Sleepless Nights: Navigating My Insomnia

Sleep is essential for maintaining physical, mental, and emotional health. While the effects of sleep deprivation can vary from person to person, going without sleep for even 24 hours can have significant impacts on cognitive function and overall well-being. After 48 hours without sleep, the body and mind begin to experience extreme sleep deprivation, leading to potential microsleeps and disorientation. Understanding the consequences of sleep deprivation is crucial for recognizing the signs and prioritizing healthy sleep habits.

Sleep deprivation symptoms

Sleep deprivation can have a significant impact on your body and overall health. The longer you go without sleep, the more severe the symptoms become. After 24 hours without sleep, you will likely feel tired and exhausted. After 36 hours, you will have an overwhelming urge to sleep, and you may experience microsleeps—brief periods of sleep during waking time. You may also start to hallucinate.

After 48 hours without sleep, it becomes even harder to stay awake, and you are more likely to experience microsleeps. You may also notice perceptual distortions, increased irritability, and temporal disorientation. After 72 hours, your urge to sleep will strengthen and may become uncontrollable, and your hallucinations may become more complex.

If you go without sleep for 96 hours or more, your perception of reality may be severely distorted, resembling acute psychosis. Your urge to sleep will feel unbearable. These symptoms will go away once you get enough sleep, but it can take days or even weeks to fully recover from sleep deprivation.

Sleep deprivation can also have negative consequences for various body systems and organs. It can impair your heart and circulatory health, increasing the risk of high blood pressure and high cholesterol. It can also negatively impact metabolic systems, with people experiencing chronic sleep deprivation being at a higher risk of developing Type 2 diabetes.

Sleep deprivation weakens your immune system, making it harder for your body to fight off infections. It can also increase pain sensitivity and have detrimental effects on mental health, making it more difficult to manage and process emotions. People with sleep deprivation are more likely to experience symptoms of depression and anxiety.

Additionally, sleep deprivation can cause specific symptoms, including trouble thinking, focusing, and remembering, as well as slowed reaction times. More severe symptoms include microsleeps, uncontrollable eye movements, trouble speaking clearly, drooping eyelids, hallucinations, and impulsive or reckless behaviour.

Insomnia causes

Insomnia is a common problem, affecting around 1 in 3 adults worldwide. It can be triggered by many factors, and it is not always possible to identify a clear cause. Here are some of the most common causes of insomnia:

Stress, Anxiety, and Depression

Stressful or difficult life circumstances may not necessarily cause insomnia, but they are very common contributors. About half of the people with chronic insomnia also have at least one other mental health condition, such as anxiety or depression.

Physical Health

Your physical health can also affect your sleep. Temporary illnesses like minor infections or injuries, or chronic conditions like acid reflux, Parkinson's disease, or asthma can impact sleep quality. Conditions that affect your circadian rhythm, or your body's natural sleep/wake clock, are also factors.

Life Changes

Brief or temporary changes, such as jet lag, sleeping in an unfamiliar place, or adjusting to a new work schedule, can disrupt your sleep. Long-term changes, like moving to a new home, can also have an impact.

Sleep Habits

Your sleep habits, also known as sleep hygiene, can contribute to insomnia. This includes whether you take naps, when you go to sleep, if and when you consume caffeine, and other habits. Improving your sleep hygiene can help treat insomnia.

Substances

Alcohol, caffeine, nicotine, and drugs can all disrupt your sleep. Even nighttime snacking or heavy meals before bed can make it harder to fall asleep.

Environment

A room that is too hot or cold can make it difficult to sleep. It is important to keep your bedroom at a comfortable temperature and ensure it is dark, quiet, and free from distractions like electronic devices.

Genetics

Sleep traits and conditions, including insomnia, seem to run in families. Research indicates that there may be a genetic reason why some people need less sleep than others.

Other Medical Conditions

Many other medical conditions are linked to insomnia, including diabetes, cancer, asthma, gastroesophageal reflux disease (GERD), overactive thyroid, and Alzheimer's disease.

