Sleep is a basic human need. Sleep is not only related to our basic survival, sleep also affects memory, mood and other behavioural, cognitive and psychological states of everyday life.

 

Insomnia is often understood as difficulty in falling asleep. However, the inability to maintain a deep sleep, challenges in falling into a deep sleep, or lack of actual sleep to satisfy personal rest (due to a variety of personal factors) can also be regarded as insomnia.

 

Common symptoms of insomnia include:

  • Difficulty in falling asleep after going to bed with the lights turned off; it takes more than 30 minutes to fall asleep after tossing and turning.

  • Leaving the sleep phase in the middle of the night, waking up in the middle of the night, and having difficulty falling asleep after waking up.

  • Sleeping less than three sleep cycles or less than six to seven hours – as this causes insufficient rest to interfere with daily work life.

  • Feelings of exhaustion after waking up from sleep.

 

What is insomnia?

Insomnia fits under the category of psychological diseases. It is recommended to seek medical treatment if its symptoms affect the normal life of an individual. Insomnia can affect an individual’s work, learning, memory, as well as personality. If the symptoms of insomnia are due to external factors, such as construction, there is less need for concern. If symptoms persist, then it is still recommended to seek out a medical professional to better understand the condition.

The following four aspects outline some of the causes of insomnia:

1. Physiological:

Insomnia due to physical conditions such as neuralgia, chronic stomach problems, or endocrine factors.

Example #1: Maria recently had her period, which resulted in difficulty falling asleep for extended periods of time. This resulted in further endocrine disorders.

Example #2: Larry is active in his sleep, but suffers from waist pain, and wakes up painfully every time he turns over. Difficulty in obtaining quality sleep contributes to both mental and physical discomfort.

2. Cognitive and psychological status:

Insomnia disorder caused by mood, major events, anxiety, stress, anxiety, depression and other persistent mental factors (excessive focus on sleep can also cause insomnia).

 

Example: Michael is a new immigrant and has trouble staying asleep due to a combination of excitement and nervousness. As a result, his work efficiency is extremely low during the day; as soon as he lies on the bed, his brain is full of reflections of the workday which, in turn, trigger negative emotions and further affects his ability to sleep.

3. Environmental:

Chronic lack of quality sleep may be attributed to environmental factors such as sound and light.

4. Medications and personal habits:

Chronic lack of quality sleep due to mental stimulation from certain drugs/foods or decreased intracranial chemicals associated with sleep.

Example: Rachel has been drinking excessive amounts of coffee for several months; this has led to long-term difficulty in falling sleeping.

Example: Aaron enjoys drinking a few glasses of wine before going to bed. As a result, even though he easily falls asleep, his sleep stage is chaotic and his sleep quality is poor.

How to alleviate insomnia?

1. Find ways to reduce psychological pressures
  • Practice mindfulness activities such as meditation to promote relaxation and to divert one’s attention
  • Take a bath
  • Increase emotional connections with those around you
  • Avoid strenuous exercise three to four hours before bed
  • Go to bed and wake up at regular times, but avoid going to bed too early
 
2. Pay attention to the influence of environmental factors
  • Cut down on caffeine intake
  • Improve bedroom environment (temperature, lighting, sound, colour, etc).
  • Designate the bedroom for sleeping only; relocate other activities elsewhere
  • Avoid daytime naps
  • Avoid eating too much before bed

 

3. Seek professional psychological help

How family and friends can help:

  • Help eliminate psychological factors that interfere with sleep
  • Be mindful of and understand the abnormal emotions and behaviours caused by insomnia
  • Accompany and encourage improvement of sleep schedule
  • Observe the situation and recommend medical treatment

 

Sleep diary

Keeping a sleep diary can help medical professionals better understand the situation and provide suitable medical recommendations.

 

A sleep diary should include:

  • Information for sleeping length, duration, time, environment, and the number of times/reasons for waking up

  • Information collected for at least two consecutive weeks

 

Example:

Robert: January 1. Sleep as usual, master bedroom at home.

 

Last night: went to bed after bathing at about 23:48 and fell asleep after 5 minutes.

Morning: Got up at 07:14, got up once last night due to the sound of ambulance siren, don’t remember the time. In the morning, I still felt refreshed and relaxed.

 

Nap: 14:30–16:00, no wake up/interrupted sleep.
 


Insomnia self-examination:

  1. Pittsburgh sleep questionnaire (PSQI)
  2. Insomnia severity table (ISI)
  3. Fatigue severity inventory (FSS)
  4. Sleep beliefs table (DBAS)