An Overview of Insomnia
Insomnia is a prevalent sleep disorder affecting millions of adults in America. It makes falling or staying asleep difficult, can cause early wakings, and decrease quality of life.
Everyone is different, but most adults need between 7 to 9 hours of sleep a night for optimal functioning.
Many people experience small windows of acute insomnia, which is insomnia that lasts three months or less. It is usually caused by a traumatic event or life-changing experience. For example, starting a new job or the death of a loved one. But this type of insomnia usually only lasts for a couple of weeks and wears off on its own.
However, wome people experience insomnia for longer than three months. These people are said to be suffering from chronic insomnia. Insomnia may be the primary issue, or it could be related to another issue like an underlying medical condition or medication you are taking.
General symptoms of insomnia include:
- Difficulty falling asleep at night
- Waking up during the night when you should still be sleeping
- Waking up too early in the morning
- Not feeling rested after sleeping
- Being tired in the day
- Irritability
- Depression
- Anxiety
- Difficulting remembering things or paying attention
- Increased errors or accidents
- Worrying about falling asleep
If you notice these types of symptoms, you may be experiencing some type of insomnia. Now may be a good time to speak with a health care professional who can help you with your situation. They may be able to help you identify the exact type of sleep disorder you have as there are a few different types of insomnia.
For example, you may have psychophysiological insomnia and need specific treatment to alleviate your symptoms.
What Is Psychophysiological Insomnia?
Psychophysiological insomnia is a form of chronic insomnia that is thought to be caused by two different factors. They are psychological and physiological factors.
Psychological factors are ones that are behavioral and cognitive. That means they are created in the mind. Physiological ones are ones that are caused in the body. Together these factors create a state of increased arousal and sleep-preventing associations that result in insomnia.
One unique point about this type of insomnia is that it is the frequent worry about the inability to sleep that keeps patients up at night. It usually develops while patients are experiencing periods of stress. Anxious thoughts may keep them awake and after several nights, they may begin to develop a concern that they cannot sleep.
Soon, their normal bedtime routine only brings on stress that they will not be able to fall asleep. The added stress increases the arousal in the mind and body and keeps them from falling asleep. Many people who suffer from this type of insomnia report experiencing racing thoughts. They develop into a cycle that makes sleep more and more difficult despite the effort put in.
As they try to quiet their mind and fall asleep, they may begin to feel more stressed and frustrated that sleep isn’t coming. This leads to more agitation that keeps the body alert and less able to initiate sleep. The result of this scenario is that the sleep environment (aka your bedroom) loses its ability to help stimulate sleep.
This then results in persons who are able to fall asleep easier in places away from their bedroom or usual sleep environment. Someone with this sleep disorder may find that they can easily fall asleep reading on the couch but when they move to their bedroom they are unable to fall back asleep.
These symptoms can lead to a decrease in overall wellness, which can lead to decreased mood and happiness. Impairment in attention, decreased motivation, and increased fatigue are also common symptoms of this type of insomnia. If left untreated, this type of insomnia can persist for years and even decades.
There are specific criteria that identify cases of psychophysiological insomnia.
First, someone must be experiencing difficulty falling asleep or staying asleep. They may also wake up too early. Or, they may sleep but wake up without feeling rested on a regular basis. Their sleep difficulty must happen despite there being enough time for proper rest and sleep.
Insomnia must last for at least one month. And the person suffering from it must have evidence that they have been having difficulty sleeping or having extra mental arousal in bed that prevents them from falling asleep.
Evidence can include having excessive focus in bed, but not at times when not intending to fall asleep. The ability to sleep better away from home, or having intrusive thoughts in bed that make it hard to relax enough to fall asleep can also serve as evidence that the person is experiencing trouble with sleeping when and where they should be.
And lastly, to meet the criteria for psychophysiological insomnia, the sleep disturbance must not be better explained by another sleep disorder, medication, or other factors.
How Can You Recognize Psychophysiological Insomnia?
It can be difficult to identify psychophysiological insomnia on your own. Different types of insomnia are similar in symptoms and people can often have overlapping sleep disorders.
However, there are some red flags you can watch out for.
The onset of psychophysiological insomnia occurs in adulthood. However, many people who are diagnosed often report having sleep issues early on, even in childhood. It is common for those who suffer from insomnia to identify as light sleepers in general.
It may persist for months or years, and build in intensity. This type of insomnia is thought to increase in severity with time. It does not need to occur every night though. If you experience trouble sleeping at least three nights a week then you may be experiencing this type of sleep disorder.
It is common for those with psychophysiological insomnia to feel like they have lost their motivation and have no energy. You may also experience feelings like depression.
Fatigue and malaise are common experiences, but they are not accompanied by daytime napping. Instead, patients often report difficulty with falling asleep for a daytime nap as well as trouble falling asleep at night time.
