As we all know, sleep is vital for our overall health and wellbeing. Yet at one point or another, we have all experienced the detrimental effects of a bad night’s sleep – perhaps catching yourself nodding off at your desk (been there!), unable to concentrate (done that!), suddenly finding everyone and everything a little irritating, or just not being quite as efficient as you’d like.
Insomnia is officially defined as ‘difficulty falling asleep, staying asleep, or both’, and is an increasingly common sleep problem for adults. The National Institutes of Health estimates more than 30% of the general population experience some sort of sleep disruption, and in the USA approximately 40 million adults experience insomnia annually.
Prolonged sleep deprivation can be hazardous to both your emotional and physical wellbeing. Here are some surprising facts about insomnia that you need to know, so you can better understand how to deal with the lack of Zzz's and finally get better sleep.
Women are more likely to experience insomnia then men.
A poll conducted by the National Sleep Foundation showed that 63% of women experienced symptoms of insomnia at least a few times a week compared to 54% of men.
Although more research is needed to define the root cause of this disparity, the hormonal fluctuation that women experience during the menstrual cycle, pregnancy and menopause is a likely culprit. Pregnant women, especially in the third trimester, are more likely to have disrupted sleep due to discomfort, leg cramps and the all-consuming need to use the bathroom more frequently. Additionally, because insomnia can be a secondary symptom of some medical conditions, conditions more common in women like depression, anxiety and fibromyalgia can contribute to this statistic.
Our increasing reliance on all things digital has triggered a surge in sleep disorders.
Insomnia is on the rise, certainly in the UK where a large scale, long term study showed a steady increase in insomnia over a 15-year period from 1993-2007. Conducted by researchers from a number of universities, the study also supported the fact that insomnia is more likely to affect women – so with an increasing array of technology at our fingertips, screens around every corner and our smartphones and tablets never far from our sides, are we inadvertently putting our wellbeing and ability to sleep at risk?
A poll conducted by Time/Qualcomm, specifically 4,700 participants in 7 countries, found that 68% of respondents place their mobile device next to their bed and that young people were more likely to say they ‘don’t sleep as well’ because ‘they are connected to technology all the time’.
Before artificial light, our day was dictated by the rising and setting of the sun, and our evenings were spent in (relative) darkness. Now our evenings are spent surrounded by light – television, e-readers, smartphones etc. However, all this light is sending our body’s biological clock, the circadian rhythm, completely haywire, resulting in worse sleep.
The circadian rhythm is controlled by a part of our brain called the SCN, located in the hypothalamus, that responds to light and dark signals. Light travels through our eyes via the optic nerve to the SCN, signalling the internal clock that it is time to be awake. Conversely, as light dwindles, the SCN signals the release of the hormone melatonin, which helps promote sleep, meaning light supresses the production of melatonin.
You may have heard that different types of light have different effects. Blue light, emitted from smartphones and tablets, has been found to be the most effective at suppressing melatonin, at least twice as long as green light. Red light has the least power to affect the circadian rhythm, so if you read at night, having a red light over your shoulder would certainly be beneficial!
Believe it or not, animals can suffer from insomnia too – though with surprising consequences.
Sleep is such a complex process influenced by a huge amount of internal and external environmental factors, and because problems with sleep can be attributed to specific personal problems, it can be hard to pin-point specific causes. As with most human diseases and disorders, a great deal of mechanistic information can be gleaned from observing and studying animal models – and an unlikely model candidate turned out to be fruit flies!
Researchers at the Washington University School of Medicine somehow managed develop an insomniac fly that naturally slept only 1 hour a day, compared to the normal 12 hours. In these flies they found evidence of cognitive impairment – they had a much more difficult time maintaining balance, were slow learners and also gained more fat.
The sleep-deprived fruit flies clearly suffered, but what was most surprising was that they also showed some resistance to the adverse effect of insomnia. Whereas going 70 hours without sleep would prove fatal to a normal fly, the insomniac flies could go without sleep for up to 240 hours and still survive!
Could lack of sleep be making you sick?
Over the last decade or so, continuing research has shown sleep disturbance to be a powerful influence on the risk of developing inflammatory disease, influencing the progression of major illnesses such as cardiovascular disease and cancer, as well as having a role in the development of depression.
