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Insomnia is well-known in popular culture as the maddening inability to fall asleep when you really want to.

It is also a serious medical condition with a variety of causes and an even wider array of possible treatments. In every case, the sense of desperation associated with insomnia only worsens the condition, as sleep deprivation creates a frustrating spiral of symptoms and associated issues.

But, really, how serious is insomnia? And it’s serious, what can you do about it? Here’s everything you need to know.

What is Insomnia?

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Insomnia is defined as a difficulty falling asleep or staying asleep, even when a person is exhausted and has otherwise good sleep conditions. Insomnia often leads to dissatisfaction with sleep, even if it does not involve the cinematic example of someone tossing and turning and watching the clock tick through the whole night. Insomnia leads to intense daytime side effects including fatigue, lack of energy, difficulty concentrating, mood shifts, and decreased quantitative performance in professional or academic environments.

Insomnia is often situational, which is known as acute insomnia. This falls under the category of that ‘Christmas Eve feeling’ that kids get when their excitement about gifts prevents them from sleeping, or the more difficult sensation of not being able to sleep before a stressful exam, early morning flight, or major life event.

Drinking too much caffeine may also contribute to insomnia. Many people experience this type of temporary insomnia, and it tends to resolve as soon as the event they are anxious or excited about passes, or within a few days after they relax and their natural exhaustion leads to sleep.

Chronic insomnia is a more severe sleep disruption, defined as occurring three or more nights per week and lasting at least three months. Chronic insomnia may still be caused by specific external factors like changes in an indoor or outdoor environment, bad ‘sleep hygiene’ (ie: screen time in bed, bright lights, stressful content, or other visual and auditory stimuli close to bedtime), working an erratic schedule, and long-term situational stressors.

It is also often caused by more serious, insidious factors like clinical disorders, medications, or unknown psychological factors that contribute to poor sleep quality. People who suffer from chronic insomnia, regardless of the cause, can benefit from a number of potential treatment strategies from routines to counseling to medication.

Recognizing Insomnia Causes

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One of the most important factors in treating insomnia is evaluating and recognizing the causes behind it. Even the most powerful sleep medications may not effectively treat schedule or sleep hygiene based insomnia, even if they temporarily induce a deep, medicated sleep.

Similarly, great sleep hygiene practices do not always lead to restful sleep for those suffering from medical conditions or side-effect-induced insomnia.

Recognizing the cause of your insomnia is the first step to seeking effective treatment. It is important to pause and consider recent changes in lifestyle or setting--a recent move, change in job or shift time, upcoming life event, or even binge-watching a TV show in the evening can disrupt your body’s normalized sleep patterns and circadian rhythm.

If no obvious situational factor has changed, then it is time to consider deeper medical or psychological factors that can contribute to insomnia. As with many mental illnesses, there is an unclear cause-and-effect relationship; anxiety, stress, and depression can all lead to insomnia, but poor sleep can also contribute to those conditions.

Similarly, external factors can lead to anxiety, stress, depression, or insomnia, thus creating a cycle where it is difficult to parse out root causes and treat them appropriately. For this reason, professionals often recommend a holistic approach to treating insomnia.

Insomnia Treatments

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It is tempting to beg for a bottle of Ambien as soon as you feel tired for more than a few days, but pills are limited in their scope and may not treat root causes of insomnia, which can leave you feeling more profoundly drained even if you technically sleep for the recommended seven-to-nine hours per night.

Medical professionals across disciplines often recommend starting with situational treatments and cognitive behavioral changes to address root causes of insomnia before resorting to pills for temporary relief.

The primary methods of treating insomnia revolve around the humorous-sounding term sleep hygiene. While this sounds like a strange malaprop, it is a serious term that refers to conditions surrounding sleeping. While common sense suggests that bright lights and loud noises are not beneficial for sleep, science backs this up on a level that identifies poor sleep hygiene as a serious cause of insomnia.

In 2018, most people admit that looking at their smartphones is the last thing they do before going to sleep and the first thing that they do when they wake up. This is counterproductive on several levels, from the garish blue glow that interrupts our melatonin production and circadian rhythm to the psychological addictive factors that most apps are designed around.

Sleep hygiene even encompasses daytime habits like alcohol and caffeine consumption, not getting enough exercise or getting too much vigorous exercise too close to bedtime, and other disruptive practices that do not set your body up for sound sleeping.

Disruptive noises, flashing lights, and other environmental factors can prevent or interrupt sleep, which is why covering bright light sources or windows is a natural human inclination, and why sound machines are popular, especially in places where irregular, surprising noises are common. Even ambient temperature can play a large role in quality of sleep.

For people who suffer from chronic insomnia and begin to spiral into concern and profound restlessness, more serious behavioral treatment like intentional sleep restriction, mindfulness meditation, and passive awakeness (part of the paradoxical intention school of psychology) can help.

All of these are medically-recommended practices that are aimed at eliminating the dramatic ‘laying in bed staring at the clock on the wall all night’ style of insomnia, either by removing an insomniac person from bed when sleep is unlikely or by creating alternatives to insomniac fixations, which worsen insomnia when a person focuses on the fact that they cannot sleep.

When psychological treatments prove ineffective, even under medical professional guidance, medications are an option for people whose insomnia is becoming detrimental to their health. The problem with these medications is that they are not recommended for long term use, have serious side effects for people who may need to wake up in the middle of the night, and are relatively powerful medications that are simply not suitable for everyone. While sleeping pills can provide relief for chronic insomnia, they should be used as part of a holistic regimen that focuses on returning to healthy, restful sleep, rather than a nightly crutch that ignores root causes of insomnia and associated conditions.

Your Sleep Matters

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If you’re struggling with insomnia, don’t take it lightly. The inability to sleep affects everything from your mood to your productivity to your ability to drive effectively. Begin with seeking natural treatments to your insomnia, such as improving sleep hygiene. If that fails to help, consider vitamins or supplements, such as melatonin or valerian root.

If all else fails, visit your doctor. They may be able to help you determine the root cause of your insomnia, as well as treat it in a medically safe method.

Whatever the case, your sleep matters. Don’t neglect it.

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