People may also experience symptoms like tension headaches or cold hands and feet. They can fall asleep in random instances where there is no effort, like when watching television or reading a book.
What Are the Risks of Physiological Insomnia?
Proper sleep is crucial for overall health and well-being. Not getting enough rest can decrease a person’s ability to function throughout the day properly. It can cause safety concerns and minimize the quality of life.
There is a risk of serious injury or death if you operate any type of machinery or drive during the day. There are about 100,000 police-reported drowsy-driving accidents every single year. This is because being tired reduces reaction times, awareness, and attention span.
Having this sleep condition also significantly increases the risk of someone having an episode of depression.
And, there is the risk of developing a dependence on prescription sleep aids or over-using nonprescription ones. Many patients who have chronic insomnia develop a condition called paradoxical worsening of insomnia. This can occur weeks or months after starting a benzodiazepine or barbiturate.
The worsening occurs because tolerance has developed and the initial dosage is in effect, too low. Or it may be because the patient tries to stop medication thinking they no longer need it and see an increase in symptoms as a result.
The best way to avoid risks is to talk to your doctor about your sleep condition. They may be able to help identify your condition and decide on the best treatment. They may also refer you to a sleep specialist who can assess your condition and discuss possible options with you.
How Do You Treat Psychophysiological Insomnia?
There is a general treatment approach to insomnia regardless of the type of insomnia. So far, there is no evidence that any type of insomnia responds better to any one type of treatment.
Usually, more than one type of treatment is attempted to make a positive impact on the person’s sleep.
Cognitive Behavioral Approaches to Treatment
Sleep experts may recommend a multicomponent behavioral therapy to treat insomnia. It is referred to as CBT-1. This treatment usually contains three core treatments ordered according to priority. They are stimulus control, sleep restriction, and sleep hygiene therapies.
An interesting point is that formal cognitive therapy is not usually part of CBT-1 interventions for insomnia patients.
Stimulus control therapy is designed to restrict the activities that are done in the bedroom and especially on the bed. The only behaviors that should be carried out in the bed are sleep and sex. The time spent awake in bed should be limited as well. When you wake up you should move from the bed and out of the bedroom to get the day started in a new environment. That way your brain is wired to associate your bed with sleep and nothing else.
Sleep restriction therapy sets limits for patients regarding how much time they can spend in bed. They are supposed to limit their bedtime to the average amount of sleep time they experience. Over time their total sleep time should increase incrementally.
Sleep hygiene therapy is an intervention where clinicians and patients discuss what good sleep habits are and discuss how patients can practice them. Sleep hygiene instructions have not proven to be effective when provided alone.
Pharmacologic Treatment Approaches
There are four main ways pharmaceuticals are used to attempt to treat insomnia. The first is with sedative-hypnotics. This includes the use of barbituates, benzodiazepines, and benzodiazepines receptor agonists.
The second approach includes the use of melatonin agonists. Melatonin receptors are thought to be involved in the regulation of sleep and the circadian rhythm. So using melatonin and compounds that bind to melatonin receptors is believed to make an impact on reducing sleep latency and increasing overall sleep time.
The third method is to try low-dose doxepin. This compound was originally developed and marketed as an antidepressant. But it is thought to have reduced risk for tolerance and side effects.
The last approach to treating insomnia through prescription medications is to use other off-label approaches and take medications like antidepressants and antipsychotics.
There is limited data about the efficacy of all of these pharmacologic approaches. What data does exist does not suggest that any one method of treatment has a better or safer profile than the sedative-hypnotics.
CBD for Psychophysiological Insomnia
One alternative you can try to help with insomnia is a CBD supplement.
CBD is a cannabinoid that comes from cannabis. It is found in high concentrations of hemp. Since hemp is legal after the passing of the 2018 Farm Bill and Controlled Substances Act, CBD is legal to sell throughout the country.
It is significantly different from THC, the other well-known cannabinoid found in cannabis. THC is responsible for making people feel high, but CBD comes with absolutely no intoxicating effects.
What it does have are powerful therapeutic effects. They are why many consider it to be a safe and effective way to find help with many conditions, including sleep disorders.
It works in the body to create feelings of calmness and relaxation that many report as being helpful for falling asleep. Studies show that it also helps with things like inflammation and pain management, which may be comorbid conditions that worsen insomnia.
Taking CBD to relax and balance your body about an hour or two before you want to fall asleep may help you find enough peace of mind to fall asleep when your thoughts usually start racing.
If you are looking for a quality CBD product to help you find some shut eye, we recommend trying our CBD gummies for sleep or our Mellow Mint CBD oil for sleep. They are specially formulated with melatonin to achieve maximum relaxation.
Also, read our Lab results that show exactly what is in each of them. That way you can be confident you are buying a product that is quality and effective.