Insomnia is not just an annoyance. It can have serious effects on your health.

The first time Erika Zar saw a doctor for her inability to sleep or insomnia, she was 9 years old. “Mostly I remember him asking questions about how much soda she drank,” she said. Unfortunately, the doctor was unable to help her. Zar’s insomnia followed her into adulthood, worsening her mental health issues along the way.

“For many years before I learned how to manage it, insomnia was definitely a contributing factor to my lifelong anxiety and depression,” Zar said. “I remember many dark nights feeling almost suicidal.”

Insomnia can affect physical and mental well-being, worsen existing health problems, and increase the risk of chronic diseases in the future. And it can also affect your ability to function during the day. Fortunately, there are things you can do to get more and better sleep.

Sleep disorders, including insomnia, affect millions

Sleep disorders, which are any condition that causes a change in the way you sleep, affect an estimated 70 million Americans. While there are more than 80 types of sleep disorders, the most common are insomnia, sleep apnea, restless legs syndrome, and narcolepsy.

Insomnia can be grouped into two types: acute and chronic. Acute insomnia is a short-term problem that lasts days to weeks and is often accompanied by a specific stressor: a worry that keeps you awake at night.

Chronic insomnia is a long-term condition, lasting for months or more. Like acute insomnia, it can be linked to stressful situations, said Dr. Smita Patel, an integrative neurologist and sleep medicine physician at the iNeuro Institute and a member of the HealthyWomen’s Women’s Health Advisory Council (WHAC). It can also have other causes, Patel said: irregular sleep schedules, poor sleep hygiene, persistent nightmares, mental health disorders, underlying physical problems, medications, a noisy or restless bed partner, or other sleep disorders.

With both acute and chronic insomnia, people have difficulty falling or staying asleep to the point that it affects their ability to function during the day. It’s important to note that insomnia is not the same as sleep deprivation, Patel said.

“Usually people with insomnia want to sleep, can go to bed at the same time, etc., but usually can’t fall asleep or stay asleep, or wake up too early,” he said. In other words, staying up too late watching your favorite show doesn’t count as insomnia.

Changing hormones, disturbed sleep

According to Patel, women are twice as likely as men to have difficulty falling asleep or staying asleep, and hormones play a key role in this gender gap. Because estrogen and progesterone influence sleep, insomnia is most common during the premenstrual period and postmenopausal years, when hormonal changes are most extreme.

Insomnia is also a major problem for women during perimenopause, the transition period leading up to menopause. In one study, between 31% and 42% of perimenopausal women reported experiencing insomnia, with symptoms worsening as the women approached menopause.

Stress and nutrition among risk factors for insomnia

Stress is one of the biggest risk factors for insomnia, as many of us have learned the hard way during the Covid-19 pandemic. Nearly 3 million people Googled “insomnia” in the US during the first five months of 2020, an increase of 58% over the same time period in the previous three years. Whether stress is immediate (anxiety about a test the next day) or chronic (worries about the future), it can keep you from falling asleep or staying asleep.

Nutrition can also play a role in insomnia. Patel points to research showing that a diet high in sugar and trans fat and low in fiber can negatively affect your ability to fall asleep and stay asleep. The relationship between nutrition and insomnia is often double-edged, as lack of sleep can make you crave the types of foods that make insomnia worse.

Other risk factors for insomnia include being older than 60, having a family history of insomnia, and not having a regular sleep schedule. There also appears to be a connection between psychiatric disorders, such as depression and anxiety, and insomnia. “Many with chronic insomnia have a psychiatric disorder, and most with a psychiatric disorder have insomnia,” Patel said.

Saundra Jain, PsyD, LPC, a psychotherapist and adjunct clinical affiliate at the University of Texas at Austin and a member of Healthy Women’s WHAC, said she hears about problems associated with sleep deprivation in her psychotherapy practice quite often. “The data supports that sleep difficulties are very common in those who suffer from mental health problems such as depression, anxiety, bipolar disorder and other conditions,” said Ella Jain.

Long-term impacts of insomnia

In addition to making existing health problems worse, insomnia can increase the risk of developing new ones. Lack of sleep is associated with chronic conditions such as depression and other mood disorders, high blood pressure, cardiovascular disease, type 2 diabetes, and obesity.

Insomnia can also be related to brain problems, including memory loss and difficulty concentrating. “In the long term, lack of sleep can put someone at higher risk for cognitive decline and dementia,” Patel said.

Sleep helps the brain perform important housekeeping tasks, removing potentially dangerous substances like amyloid beta proteins that are associated with Alzheimer’s disease. Many factors contribute to Alzheimer’s risk, and lack of sleep may be one of these factors. “Studies have found that even one night of sleep deprivation can increase the amount of amyloid beta in the brain,” Patel said.

Taking steps to sleep better

The good news? Even the most severe insomnia can be controlled. Patel and Jain recommend these steps for better sleep:

Set a consistent wake up time. What time you wake up has a huge impact on how you sleep. Patel suggests getting up at the same time every day, even on the weekends. Once he’s awake, tell his body it’s time to start the day by exposing yourself to bright light as soon as possible. Natural light is best, but a full spectrum light box works too.

Add movement to your routine. “A lot of people, especially those who work from home, don’t move around enough during the day,” Patel said. And Zar said, “I never fall asleep faster or fall asleep better than when I’ve done a good amount of strenuous physical activity during the day.”

Consume carbohydrates and caffeine in moderation.. Since high-carbohydrate diets are linked to poor sleep quality, people with insomnia may benefit from eating fewer complex carbohydrates. As for caffeine, Patel said it’s best consumed earlier in the day if you’re sensitive to it.

Seek professional support. Insomnia often results in excessive worry about not being able to sleep, Jain explained, which further fuels sleep deprivation and causes a negative cycle. She recommends cognitive behavioral therapy for insomnia (CBT-i), a program that has helped many of her patients break the cycle. Medications may also be an option to help treat insomnia.

Taking insomnia one night at a time

Although he still has the occasional sleepless night, Zar is no longer at the mercy of insomnia. With consistent practice of techniques like those suggested above (including the help of a good therapist), Zar is getting the rest he needs. Where in the past he worried about never going back to sleep, he now knows that he will, even if he has a bit of work to do.

This resource was created with the support of Eisai.

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