiene rules to restore your body’s natural state of being.

Here are 10 practical, science-backed, and doctor-approved strategies to help you improve your sleep hygiene and beat insomnia.

Create an Ideal Sleep Environment

Creating a serene sleep environment is vital to ensure restful sleep. Your bedroom is the place where you come to restore yourself after a tiring day. If you’re waking up each day with a sore neck, or back pain, there’s a high probability that your bedroom is not optimized for sleep. Fortunately, with a few simple tweaks, you can turn your bedroom into a sleep paradise. To create a sleep-effective bedroom, you must take into account three important factors – sound, temperature and comfort. The ideal sleep environment should be quiet, cosy, and ideally at 60 to 67 Fahrenheit for optimal sleep.

A good mattress, comfy pillows, and warm sheets play a major role in keeping you sound asleep throughout the night. Look for pillows that provide extra comfort, feel nice against your skin, and are mouldable.

Fixing the problems that keep you awake at night can make a drastic change in the quality of your sleep.

Below is a look into different medical conditions that disturb normal sleep patterns.

Incontinence

Patients living with incontinence have sleep difficulties, as they are preoccupied about wetting the bed at night. However, some people do not like wearing pads. If incontinence is what keeps you awake at night, you might find it practical to switch to waterproof mattress protectors, duvets, and pillowcases.

Experts recommend looking for waterproof mattress covers and bedroom protectors that are made from washable materials and have elasticated corners to fit the mattress easily.

Falls Due to Neurological and Orthopaedic Conditions

If the fear of falling from the bed is what keeps you awake at night, you might find it useful to invest in setting up some safety bed aids. Bed rails are great options when it comes to creating a safety barrier to prevent you from falling from bed at night.

Acid Reflux, Gastroesophageal Reflux, Laryngopharyngeal Reflux, and Hiatal Hernia

Living with reflux, or hiatal hernia, can make life miserable. If you’re tired of waking up every day with a sour taste in your mouth, a persistent dry cough, a sore throat, asthma-like symptoms, and middle chest pain, it is time to invest in a wedge pillow.

According to a study published in the International Society for Diseases of the Esophagus Journal, the use of a positional therapy device can significantly decrease nocturnal reflux symptoms, hence improving sleep quality. Wedge pillows are designed to keep acid reflux at bay. The wedge-like shape keeps your body in an inclined position so that anything found in your stomach can’t reflux backwards to your mouth.

Dust and Mould Allergy

Dust and mould allergy can affect sleep quality. You may find yourself waking up in the middle of the night coughing and sneezing due to dust particles, or mould, that may be inside your mattress. You don’t have to keep suffering indefinitely from both allergic reactions and insomnia. Anti-allergenic mattress protectors are readily available.

Leave Your Worries Behind

If you feel that the primary cause of your insomnia is those never-ending worrying thoughts, it might be time to start learning how to clear your mind before bedtime. Some people find it useful to keep a sleep diary. Journaling is a very effective, scientifically-proven method of reducing stress and clearing the mind.

Restore a Healthy Sleep-wake Cycle

Your sleep-wake cycle is controlled by your body’s internal clock. The NHS recommends going to bed and waking up at the same time every day. This helps your internal sleep-wake clock accommodate your sleep patterns to a specific time of the day so that your body automatically shifts into a state of relaxation at bedtime.

Eat Sleep-promoting Foods and Avoid Large Meals

At bedtime, your digestive system is supposed to relax and rest. Large meals at bedtime stimulate your digestive system. Health experts recommend having your last meal of the day 3 to 4 hours before bedtime.

Also, cutting down on drinks that contain caffeine, such as caffeinated teas, coffee, or energy drinks, will help your body prepare itself for sleep better. Consider drinking a warm cup of milk, or a relaxing herbal tea, such as chamomile infusion. 

Reduce Screen Time

We live in a smart world where the use of electronic devices at bedtime is today deemed as normal. But did you know that these extra minutes of screen time at bedtime could have a negative impact on your sleep quality?

Studies show that using your smartphone, or tablet, before sleep can make it more difficult to fall asleep. This is because your biological clock uses light as a means of communication to tell your body to release melatonin, the sleep hormone. Exposure to artificial light from electronics has pretty much the same effect on melatonin secretion as natural light. As your body can’t differentiate between artificial and natural light, it still thinks that it’s daytime. Consequently, melatonin secretion remains low until you switch off those light-emitting devices.

While there are numerous ways to eliminate insomnia, sometimes severe insomnia may not readily resolve. Persistent insomnia requires help from a professional sleep specialist, or a qualified medical doctor. Doctors will usually prescribe a sedative to help you sleep better.

Light Projection

Light Projectors can help with restlessness, insomnia and even help to ease the effect of tinnitus. The Lifemax Star Projection Cube helps to soothe with a mixture of lullaby and nature sounds and will turn your ceiling in to a night sky scene. A timer also automatically switches the light off, ensuring you are not disturbed once you have dropped off.

The Lifemax Projection Humidifier will help you to relax and unwind. This mobility aid has a generous misting capability and an aromatherapy option with calming colour changing scenes that can be projected onto your ceiling to help you drift off to sleep.

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It is advisable to seek support as soon as possible if you feel that you might be suffering from severe insomnia. Most people recover completely with the right support and help. We’ve compiled a list of useful organizations dedicated to the management of sleep problems…

Hope2Sleep – is a registered charity run by passionate and dedicated sleep apnoea sufferers, sleep professionals and volunteers, to help people get better sleep by improving conditions that affect sleep, particularly breathing problems. Click here to visit their website.

The Children’s Sleep Charity – is a national, award-winning charity that aims at providing support to children suffering from insomnia and other sleep problems. The Children’s Sleep Charity offers workshops, clinics and useful information to help your child get better sleep. You can visit The Children’s Sleep Charity by clicking on this link.

The Sleep Council, founded in 1995, has been dedicating its time and effort in helping people improve the quality of their sleep and increase awareness about the importance of sleep health. Find out more about The Sleep Council here.

Insomniacs – is a website that provides practical information on how to beat insomnia and other sleep problems. Since the majority of the contributors of insomniacs had once suffered from insomnia themselves, the content provided on the website gives a clear insight into what actually works and what does not. You can visit Insomniacs here.

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Medical terms are often baffling and difficult to fully understand. To help, we have listed some frequently used terms below.

Circadian rhythm – is the body’s internal biological clock. It is the body’s natural rhythm of physical, mental, and behavioural patterns that occur over 24 hours. The circadian rhythm is affected by exposure to light and plays a significant role in regulating an individual’s sleep patterns.

Hiatal hernia – is a surgical condition in which part of the stomach moves into the lower portion of the oesophagus. Hiatal hernia is characterised by persistent symptoms of acid reflux that do not resolve with medications.

Hypothalamus – is a small part of the brain that plays a key role in the regulation of the sleep-wake cycle. A small region known as the suprachiasmatic nucleus found inside the hypothalamus communicates with the pineal gland to tell it to induce sleep by releasing melatonin.

Melatonin – is a vital hormone secreted by the pineal gland to promote sleep. Melatonin secretion is triggered by darkness.