Sleep disorders

Other common sleep disorders include:

• Sleep apnea: A breathing disorder in which you stop breathing for 10 seconds or more during sleep.
• Restless leg syndrome (RLS): A tingling or prickly sensation in your legs, along with a powerful urge to move them.
• Hypersomnia: Being unable to stay awake during the day, including narcolepsy, which causes extreme daytime sleepiness.
• Circadian rhythm disorders: Problems with the sleep-wake cycle, making you unable to sleep and wake at the right times.
• Parasomnia: Acting in unusual ways while falling asleep, sleeping, or waking from sleep, such as walking, talking, or eating.

If you are experiencing sleep difficulties, it is important to consult a healthcare professional for a proper diagnosis and treatment plan. They may recommend lifestyle changes, such as improving sleep hygiene, or other interventions such as cognitive behavioural therapy or medication.

Sleep hygiene

Set a Sleep Schedule

Having a set sleep schedule is essential for normalizing sleep as an integral part of your day. Try to wake up at the same time every day, even on weekends, to maintain a consistent sleep rhythm. Calculate your bedtime based on your wake-up time, and prioritize sleep over other activities. If you need to adjust your sleep schedule, make gradual changes to avoid disrupting your body's natural rhythm. Limit naps to short durations in the early afternoon to avoid interfering with your nighttime sleep.

Follow a Nightly Routine

Establish a pre-sleep routine that prepares your mind and body for rest. Keep your routine consistent by performing the same steps each night, such as changing into comfortable clothes and maintaining personal hygiene. Dedicate 30 minutes before bedtime to winding down and engaging in calming activities like soft music, light stretching, reading, or relaxation exercises. Avoid bright lights, as they can hinder melatonin production, which is crucial for sleep.

Optimize Your Bedroom

Create a sleep-conducive environment by making your bedroom calm and comfortable. Invest in a high-quality mattress, pillow, and bedding that suits your preferences. Maintain a cool temperature, usually around 65°F (18.3°C), as it is more conducive to sleep. Use heavy curtains or an eye mask to block out light, and consider earplugs or a white noise machine to minimize disruptive noises. You can also try using calming scents like lavender to promote relaxation.

Cultivate Healthy Daily Habits

Incorporate positive habits into your daily routine to support your circadian rhythm and enhance sleep quality. Get exposure to natural light, especially sunlight, as it is a key driver of your body's sleep-wake cycle. Engage in regular physical exercise, but avoid late-night workouts that may stimulate your body and make it difficult to wind down. Avoid smoking, as nicotine disrupts sleep. Minimize alcohol consumption, especially later in the evening, as it can disrupt sleep during the second half of the night. Limit caffeine intake to the morning or early afternoon, as it is a stimulant that can interfere with your sleep when consumed later in the day. Finally, avoid heavy, spicy, or large meals close to bedtime, as they can impact your digestion and make it challenging to fall asleep.

Sleep supplements and medication

Over-the-Counter Sleep Aids

Over-the-counter (OTC) sleep aids often contain antihistamines, which treat allergies but can also cause drowsiness. Examples include diphenhydramine (Benadryl) and doxylamine (Unisom SleepGels, Unisom SleepMelts). However, these antihistamines are not recommended for regular use and may cause side effects such as grogginess during the day and trouble emptying the bladder. They are also not suitable for pregnant or breastfeeding individuals, those with closed-angle glaucoma, or older adults, especially those with liver or kidney issues.

Natural Sleep Aids

Natural sleep aids, such as herbs and supplements, can also be effective in promoting sleep. However, it is important to consult a healthcare provider before taking any natural sleep aids to avoid possible side effects and interactions with other medications. Here are some common natural sleep aids:

