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Health and Disease

Insomnia: The Most Common Sleep Disorder

Oftentimes, we find ourselves struggling to get a decent night of sleep. When this problem persists, it is possible that effects of insomnia are at play. Such a common disorder is something to be wary of, especially since sleep is a crucial mechanism that we take for granted.

Introduction

When thinking about the most crucial functions of life, one may visualize the actions of eating food or drinking water. However, what is often overlooked but equally as important is the mechanism of sleep! The rejuvenating and recharging of the body during sleep is essential to maximize one’s health. It maintains cognitive functions, fights off disease, and repairs our body to make way for growth. While the necessity of sleep is evident, it, unfortunately, is taken for granted by many. People can form bad habits and choose to neglect their sleep. In other cases, work and school can get in the way of a good night’s sleep. On average, a young adult needs about 7-9 hours of sleep a night. When this threshold is not met over extended periods, negative effects can occur. 

Insomnia

When one’s sleep patterns or habits are changed, overall health can be negatively affected. When health is being harmed, a sleep disorder may have been developed. The most common and prominent sleep disorder is called insomnia. The disorder of insomnia is characterized by trouble falling asleep, trouble staying asleep, or waking up too early and being unable to return to sleep. When this occurs, one’s health is at stake considering that the necessity of sleep is being compromised.

Insomnia is split into two types; acute insomnia and chronic insomnia. Acute insomnia is a short-term version of the disorder, often lasting days or weeks. On the other hand, chronic insomnia occurs for much longer, around the duration of a month or more. According to a study done by the University of Pennsylvania School of Medicine in 2018, about 1 in 4 Americans experience acute insomnia each year. Fortunately, about 75% of those affected individuals were able to recover before the disorder became chronic. Why is acute insomnia so common? There are a multitude of factors behind the disorder’s development.

Causes

In most cases, insomnia develops from poor habits. Staying up late while looking at the bright screens of phones, computers, and TVs can change one’s sleep cycle due to prolonged exposure to light. A dark environment is usually beneficial to falling asleep. Furthermore, eating a hefty meal at a late time can also contribute to trouble sleeping. One may not feel truly comfortable and ready to sleep with a full stomach. 

Insomnia is also usually associated with negative thoughts and emotions that can disrupt proper sleep. Recurring, nightly concerns can elevate feelings of stress; your mind can stay active and overthinking, and thus make it hard to fall asleep. These negative emotions reappear every time you sleep, and eventually, it becomes a cycle of overthinking and not sleeping.

While insomnia can be a primary, stand-alone disorder, it is also possible that other preexisting conditions influence the development of insomnia. Disorders regarding mental health, such as depression and PTSD, can cause trouble sleeping by keeping one awake too long. Furthermore, medications like antidepressants that are meant to combat such mental health disorders can contain ingredients that make sleeping harder, like caffeine. Physical conditions and medical conditions that cause pain, inner-body discomfort, and trouble breathing also would cause difficulty with sleep.

Overall, it is clear that there are a plethora of causes behind insomnia. While not all are easily solvable, such as insomnia that develops due to other medical conditions, some treatments can have a potentially effective resolution.

Symptoms

As mentioned earlier, insomnia is usually marked by difficulty falling asleep or staying asleep. Other symptoms of the disorder include a lack of feeling well-rested after sleep, which can affect behavior and actions throughout the day due to tiredness. Insomnia can also cause a lack of concentration in school or work, as cognition would be lacking without proper sleep over time. Such factors can contribute to the development of heightened anxiety and stress oversleep and general life activities, which can even lead to depression. Overall, one’s life can be changed drastically without maintained sleep. 

Treatments

The treatments of insomnia can vary based on the root problem behind the disorder. As mentioned earlier, it is seen that insomnia frequently stems from poor habits and negative emotions regarding sleeping. One of the most effective treatments that deal with such issues is a type of therapy known as Cognitive Behavioral Therapy for Insomnia (CBT-I). It is a talk therapy that is usually done with a medical professional, but there are many options to consider on the Internet and apps. CBT-I mainly targets the bad habits surrounding one’s lack of sleep; it analyzes thoughts, behaviors, and emotions. Furthermore, it helps people control or eliminate negative thoughts and actions that keep them awake. The patient and therapist would look at and assess these habits, then change them for better sleep results. There are several parts of CBT-I, such as sleep restriction that limits the amount of time spent in bed throughout the day, and any daytime naps. Removing these habits would likely make the patient more tired during the night, and thus make sleeping easier. Another example of a CBT-I method is relaxation techniques that emphasize muscle relaxation and breathing techniques to ease an active mind, stress, and anxiety that can occur in the nighttime. Once more, CBT-I is an analysis and changing of one’s habits to influence better sleep. It is usually personalized based on each patient’s specific habits and cases, and thus the specific methods utilized can vary.

When a patient’s situation worsens, prescription medication can be an effective treatment, though it is suggested that medication is not used for extended periods. Prescription pills can induce sleep or maintain a sleeping state. Prominent examples of such medication include Eszopiclone and Ramelteon. 

Eszopiclone is a hypnotic medication, which works by being a GABA receptor agonist. GABA is an inhibitory neurotransmitter that inhibits certain brain signals and decreases activity in the nervous system, so by being an agonist, Eszopiclone can promote a decrease of nervous system activity during sleeping time. This medication particularly helps people fall asleep faster, stay asleep longer, and lessen how often they wake up during the night.

Ramelteon is a medication that serves as a melatonin receptor agonist. Melatonin is a neurotransmitter that regulates the timing of circadian rhythms and sleep in response to darkness, so by being an agonist to melatonin, sleep in the dark would likely be enhanced. As with Eszopiclone, Ramelteon medication helps people fall asleep faster, stay asleep longer, and lessen how often they wake up during the night.

Many other prescribed sleeping pills also serve as a GABA or melatonin agonist to promote better sleep quality in the same way that Eszopiclone and Ramelteon do. 

Brian Caballo, Youth Medical Journal 2020

References

By Brian Caballo

Brian Caballo is a student at The Bronx High School of Science in New York City, NY. He is mainly interested in the fields of neuroscience and stem cell biology.

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