Insomnia: causes and treatments

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Extract from the article: While stress and anxiety are the best-known and most common risk factors for insomnia, other ailments and unsuspected everyday situations can also be the cause of this sleep disorde

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While stress and anxiety are the best-known and most common risk factors for insomnia, other ailments and unsuspected everyday situations can also be the cause of this sleep disorder.

In Togo and throughout the world, a significant proportion of the population suffers from insomnia. To the average person, insomnia means not sleeping properly, even if it's only for a night or two. The idea of the insomniac who doesn't sleep a wink at night is wrong: many people, as soon as they haven't slept an hour or two, claim that they haven't slept all night. But in fact, this is extremely rare. In such cases, it's more a question of occasional or transitory insomnia.

What is insomnia, in the pathological sense of the term?

It's a persistent difficulty in sleeping for at least four consecutive weeks and a majority of nights a week. This is known as chronic insomnia. There is insomnia at the start of the night, when it is difficult and late to fall asleep; insomnia in the middle of the night, when people wake up frequently and for more than 20 minutes; and insomnia at the end of the night, when people wake up much earlier than usual. Then, overall, the fact that sleep is not restorative.

Whether short or long term, insomnia is in the vast majority of cases caused by stress and anxiety. This is the most common cause. It results in difficulty falling asleep and/or multiple night-time awakenings. By definition, stress hormones are wakeful, but they continue to be so in the evening and at night when they should no longer be working. However, there are many causes of insomnia, some of which are often unsuspected, and which have their origins in a healthy lifestyle.

Too much light and noise in the evening

You should turn off all screens: television, smartphone, tablet, computer at least 1? to 2 hours before your bedtime, depending on your biological clock. The cause: the blue light they emit. Blue light blocks the secretion of melatonin, the sleep hormone normally produced by the brain in the evening. It will therefore be produced more slowly if you look at screens in the evening.

Noise in the bedroom is also a source of insomnia to which attention should be paid: it's a very common problem, especially in cities, and chronically impairs sleep quality. So pay attention to the noise environment in your home and neighbourhood.

Sleep apnoea

Sleep apnoea is often ignored for a long time. At first, they can make you feel like you're having a sleepless night. It is a disease characterised by frequent pauses in breathing during sleep.

This condition is dangerous if left undiagnosed and untreated. In the long term, sleep apnoea has been shown to increase the risk of cardiovascular disease and death.

Doing sport after 4pm

The effects of evening sport on sleep are controversial. While some claim that it helps you sleep better, others think the opposite: playing sport or engaging in fairly intense physical activity has the effect of heating up the body. In order to fall asleep, you need your body temperature to drop. What's more, it excites the brain, which can cause a delay in falling asleep. So sport is good, but to reap its full benefits, it should be avoided after 4pm. However, you should be aware of your body and how it reacts to sport after these hours.

An overheated bedroom

It can be tempting to overheat your bedroom to feel like you're in a cocoon. But your sleep could suffer as a result, particularly as breathing could be impaired: because we have temperature sensors in our nasal cavities, we recommend that the air we breathe in the bedroom should be between 18 and 25°C, with sufficient humidity. Air that is too dry, too cold or too hot can damage your health.

In addition, the bedroom should be well ventilated, whatever the day of the year, by opening the windows for ten minutes before going to bed, to renew the air. This is because indoor pollution and unpleasant odours from household products, air fresheners and so on can really affect the quality of your night's sleep.

A heavy meal eaten too late in the evening

The hectic pace of life can lead us to eat our evening meal too late, and also to adopt unhealthy eating habits. A heavy evening meal eaten too late can have a detrimental effect on sleep quality. In the evening, the meal should be finished at least 1? to 2 hours before bedtime, to allow time for digestion. And you should eat lightly, as fat delays digestion.

Foods to avoid before going to bed include meat and sugars with a high glycaemic index (GI), which have an exciting effect. Alcohol also makes you drowsy and disrupts your sleep cycles. On the other hand, starchy foods, which provide slow sugars (low GI sugars) and legumes should be favoured: they promote the secretion of melatonin, making it easier to fall asleep and ensuring a peaceful night's sleep.

Other causes

Insomnia can be caused by certain organic illnesses, such as hyperthyroidism, restless legs syndrome or nocturnal asthma. Mental health disorders, too, such as chronic stress and anxiety.

Insomnia anxiety

Whatever the cause of this sleep disorder, it is insomnia anxiety that becomes the main source. In other words, if you've had a bad night or two, with nocturnal awakenings, you go to bed fearing that it will happen again. Before going to sleep, change to a positive frame of mind.

The risks associated with insomnia are ‘major’: the brain works much harder at night than during the day. During sleep, it regulates hormonal secretions and the immune system rebuilds itself. So, in the short term, insomnia can make us more vulnerable to viruses. In the long term, we are more vulnerable to hypertension, overweight, diabetes, cardiovascular disease, metabolic problems, autoimmune diseases such as skin diseases, endocrine diseases and cancer.

Another function that is regenerated during sleep: the psychological and emotional. Insomnia leads to anxiety and irritability. This becomes a vicious circle: we become more vulnerable to stress, but stress is a factor in insomnia. Poorly managed sleep can also lead to concentration difficulties and memory problems.

Treatment depends on the cause

The treatment of insomnia depends on its cause. While the problem can be corrected fairly quickly by following the healthy lifestyle rules mentioned above, things become more complex when it is accompanied by stress and anxiety. This calls for a psychotherapeutic approach, to provide effective stress management tools. Above all, avoid taking psychotropic drugs, including anxiolytics, sleeping pills and antidepressants: stress should not be treated primarily with medication.

William O.

Article validated by Dr Jean-Claude Bakpatina, General Practitioner at the Floreal Clinic in Lomé.