Insomnia: Symptoms, Causes, Diagnosis, and Treatment

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Insomnia: Symptoms, Causes, Diagnosis, and Treatment
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Each night, as millions of people are peacefully sleeping, millions more can’t fall asleep or stay asleep. For an estimated 60 percent[1] of the adult population, an inability to sleep is just a now-and-then glitch. For about 15 percent of adults[2], however, insomnia is chronic and can affect their mood, daytime alertness, performance, mental well-being, and physical health. Insomnia is a sleep disorder that can make it hard to fall asleep, hard to stay asleep, or cause a person to wake up too early and not be able to get back to sleep. In acute insomnia, sleeplessness lasts for days or weeks and is usually tied to a temporary stressful situation. Insomnia is considered chronic if a person has trouble falling asleep or staying asleep at least three nights a week for a month or longer. What causes sleep to consistently elude millions of people around the globe? For many chronic insomnia sufferers, their inability to fall asleep or stay asleep is due to trauma to a part of the brain called the limbic system. While this might sound a bit alarming, this is actually good news, as it means that neuroplasticity can be harnessed to promote repair of the limbic system. When normal limbic system function is restored, so is a person’s ability to quickly and easily drift off into dreamland. In this article, we’ll be covering everything you need to know about insomnia, including how re-origin, a neuroplasticity-based treatment program, can help you retrain your brain to get the sleep you need to stay happy and healthy. Insomnia is also known as:
  • Chronic insomnia
  • Chronic insomnia disorder
  • Sleeplessness

Symptoms of Insomnia

Many people think that the term “insomnia” refers to a complete lack of sleep and while some sufferers may not be able to sleep for nights at a time, most people experience a combination of the following sleep problems and symptoms[3]:
  • Difficulty falling asleep at night
  • Waking up in the middle of the night and not being able to go back to sleep
  • Waking up too early and not being able to go back to sleep
  • Not feeling well-rested after a night’s sleep
  • Daytime tiredness or sleepiness
  • Irritability
  • Difficulty paying attention
  • Difficulty focusing on tasks
  • Difficulty remembering things
  • Increased errors or accidents
  • Ongoing worries about sleep
  • Depression
  • Anxiety
Over time, a chronic lack of sleep can increase the risk of more serious health problems[4], including:
  • Lowered immunity
  • Lowered sex drive
  • Obesity
  • High blood pressure
  • Kidney disease
  • Heart disease
  • Diabetes
Additionally, insomnia often co-occurs with other limbic system disorders[5], including general anxiety disorder, depression, chronic Lyme disease, fibromyalgia, post-viral fatigue, and multiple chemical sensitivities. While these conditions might seem unrelated at first glance, they all stem from brain circuitry that’s stuck in a fight-or-flight pattern, which can cause all sorts of wide-reaching symptoms and conditions.

Causes and Risk Factors of Insomnia

At its core, insomnia is the result of an impairment in a part of the brain called the limbic system. The limbic system[6] is a set of structures in the brain that help us detect and respond to threats to our safety. When the limbic system becomes overstimulated due to stress or trauma, it can become chronically activated or “turned on,” leading to a number of symptoms and conditions, including insomnia. The stress or trauma that leads to this impairment can be either mental or physical and usually includes a “perfect storm” of stressful events. For example, getting in a car accident while attending graduate school and then coming down with a viral infection. The stressors essentially overwhelm the brain, changing the circuitry in the limbic system[7]. When the limbic system becomes impaired in this way, its protective mechanisms fire more rapidly and inappropriately. It continuously sends out alarm signals making the sufferer feel like something is always wrong, even when there is truly no danger. Being in a chronic state of fight-or-flight can make getting good sleep extremely challenging. On top of that, there are all of the habits that come along with not getting adequate sleep—compulsively looking at the clock, worrying about not getting to sleep[8], trying to “force” oneself to sleep. These habits lead to further hyperarousal, which naturally, causes more insomnia. Ultimately, sufferers get stuck in a chronic loop[9] of anxiety-insomnia-anxiety. Soon, just the sight of their bed, the mention of the word “sleep,” or the tick of the clock toward 10:00 pm can trigger anxiety and render a person wide awake. someone more likely to develop insomnia:
  • Having a high chronic stress load
  • Experiencing traumatic or stressful life events (contracting a virus, getting in an accident, experiencing an emotional event, childbirth, etc.)
  • Experiencing traumas or stressful events in close succession
  • Poor sleep habits (irregular bedtime schedule, stimulating activities before bed, an uncomfortable sleep environment, etc.)
  • Having a mental health disorder or physical health condition
  • Substance abuse

How Insomnia is Diagnosed

To diagnose insomnia, a doctor will perform a physical exam, ask about your symptoms and sleep habits, and recommend blood tests, which helps them determine if another condition may be causing your symptoms.

