It's been weeks, if not months, of restless sleep, and you've long abandoned counting sheep. It's time to confront the condition that's keeping you up at night.
The naturopath: Pamela Frank, Forces of Nature Wellness Clinic, Toronto
"Insomnia is associated with a state of hyperarousal. My patients often report an inability to ‘turn their brains off.' They stress over their lack of sleep, which only creates a vicious cycle. The condition can appear as difficulty falling asleep—referred to as sleep initiation insomnia—or not being able to go back to sleep after waking one or more times during the night, called sleep maintenance insomnia.
"Besides the obvious fatigue, a lack of sleep can decrease physical and mental functioning as well as lower vitality and increase cravings for carbs, caffeine and sugar; other major health consequences, like a poor response to insulin, can also appear. Before seeing a specialist, check your caffeine intake—no coffee, tea or chocolate after noon—and ensure that your bedroom is dark, cool and quiet. Sedentary work can leave you overly energized at the end of the day, so exercise can help—but working out late in the day can be too stimulating for some.
"After auditing your sleep habits and making room for healthy ones, consider certain natural medicines on the advice of your naturopathic doctor. Our pineal gland, located in the brain, naturally secretes melatonin when night falls, but you can take melatonin supplements for sleep initiation; grogginess and nightmares are, however, common side-effects. Valerian root, taken in tea, tincture or tablet form, is one of the best natural sedatives, while magnesium has a relaxing effect on the nervous system."
The psychiatrist: Dr. Atul Khullar, Northern Alberta Sleep Clinic, Edmonton
"Many people will cite insomnia when they've simply had a poor night's sleep or experienced symptoms of insomnia disorder, but insomnia is a clinical diagnosis of consistent sleep problems that interfere with daily functioning. Patients' biggest issues with the disorder include feelings of nonrestful sleep or daytime fatigue, anxiety, depression and pain.
"Women, people over 60 and people with severe stress or a medical or mental health condition are most at risk for having or developing insomnia. Someone with insomnia also has an increased risk for heart disease, high blood pressure, diabetes and possibly dementia. Before seeing your health-care professional, look into making simple changes to your sleep behaviours, such as slowly reducing caffeine and alcohol intake, keeping electronics out of the bedroom and keeping the room temperature at 18°C to 19°C. A health-care professional can then review your symptoms, medications and any medical conditions in order to make a clinical diagnosis.
"One mainstay treatment is cognitive behavioural therapy, a systematic process of changing sleep-interfering thoughts and actions on your own or with the help of a therapist. Medications for sleep should be used with caution and only after or with behavioural therapy. Avoid over-the-counter medications for sleep, as they can have dangerous effects, such as slowed thinking, confusion and the tendency to lose your balance. And use your bedroom only for sleep and intimacy."
What is insomnia?
The main difference between insomnia and a one-off poor night's sleep has to do with frequency and duration. Insomnia is defined by a difficulty falling asleep or staying asleep for at least three nights a week that lasts one month or longer. In addition to having trouble falling or staying asleep, someone with insomnia could experience such impairments as poor concentration, irritability, anxiety, headaches, mood changes and muscle pain throughout the day.
Insomnia can be either its own lifelong disorder—triggered by travel, a stressful life event or shift work—or be a symptom of a larger problem. Those larger issues causing restless nights and irritable days include the use of certain medications, depression, Alzheimer's disease or another sleep condition like sleep apnea or restless legs syndrome.
Listen up, ladies
Women are more likely than men to have insomnia; hormonal changes during the menstrual cycle and menopause can affect slumber. Anxiety, depression, fibromyalgia and restless legs syndrome (also more common in women) can cause this disorder, too.