Insomnia is a disorder described by patients as difficulty falling asleep, waking up frequently during the night, or waking up before the time they consider usual.
In addition to this nocturnal disturbance, patients are also affected in their quality of life because they have not had a good night’s rest. In general, they have difficulty concentrating, they are more moody, more agitated, more sleepy and more tired.
We do not have a specific test or examination, therefore for the diagnosis of insomnia disorder, the interview with the patient is fundamental.
Are there different types of insomnia?
The latest international classification of sleep disorders that talks about insomnia disorder, only divides it into acute insomnia or chronic insomnia.
Previously, we spoke of primary insomnia, secondary insomnia, etc. However, after noting that insomnia itself is a disease and carries a risk (such as cardiovascular risk or risk of psychiatric disease…), even if it is due to other reasons, it must be treated. Therefore, in the last classification, regardless of whether it is related to hyperthyroidism, anemia or depression, among others, we must differentiate between acute or chronic insomnia and treat it. Acute insomnia is that which affects the person for less than three months. When the insomnia lasts more than 3 months, we speak of chronic insomnia. Thus, if the insomnia is acute, but lasts more than 3 months, is not resolved and the problem persists, then it becomes chronic.
What are the causes of insomnia?
Insomnia has multifactorial causes. Usually, there is a trigger or stressor, but this factor can be varied. It can be:
- An upset
- Family conflict
- Occurrence of pain
- Illness
- Loss of work
In other words, the reason for insomnia is multifactorial, so it can have its origin in many causes.
What are the best tips to prevent insomnia?
First of all, try to take care of your sleep and try to maintain hygienic sleep standards. This can be achieved by
- The regularization of schedules
- Not taking stimulants
- Exposing yourself to plenty of light in the morning
- Not abusing light (such as mobile devices) and stressful activities in the afternoon.
How can it be treated?
Currently, the guidelines tell us that the first line of treatment is cognitive-behavioral therapy, which can be isolated or associated with drugs, depending on the needs of each patient.
This means that the drugs or hypnotics used so far do not cure the problem causing the insomnia, although sometimes they should be used.
That is to say, if the problem that caused the insomnia was a loss of work, the hypnotic will not give the patient back his work, but it will facilitate sleep during the period of time that the pharmacological treatment lasts, but it is not free of side effects. Therefore, the hypnotic is not a treatment of the etiology of the problem, but a treatment of symptoms, which allows sleep to be enhanced, but when the drug is withdrawn, the problem that caused the insomnia has not been solved.
It may be the case that a patient suffers insomnia because he lost his job and takes hypnotics for a while. If during this period you recover your work, the etiology that caused the insomnia will have been resolved, so that when you stop taking the hypnotic, perhaps the insomnia will have been resolved. However, it will not have been cured by the hypnotic.
For this reason, cognitive-behavioral therapy is postulated to reinforce all those processes that will facilitate biological sleep, as well as all those attitudes and behaviors that we sometimes do incorrectly in order to perpetuate our insomnia problem.