If the cause of your insomnia isn’t clear, a sleep study may be ordered. This entails spending the night at a sleep center where tests are done to monitor and record a variety of body activities while you sleep, including brain waves, breathing, heartbeat, eye movements, and body movements.

How Insomnia is Treated

A significant amount of research has been conducted to find ways to help individuals who suffer from insomnia. However, many people find that treatments don’t “stick” unless they address the underlying limbic system dysfunction first. Before delving into how re-origin can help from a neuroplasticity perspective, let’s review the most common, traditional treatment methods for insomnia[10]:

Cognitive Behavioral Therapy (CBT)

CBT is a type of talk therapy that is commonly used to help those with insomnia. The cognitive part of CBT teaches sufferers to recognize and change thoughts and beliefs that affect their ability to sleep, while the behavioral part of CBT helps people develop good sleep habits and avoid behaviors that keep them from sleeping well. Some behavioral strategies may include maintaining a consistent sleep schedule, practicing relaxation techniques, and avoiding caffeine and alcohol in the evening.

The process of overcoming insomnia through CBT often takes several months of weekly visits to a therapist. While CBT is helpful for many insomnia sufferers, it can be quite expensive, which is a drawback for patients seeking treatment.

Prescription medications

Prescription sleep medications, such as Ambien or Lunesta, can help insomnia sufferers fall asleep and stay asleep. However, doctors don’t recommend relying on prescription medication for more than a few weeks, as there is a risk for dependence. Sleeping pills can also have many side effects, such as causing daytime grogginess and increased risk of accidents. Sometimes, other types of drugs such as antidepressants, anti-anxiety medications, and antipsychotics, are prescribed “off label” to help with insomnia. These drugs also come with side effects and can be difficult to discontinue. While medications may offer a short-term solution, they don’t permanently repair the root neurological cause of insomnia. A person may sleep better when they’re on medication, however, insomnia tends to immediately come back when the person discontinues the medication.

Over-the-counter sleep aids

A number of non-prescription sleep medications are available over the counter. These drugs typically contain antihistamines, which can make you drowsy, however, they’re not intended for regular use. Over-the-counter drugs can also cause side effects, such as daytime drowsiness, dizziness, confusion, cognitive decline, and difficulty urinating. As with prescription medications, over-the-counter drugs are only a temporary fix and don’t address the root neurological cause of insomnia.

Natural remedies

In an effort to get some sleep, many people turn to natural remedies in lieu of or in addition to more mainstream treatments. These may include:
  • Natural supplements, such as melatonin, magnesium, valerian root, lemon balm, and chamomile
  • Aromatherapy
  • Yoga
  • Massage
  • Meditation
While these natural practices may help calm your nervous system to a certain extent, they are typically not able to fully repair an impaired limbic system and resolve insomnia.

How re-origin Approaches Insomnia

Insomnia occurs when the limbic system becomes traumatized due to experiencing physical or emotional trauma. In this impaired state, the limbic system repeatedly sends out inappropriate alarm signals to warn of danger, leading to many potential symptoms, including insomnia, anxiety, and depression.

The good news is that your restless, sleepless nights can be eliminated (or at the very least, greatly reduced to just the occasional night of fitful sleep). At re-origin, we focus on addressing the underlying cause of insomnia: a dysfunctional limbic system. The goal of re-origin’s program is to calm the overactive fight-or-flight response and interrupt the faulty neural pathways in the brain that are perpetuating your symptoms.

Using specific neurocognitive exercises, you can get your brain out of “emergency mode” and back to a place of safety, balance, and calm. Once you have retrained your hyperactive, traumatized brain, your inability to fall asleep or stay asleep will naturally resolve.

re-origin’s approach does not chase or mask symptoms, but rather works to rewire the part of the brain that is causing the dysfunction, resulting in long-lasting recovery. The program is easy to follow, self-directed, cost-effective, and takes just minutes a day to implement.

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How to Live and Cope with Insomnia

Living with insomnia is brutal—but thankfully you don’t have to. At re-origin, we want to help you recover from insomnia, eliminating the need for coping mechanisms altogether.

Our program involves applying an easy-to-follow, five-step neurocognitive technique to calm the sympathetic nervous system, rewire faulty conditioning in the brain, and create new, functional neural pathways. The key to overcoming insomnia lies in systematically applying our techniques and being persistent and consistent in your efforts. With dedication, repetition, and a good dose of patience, you can change your brain and consequently, your ability to get restful sleep.

