Insomnia: A silent threat to physical and mental health

September 11, 2024

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By Michelle Chong Hui Yi;
Clinical Psychologist;
Sunway Medical Centre

Insomnia is a disorder that causes an individual to have difficulty falling asleep, waking up frequently or waking up easily despite having enough time to sleep. It is a condition that should not be dismissed. In fact, it needs to be addressed as it will have a negative impact, especially on physical and mental health, hence affecting daily life.

In addition to not being able to focus during the day, insomnia will also affect feelings and emotions, cause anxiety, and can even lead to heart disease, type 2 diabetes, obesity and stroke.

Getting adequate and quality sleep is very important to ensure enough rest for the body and mind. Inadequate sleep or rest may cause individuals to experience fatigue during the day, easily triggered, moodiness and difficulty concentrating in daily activities.

Based on the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), insomnia is classified as a sleep-wake disorder, and to identify whether an individual is facing this condition, one main complaint would be related to dissatisfaction with the quality or quantity of sleep, and with at least one of the following symptoms:

Difficulty falling and staying asleep.
Waking up early in the morning and being unable to go back to sleep.
Having difficulty sleeping at least three nights per week for a period of at least three months despite having sufficient opportunity or time to sleep.
Sleep disorders that are not caused by other sleep disorders such as narcolepsy, breathing issues, and are not associated with physiological effects such as drug and medication abuse.
Mental disorders such as depression, anxiety or confusion.

Women are more likely to suffer from sleep disorders
Insomnia can be a short-term issue or a chronic problem. It can occur among individuals of different age groups such as children, teenagers, and adults, based on certain factors. However, it occurs more often in adults and is usually caused by changes in sleep patterns and medication intake.

In terms of gender, women are more likely to suffer from sleep disorders, this may be linked to hormonal changes, pregnancy, menopause and other factors.

Insomnia can be divided into several types, including:

Short term insomnia - or acute insomnia, often caused by stress, illness or environmental factors. Usually, the situation will continue for about three months and may progress to the stage of chronic insomnia if prolonged.
Chronic insomnia - is a long-term problem, occurring at least three times a week for more than three months. It can be caused by other health problems, psychological issues or lifestyle factors.
Onset insomnia - difficulty falling asleep at night and usually taking more than 30 minutes to fall asleep.
Maintenance insomnia - waking up in the middle of the night and having difficulty going back to sleep.
Comorbid insomnia - occurs with other medical conditions or psychiatric related factors, such as depression, anxiety or chronic pain.

Factors that contribute to sleep disorders differ for individuals, including:

Emotional stress, life stress and long-term stress as it trigger a reaction that releases hormones such as adrenaline and cortisol that increase the level of alertness.
Excessive caffeine or alcohol consumption.
Irregular sleeping hours.
Excessive usage of electronic devices because the blue light blocks the production of melatonin, a hormone that regulates sleep.

Insomnia can be treated through non-pharmacological approaches such as Cognitive-Behavioural Therapy for Insomnia (CBT-I), which is a treatment to change thoughts and behaviours that contribute to insomnia. The method is effective in improving the quality and duration of sleep.

Individuals with insomnia can get medical advice from a doctor, and the doctor will refer them to a specialist, such as a psychologist or psychiatrist, if necessary.

In addition, it is suggested to change lifestyles such as adopting healthy sleeping habits, exercising regularly to release endorphins and improve mental health, and at the same time adopting activities or hobbies that can reduce stress.

Some tips to improve quality of life, include:

Practice a regular sleep and wake-up schedule.
Set up a relaxing sleep routine by doing activities to calm the mind before bed such as reading, taking a warm bath or meditating.
Ensure the bedroom is conducive to sleep such as dark, quiet and has a comfortable temperature.
Avoid using electronic devices such as mobile phones, tablets and computers before going to bed.
Avoid heavy meals, caffeine and alcohol near bedtime.
Exercise regularly but avoid strenuous exercise when it is almost bedtime.
Practice stress reduction techniques such as meditation and yoga.
Reduce naps during the daytime. If necessary, make sure naps are between 20 and 30 minutes and avoid sleeping in the late afternoon.

If sleep problems persist after practicing the tips, seek advice from medical or other relevant experts. Individuals suffering from sleep disorders need to be patient because improving sleep habits and overcoming insomnia may take time. Be patient with yourself and continue to practice healthy and quality sleep habits for overall well-being.

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