insomnia

When Counting Sheep Doesn’t Work: What is Insomnia?

The blue light glows from the digital clock sitting on the nightstand. It slowly ticks inching its way toward midnight…1am…2am. It seems impossible to fall asleep. Most people know the feeling of lying in bed wide awake mentally counting the hours of sleep they will get if they fall asleep at that exact second.

Although this may be a familiar feeling every once in a while for most of the population, this problem is far greater and more serious in individuals suffering from insomnia. Insomnia is a word casually used to describe the difficulty of falling and staying asleep. Insomnia is indeed a very serious issue and is more accurately defined as “difficulty initiating or maintaining sleep as well as early-morning awakenings and is associated with daytime dysfunction of at least 3 months’ duration” (American Psychological Association, 2013). In fact, sleep disorder symptoms plague approximately 40% of the population in the United States (Townsend et al., 2017).

What contributes to this growing problem of sleep disruption? Many causes of insomnia are conceivable, such as alcohol consumption, electronic use, caffeine intake, and noise or light exposure. Medical conditions and mental health disorders also play an important role in the causes of insomnia. In a study about insomnia in older adults, researchers found that anxiety was highly associated with insomnia even more so than depression or pain (Dragioti et al., 2017). Anxiety also keeps university age students up at night and contributes to students’ difficulty falling and staying asleep. Students also frequently experience excessive daytime sleepiness and less quality sleep time (Choueiry et al., 2016). As evidenced by many studies, mental health disorders and insomnia are often comorbid issues. It is not difficult to see how panic attacks or post-traumatic stress symptoms could keep a person up at night.

Consequently, insomnia has a profound impact on mental health. According to a recent study completed by Li et al. (2016), those whom struggle with insomnia are at a significantly higher risk for depression. This can be a very daunting fact given that non-depressed individuals with insomnia symptoms can further develop a mental health condition. These research results may also be useful in directing the prevention of depression in individuals with insomnia or sleep disruptive symptoms. Aside from depression, anxiety disorder symptoms can be exacerbated by insomnia (Aho et al., 2014). The hypervigilance and heightened arousal that typically accompany many anxiety disorders can make sleeping peacefully much more difficult and, thus, has many implications for daytime functioning.

It is true that insomnia is a terrible problem, but what is not true is that there is no way for it to be treated. Several treatment options exist for individuals struggling with insomnia and sleep disruption. Sleepio, an Internet-based cognitive behavioral therapy has been found to have positive results. It is a six week Internet program designed to help people sleep better. Sleep diaries, reminders to help members continue their healthy sleep journey, and relaxation audio tapes are among the useful methods. A recent study looked at the effects of this cognitive behavioral therapy for insomnia on work outcomes. Researchers found that Sleepio has a positive effect on negative affect, job satisfaction, and self-control in the workplace (Barnes et al., 2017). However, more often than therapy or in addition to therapy, sleep disorder issues are treated with medication. Pharmacological therapies have great success in treating insomnia. Selective serotonin reuptake inhibitors (SSRI’s) and benzodiazepines are often concurrently prescribed with cognitive-behavioral therapy as previously described (Aho et al., 2014).

Everybody sleeps, but not everybody sleeps well. Good sleep hygiene is fundamentally imperative to individuals’ daytime functioning, psychological well-being, and quality of life.

References

Aho, K. M., Pickett, S. M., & Hamill, T. S. (2014). Cognitive behavioural therapy for anxiety disorders and insomnia: A commentary on future directions. The Cognitive Behaviour Therapist, 7doi:10.1017/S1754470X14000117

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing

Barnes, C. M., Miller, J. A., & Bostock, S. (2017). Helping employees sleep well: Effects of cognitive behavioral therapy for insomnia on work outcomes. Journal Of Applied Psychology, 102(1), 104-113. doi:10.1037/apl0000154

Choueiry, N., Salamoun, T., Jabbour, H., El Osta, N., Hajj, A., & Khabbaz, L. R. (2016). Insomnia and relationship with anxiety in university students: A cross-sectional designed study. Plos ONE11(2).

Dragioti, E., Levin, L., Bernfort, L., Larsson, B., & Gerdle, B. (2017). Insomnia severity and its relationship with demographics, pain features, anxiety, and depression in older adults with and without pain: Cross‑sectional population‑based results from the PainS65+ cohort. Annals Of General Psychiatry, 16doi:10.1186/s12991-017-0137-3

Li, L., Wu, C., Gan, Y., Qu, X., & Lu, Z. (2016). Insomnia and the risk of depression: A meta-analysis of prospective cohort studies. BMC Psychiatry, 16

Townsend, D., Kazaglis, L., Savik, K., Smerud, A., & Iber, C. (2017). A brief tool to differentiate factors contributing to insomnia complaints. Health Psychology, 36(3), 291-297. doi:10.1037/hea0000442

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