Frequently Asked Questions

Below are answers to some of the most commonly asked questions about insomnia:

Insomnia can be either acute (occurring for less than one month) or chronic (occurring for more than one month). Additionally, there are informal terms used by researchers[11] to better categorize and analyze the different ways insomnia can be experienced. These terms include:

  • Sleep onset insomnia: Difficulty falling asleep at the beginning of the night
  • Sleep maintenance insomnia: An inability to stay asleep through the night
  • Early morning awakening insomnia: Waking up well before a person wants to or plans to wake up in the morning
  • Mixed insomnia: A combination of problems related to sleep onset, sleep maintenance, and early morning awakenings
  • Comorbid insomnia: Insomnia that is believed to arise as a result of another condition, such as physical pain, GERD, sleep apnea, or anxiety
Adults need seven or more hours of sleep per night[12]. While it may not be possible to know exactly how much sleep you’re getting, you can tell if you’re getting enough good quality sleep based on how you feel. If you wake up feeling unrested, experience daytime sleepiness, or notice you’re making more mistakes due to fatigue, you’re likely not getting enough high-quality sleep. If you’re experiencing these symptoms, it’s recommended that you visit your doctor for an evaluation to rule out an underlying cause that needs medical attention.
Absolutely! Freeing yourself from the grip of chronic insomnia takes some time and effort, but it’s entirely possible (and even likely) when you have the right knowledge and tools. With the guidance of re-origin, you can calm your overactive nervous system and rewire neural pathways in your brain that are causing and perpetuating your sleepless nights.

A Final Word from re-origin

Anyone that struggles with insomnia knows how much it can impact a person’s life. Sleep is an essential function that allows our bodies and minds to rejuvenate and repair. Without adequate sleep, people can experience a number of mental and physical health issues. Plus, everything just feels harder—like you’re wading through mud. Thankfully, you can use the principles of neuroplasticity to interrupt the overactive threat detection and response mechanism in your limbic system that’s causing your sleep disturbances. With re-origin’s proprietary, neurocognitive exercises, you’ll essentially be communicating to your brain, “Everything is okay. You can let go and relax now. It’s safe to fall asleep,” in a language it understands. With persistence, patience, dedication, and time, you can repair your impaired limbic system, change your neural pathways, and get the deep, restorative sleep you need and deserve. You can learn more about our program with a free trial at re-origin.com/neuroplasticity-training-program/

References

  1. Bhaskar, S., Hemavathy, D., & Prasad, S. (2016). Prevalence of chronic insomnia in adult patients and its correlation with medical comorbidities. Journal of family medicine and primary care, 5(4), 780–784. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5353813/
  2. https://my.clevelandclinic.org/health/diseases/12119-insomnia
  3. https://www.mayoclinic.org/diseases-conditions/insomnia/symptoms-causes/syc-20355167
  4. https://www.nhlbi.nih.gov/health-topics/sleep-deprivation-and-deficiency
  5. Reddy, M. S., & Chakrabarty, A. (2011). “Comorbid” insomnia. Indian journal of psychological medicine, 33(1), 1–4. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195148/
  6. Rajmohan, V., & Mohandas, E. (2007). The limbic system. Indian journal of psychiatry, 49(2), 132–139. Availbale From: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2917081/
  7. Perlis, M., Gehrman, P., Pigeon, W. R., Findley, J., & Drummond, S. (2009). Neurobiologic Mechanisms in Chronic Insomnia. Sleep Medicine Clinics, 4(4), 549–558. Available From: https://www.med.upenn.edu/cbti/assets/user-content/documents/NeurobioinChronicInsomniaInvitedArticle-LichstienEditor.pdf
  8. Kales, A., Caldwell, A. B., Preston, T. A., Healey, S., & Kales, J. D. (1976). Personality Patterns in Insomnia. Archives of General Psychiatry, 33(9), 1128–1134.
  9. Basta, M., Chrousos, G. P., Vela-Bueno, A., & Vgontzas, A. N. (2007). CHRONIC INSOMNIA AND STRESS SYSTEM. Sleep medicine clinics, 2(2), 279–291. Available From: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2128619/
  10. https://www.mayoclinic.org/diseases-conditions/insomnia/diagnosis-treatment/drc-20355173
  11. Bjorøy, I., Jørgensen, V. A., Pallesen, S., & Bjorvatn, B. (2020). The Prevalence of Insomnia Subtypes in Relation to Demographic Characteristics, Anxiety, Depression, Alcohol Consumption and Use of Hypnotics. Frontiers in psychology, 11, 527.
  12. Watson, N. F., Badr, M. S., Belenky, G., Bliwise, D. L., Buxton, O. M., Buysse, D., Dinges, D. F., Gangwisch, J., Grandner, M. A., Kushida, C., Malhotra, R. K., Martin, J. L., Patel, S. R., Quan, S. F., & Tasali, E. (2015). Recommended Amount of Sleep for a Healthy Adult: A Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep, 38(6), 843–844. Available From: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4434546/