Most people suffering from a cold or flu naturally want to curl up in bed and sleep. Luckily, this is not scientifically baseless as nocturnal sleep is shown to regulate aspects of your innate immune system, your body’s first line of defence against unwanted invaders. Throughout the night, both the activity and number of special, virus-fighting white blood cells called NK cells increases until late morning. Interestingly, in individuals who show sleep disturbances, this increase is lessened. Sleep deprivation has also been shown to impair other aspects of your immune system, like making vaccines less effective and could increase susceptibility to infectious disease.
Can insomnia be hereditary?
It is a question that many have asked themselves, and the answer could very well be, yes. There has been very little research into the genetic basis of insomnia, though now that is beginning to change and there is some evidence that you could have a predisposition to it.
Arousal (not what you think) can be equated to ‘wakefulness’, and plays a role in how well we are able to sleep. Arousal is ‘a state of responsiveness to sensory stimulation’, that is to say someone’s unconscious reactions to their environment. During the day a person’s level of arousal varies. We have all experienced that mid-afternoon slump, whilst others are annoyingly chipper – everyone is different. Too much arousal is associated with stress, and hyperarousal is a main factor in many cases of insomnia. The brain and body just do not wind down and switch off from daytime arousal, leaving it difficult to get to sleep.
Aside from hyperarousal, other factors that are associated with insomnia, such as nervousness and particular types of metabolism have all been shown to have a genetic component, and therefore be heritable. Also, a number of studies have shown that vulnerability to insomnia has a strong familial link, and that some genetic factors can influence insomnia symptoms in adults.
Of course, more research and large scale studies need to be done, although in the future it would be pretty useful to know if you are more at risk, therefore you can then go about trying to give yourself the best possible chance of a good night’s sleep. So even though we can’t definitively say ‘insomnia is heritable’, there is growing evidence to suggest that a number of factors that correlate with insomnia certainly have a genetic basis!
Can you die from insomnia?
The good news is no, not really. Although research into animals has suggested that going without sleep for extended periods of time can be fatal, there is no evidence in humans as to why going without sleep could prove fatal. There have been studies where humans have spent 8-10 days awake under observation, with no long lasting adverse effects. The longest scientifically reported period of time a human has gone without sleep is Randy Gardner in 1964, nodding off at 11 days and 24 minutes (264.4 hours). So unless you are planning on smashing Randy’s record, you will be perfectly safe!
However, a select group of the world’s population are not so lucky. Fatal Familial Insomnia (FFI) is a rare inherited disease (it belongs to the same class as Mad Cow Disease), the result of a specific genetic mutation, that damages the brain and nervous system leading to progressive neurodegeneration. FFI manifests in middle-aged people and if diagnosed, they will suffer increasingly severe insomnia, hallucinations, ataxia (the inability to coordinate movement) and symptoms consistent with dementia. Unfortunately, there is currently no cure or treatment to slow progression and FFI is usually fatal within 12-18 months of symptoms appearing. The mutation is only found in around 40 families worldwide, affecting about 100 people.
Alternative medicine can be the answer.
Sleeping pills and sleep aids used to be the go-to treatment for insomnia, though now they are only really prescribed for short-term treatment. They are not recommended as a long-term solution due to their possible side effects and the fact that they do not tackle the underlying cause of insomnia which can lead to dependency. As of 2010, nearly 9 million Americans were thought to take prescription sleep aids for various sleep disorders, even though they do have their uses in the short term if symptoms are particularly severe.
Short-term insomnia can usually be alleviated by lifestyle changes – making an effort to avoid caffeine and alcohol late at night, optimizing your bedtime routine and having a comfortable sleep environment. Relaxation and breathing exercises as well as meditation helps calm the body and induce sleep.
Because insomnia can be a result of other health issues like chronic pain, there is some evidence to suggest that things like acupuncture, used to complement other treatments, can improve sleep in those cases. The recommended treatment for chronic insomnia is Cognitive Behavioural Therapy (CBT). It has been shown to be just as effective as prescription medication in the short term, and possibly even long term. CBT is a therapy that combines behavioural changes (regular bedtime and wakeup, eliminating napping etc) with a talking component, aiming to change the patient’s negative thoughts and beliefs about sleep into positive ones. The advantages of this are long-lasting effects with no risk of negative side effects!
Insomnia is a complicated condition on the rise, but with more and more in depth research being conducted, we are beginning to understand more about it, and with that understanding comes better approaches to treatment!
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