Most adults need around eight hours of good, un-interrupted sleep per night as a cornerstone of good personal health, but plenty of people struggle to get enough Zs. Estimates say around a third of Americans suffer from at least brief symptoms of insomnia.
That leaves many people asking what causes insomnia.
“The better question is, what is insomnia,” said Dr. Lyle Victor, director of the Beaumont Sleep Center - Canton. “Almost everybody has a different answer to this question.”
Insomnia can have several characteristics:
- difficulty falling asleep
- waking up several times during the night
- waking up too early without being able to fall back asleep
- waking up feeling unrefreshed
To be diagnosed with insomnia, you must have daytime symptoms such as difficulty thinking or focusing, poor memory, fatigue, irritability, malaise or even depression, Dr. Victor said.
Two types of insomnia
Technically, there are two types of insomnia: Acute and chronic.
“Experts on sleep tend to say that insomnia is the perception of sleeping poorly, associated by a daytime consequence, and that it should last for at least three months to be considered a chronic problem,” Dr. Victor said.
Most people who complain of insomnia say they can’t fall or stay asleep and feel lousy the following day, he added.
By contrast, acute insomnia “may be associated with a transient life situation such as being fired from a job or a death in the family,” Dr. Victor said. It typically lasts less than three months, and resolves itself without treatment.
Chronic insomnia also occurs at least three nights per week. It can be caused by changes in one’s environment, unhealthy sleep habits, clinical disorders or certain medications.
Three other things about insomnia
Here are three more things you might not have known about the condition:
- Insomnia tends to be a long-term problem. It can last several years and persist in a cycle of improvements, remissions and relapses.
- There are various risk factors. For example, women are more than 40% more likely than men to suffer from difficulty sleeping. Socioeconomic factors such as crime, disorder and bright street lighting found in poor neighborhoods have also been associated with shorter and disrupted sleep. The elderly have higher rates of insomnia because they get less deep sleep and because their biological clocks are weaker. Insomnia can also be genetically inherited, though this area isn’t fully understood.
- There are many possible causes of insomnia, some of which may help explain it or determine whether the insomnia is acute or chronic. Grief over the loss of a spouse or a child, is one example. The loss of a job or stresses over a new job or school is another. Other possible causes include:
- relationship issues
- psychiatric problems
- irregular work hours
- a lack of a set sleep and wake-up schedule
- medications
- drug use
- drinking alcohol too close to bedtime
- staring at a screen too soon before bed
A disorder and symptom
Insomnia is also considered one of the most difficult conditions to treat, since it’s both a disorder and a symptom of other issues, so it can be difficult to make an accurate diagnosis of an underlying issue that is causing it. Oftentimes a medical condition can cause insomnia; common examples include pain, acid reflux, shortness of breath, nocturia - or frequent need to urinate at night - or anything that causes pain or discomfort. Insomnia is also common in people who experience a lot of stress, worry a lot or experience racing thoughts right before bed.
The good news is that insomnia is treatable - and that the occasional night of poor sleep doesn’t mean you’re an insomniac.
If you suffer a night or two of bad sleep, you don’t need to make up sleep hour-for-hour in order to feel well again. But if you keep losing an hour or two of sleep each night over time, you collect sleep debt, which must be paid off in the long term, lest you risk things like getting into car accidents.
You need about 20 minutes of uninterrupted sleep to get any benefits from that portion of sleep, Dr. Victor said. If your sleep is constantly interrupted, you’re probably not getting any benefits from it.