Difficulty sleeping at night
Most people have difficulty sleeping at some point in their life. If you have frequent difficulty sleeping, you may have chronic insomnia. Insomnia is associated with both night-time and day-time symptoms.
Night-time: difficulty falling asleep, waking up at night with difficulty returning to sleep, or disturbed and light sleep.
Day-time: feeling tired, sleepy, irritable
What are the causes of chronic insomnia?
Insomnia has many possible causes including:
Medical | Underlying medical condition can disturb sleep: chronic pain, nocturnal asthma, heart failure, hormonal changes associated with menopause. Medications used to treat these conditions can also disturb sleep. |
Psychiatric | Depression, anxiety and stress can be associated with sleep problems. People with insomnia are also at increased risk of developing a psychiatric problem. |
Sleep disorder | Sleep apnea, restless legs and other sleep problems can disturb sleep |
Lifestyle habits | Alcohol, caffeine and smoking close to bedtime, poor bedtime routine and other habits can disturb your sleep. |
Some people may be more prone to insomnia than others due to neuro-transmitter differences in their brain. Poor sleep can also become a habit over time.
Example
However if Arjun develops unhealthy habits, he is more likely to develop chronic insomnia
Arjun hears bad news about his father. The stress leads to difficulty sleeping for several nights. When the stress resolves, he should be able to sleep again.
However, if Arjun develops unhealthy habits (listed below), he is more likely to develop chronic insomnia.
Spends more time in bed
(to compensate for not sleeping) | Sleep will become very light |
Drinks alcohol to help him sleep | Alcohol will help him fall asleep, but will cause
night-time awakenings. |
Uses cellphone when he is not able to sleep | Cell phone emits blue light, which suppresses
melatonin (hormone required to fall asleep) |
Smokes when he cannot sleep | Nicotine in cigarettes is a stimulant |
Drinks excessive amounts of coffee, tea, soft drinks | These drinks contain caffeine, which
stimulate the brain |
Thinks and worries about sleep | This creates anxiety about sleep |
What are the health effects of chronic insomnia?
Studies show that insomnia has negative health effects. Poor sleep is associated with:
Stress, depression, anxiety
Poor attention and concentration leading to difficulty with decision making
Lower work and school productivity associated with increased absenteeism
Reduced interest in social activities and relationship problems.
Increased report of headaches, neck and back pain
Overall reduced quality of life.
What can I expect during my appointment with a sleep specialist?
When you visit us, we will evaluate your medical, psychological and sleep history. Questionnaires to assess your mood, sleepiness, possible snoring/ sleep apnea (PHQ9, ESS, STOP BANG) will be administered and you may be given a Sleep Diary to fill out.
Indication for sleep study
Your doctor may order a sleep study if they suspect an underlying sleep disorder such as sleep apnea.
What treatments are available to help me sleep better?
We will work with you to form an individualized plan that works best for you.
Counselling on good sleep habits (link to how can I get a good night of sleep)
Cognitive-Behavioral Therapy for insomnia (CBT-I)
Insomnia or difficulty sleeping at night, has many possible causes. Treatment includes both medication and behavioral therapies. CBT-I is an effective therapy for insomnia, and should be tried first before medication treatment.
CBT-I is a structured program that helps you identify and replace thoughts and behaviors that cause and worsen sleep, with habits that promote sound sleep. Unlike sleeping pills, CBT-I will help you overcome the behavior causing poor sleep, allowing you to sleep peacefully again.
Dr. Ramadevi Gourineni and her team are specialized in CBT-I and will individualize a treatment plan that works for you.
What are the causes of chronic insomnia?
Some people may be more prone to insomnia than others due to neuro-transmitter differences in their brain. Poor sleep can also become a habit over time.
Example
Arjun hears bad news about his father. The stress leads to difficulty sleeping for several nights. When the stress resolves, he should be able to sleep again.
What are the health effects of chronic insomnia?
Studies show that insomnia has negative health effects. Poor sleep is associated with:
Stress, depression, anxiety
Poor attention and concentration leading to difficulty with decision making
Lower work and school productivity associated with increased absenteeism
Reduced interest in social activities and relationship problems.
Increased report of headaches, neck and back pain
Overall reduced quality of life.
What can I expect during my appointment with a sleep specialist?
When you visit us, we will evaluate your medical, psychological and sleep history. Questionnaires to assess your mood, sleepiness, possible snoring/ sleep apnea (PHQ9, ESS, STOP BANG) will be administered and you may be given a Sleep Diary to fill out.
Indication for sleep study
Your doctor may order a sleep study if they suspect an underlying sleep disorder such as sleep apnea.
What treatments are available to help me sleep better?
We will work with you to form an individualized plan that works best for you.
Counselling on good sleep habits (link to how can I get a good night of sleep)
Cognitive-behavioral therapy (link to AMARA sleep services, CBT-I)
Medications