• Melatonin: Melatonin is a hormone naturally produced by the body that promotes sleep. Melatonin supplements have been found to improve sleep quality and duration, especially for individuals with disrupted sleep schedules, such as shift workers or those experiencing jet lag. Melatonin is generally safe for short-term use in adults but is not recommended for pregnant or nursing individuals due to limited research in these areas.
• Valerian: Valerian is an herb native to Asia and Europe, and its root is commonly used to treat symptoms of anxiety, depression, and menopause. Some studies suggest that valerian can improve sleep quality and reduce symptoms of sleep disorders, especially in menopausal and postmenopausal women. However, the results are inconsistent, and most improvements are based on subjective reports rather than objective measurements. Short-term intake of valerian root appears to be safe for adults, but its safety for long-term use and in certain populations, such as pregnant or nursing individuals, is uncertain.
• Magnesium: Magnesium is a mineral involved in various bodily processes, including brain function and heart health. It has a relaxing effect on the body and can help quiet the mind, making it easier to fall asleep. Studies suggest that magnesium may improve sleep quality, especially when combined with melatonin. Magnesium supplements are generally safe, but it is important not to exceed the recommended dosage unless advised by a healthcare professional.
• Lavender: Lavender's soothing fragrance is believed to enhance sleep. Several studies suggest that lavender aromatherapy, such as using lavender oil before sleep, can improve sleep quality in individuals with or without insomnia. Lavender aromatherapy is considered safe, but oral ingestion of lavender has been linked to side effects such as nausea, belching, and diarrhea.
• Passionflower: Passionflower, or Passiflora incarnata, is a popular herbal remedy for insomnia. Some studies suggest that passionflower tea or extract may improve sleep quality, but the evidence is mixed, and more research is needed. Passionflower intake is generally safe for adults.
• Glycine: Glycine is an amino acid that plays a role in the nervous system and may help improve sleep. Studies have found that taking glycine before bedtime can reduce fatigue, improve sleep quality, and enhance daytime performance in individuals who are sleep-deprived. Glycine supplements are generally safe, but it is important not to exceed the recommended dosage.
• Cannabidiol (CBD): CBD is a compound derived from hemp that has been found to relieve anxiety and act as a natural sleep aid. Some studies suggest that CBD can improve sleep quality and reduce anxiety. However, more high-quality research is needed to routinely recommend CBD for sleep disorders, and it is not recommended for pregnant or breastfeeding individuals due to limited research.
• Tryptophan: Tryptophan is an amino acid that has been found to improve sleep quality and reduce the number of night-time awakenings when taken in doses of at least 1 gram per day.
• Ginkgo biloba: Consuming Ginkgo biloba extract about 30-60 minutes before bed may help reduce stress, enhance relaxation, and promote sleep, according to older studies.
• L-theanine: Taking an L-theanine supplement daily may improve sleep and relaxation, especially when combined with GABA or magnesium, according to animal studies.

Prescription Sleep Aids

If natural sleep aids and good sleep habits are not effective, prescription sleep aids may be an option. However, it is important to discuss this with a doctor, as prescription sleep aids may have side effects and risks, including the potential for dependence. Some common prescription sleep aids include:

• Benzodiazepines: Examples include estazolam, quazepam (Doral), temazepam (Restoril), and triazolam (Halcion). Benzodiazepines can be addictive, so they are typically prescribed for short-term use only.
• "Z-drugs": These include eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien). Z-drugs work by slowing down brain activity and are often prescribed as an alternative to benzodiazepines. However, they may cause parasomnia, a disruptive sleep disorder that can lead to dangerous behaviors, such as sleepwalking or driving while not fully awake.
• Dual orexin receptor antagonists (DORAs): Examples include suvorexant (Belsomra), lemborexant (Dayvigo), and daridorexant (Quviviq). These medications block the wake-promoting chemical orexin in the brain, helping to induce sleep.
• Antiseizure medications: Gabapentin (Neurontin) and pregabalin (Lyrica) can help treat conditions like restless leg syndrome, which can interfere with sleep.
• Sedating antidepressants: Examples include doxepin (Silenor), amitriptyline (Elavil), and trazodone. These medications have a sedative effect and can help with sleep, but they may also cause prolonged drowsiness and memory and performance issues.

It is important to remember that sleep supplements and medication should be used cautiously and in consultation with a healthcare provider. They are typically recommended for short-term use, and developing good sleep habits is crucial for long-term sleep health.

Frequently asked questions