Why Can’t I Sleep? Insomnia — Both Acute and Chronic — Explained
If you’ve ever suffered even one night of bad sleep, you might relate to feeling so upset about sleeplessness that you want to cry. Insomnia is when that happens night after night.
The simplest definition of insomnia is not being able to sleep. The medical definition is: “perception of difficulty with sleep, despite adequate opportunity to sleep,”Sheila Tsai, MD, a pulmonologist and the section head of sleep medicine at National Jewish Health in Denver, Colorado.
It’s a complex problem that is common and comes with alarming consequences.
Data from the National Sleep Foundation (NSF) show that a whopping 54 percent of adults report having experienced at least one symptom of insomnia a few times a week within the last year, and 33 percent say they’ve had at least one symptom of insomnia every night or almost every night. (1) Studies have also shown that between 10 and 15 percent of adults in the United States have chronic insomnia that is severe enough that it affects their daytime functioning, according to the NSF.
Everyone Has Trouble Falling Asleep From Time to Time — How Do I Know When It’s Insomnia?
In simplest terms, insomnia does mean difficulty with sleeping. But there are three main criteria that indicate you may have insomnia.
First, you may have trouble falling asleep. It should generally take you 15 minutes on average to fall asleep. “Anything greater than 30 minutes is problematic,” saysSara Nowakowski, PhD, a clinical psychologist and sleep researcher at the University of Texas Medical Branch in Galveston. On the flip side, if you fall asleep before you even hit the pillow, that’s also not good, as it may mean you’re not getting adequate sleep or you have another sleep disorder like obstructive sleep apnea.
The second criterion for insomnia is waking up in the middle of the night, essentially having difficulty maintaining sleep. Although everybody normally has brief awakenings as they cycle through different sleep stages, it becomes a problem when you wake up and remain awake for 30 minutes or longer. It may happen multiple times throughout the course of the night, Dr. Nowakowski says.
And finally, the third main criterion that may mean you you have insomnia is if you wake up earlier than you want to in the morning and are unable to fall back to sleep. How much earlier? “It’s defined as before your alarm clock goes off, or before you intend to wake up,” Nowakowski says.
Another important red flag is having a disruption to your daytime routine because of sleepiness or fatigue. You may, for instance, feel irritable or simply downright exhausted. (2
One myth when it comes to insomnia is the misconception that people with insomnia do not sleep at all. “People with insomnia will report that they don’t sleep at all, but that’s physically impossible, as you can’t go night after night without sleeping,” saysGerard J. Meskill, MD, a neurologist and sleep disorders specialist with Comprehensive Sleep Medicine Associates in Houston.
Everyone Likely Experiences Acute Insomnia at Some Point
You can’t be human without having at least one bad night of sleep. After all, life, whether in the form of stress, excitement, or a change of routines, can easily get the best of you and disrupt your slumber.
So would you qualify as an insomniac with just one bad night of sleep? The answer is yes, namely because there are two different types of insomnia, and knowing which you have is key in figuring out how to treat it.
Acute insomnia is the milder form that most everyone likely deals with at some point. Thirty to 35 percent of adults have brief symptoms of insomnia, while 15 to 20 percent struggle with short-term insomnia that lasts less than three months, according to the American Academy of Sleep Medicine. (3
This brief period of struggling to sleep usually happens as a result of life circumstances. It generally lasts no more than four weeks, and typically goes away on its own once the stressor causing your sleep problems has passed, Nowakowski says. (4
For instance, you may be catching a plane early in the morning the next day and you can’t sleep because you’re worried about missing your flight. Or you may have a work deadline the next day and you’re so stressed about it that you can’t fall asleep. Health conditions that trigger worries — for instance, if you’re going in for surgery the next day — can also cause acute insomnia. Other stressors, like adjusting to a new job or moving to a new home, can lead to acute insomnia that causes sleep problems that last a few weeks.
But if your sleep troubles last longer than a few weeks (or continue after that initial stressor has passed) — or if you feel like your sleep troubles are getting worse — tell your doctor. In most cases, the sooner insomnia is addressed, the easier it is to fix.
Chronic Insomnia Means Sleep Problems Persist Frequently
Meanwhile, the more severe type of insomnia is chronic insomnia, which means you have sleep difficulties three or more days a week on average over the course of three months. Approximately 1 in 10 adults have chronic insomnia, according to the American Academy of Sleep Medicine.
Chronic insomnia tends to start because of acute insomnia, but even after the stress that initially causes the sleep problems goes away, disrupted sleep persists. People with chronic insomnia tend to experience a symptom sleep doctors refer to as “catastrophizing,” Dr. Meskill explains. “They worry about not falling asleep and what will happen if they don’t sleep, and before you know it, they have so much anxiety that they’re unable to sleep.”
Though acute insomnia can be reversed with the adoption of healthier sleep habits or it may go away on its own, most people with chronic insomnia require help from a sleep specialist to help retrain the body to get healthy sleep. The most effective treatment is a type of counseling called cognitive behavioral therapy (CBT) that helps individuals lessen the anxiety they have surrounding sleep.
Video: Can't Sleep: Hypnosis for sleep insomnia and sleeping disorders
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