Signs 

• Difficulty sleeping at night

• Waking up in the middle of the night

• Waking up earlier than usual

• Feeling tired when you wake up

• Feeling sleepy or tired during the day

• Anxiety, depression, or irritability

• Difficulty remembering things, focusing on tasks, or paying attention

• Increased accidents or mistakes

Causes 

Insomnia comes in two types; primary and secondary.

Primary insomnia is caused by:

• Alterations to your sleep pattern, such as a new work shift, jetlag, or bad habits, are adopted when having other sleep issues.

• Your surrounding environment, such as temperature, light, or noise

• Stressful situations, such as a job change or loss, moving, divorce, or death of a loved one

Secondary insomnia is caused by:

• Mental health conditions such as anxiety and depression

• Medications for asthma, high blood pressure, depression, allergies, and colds

• Tobacco, caffeine, or alcohol use

• Discomfort or pain at night

• Recreational drugs

• Endocrine problems, such as hyperthyroidism

• Sleep disorders such as restless legs syndrome or sleep apnea

Irregular sleep schedules can bring about this condition. Your body’s internal clock (circadian rhythm) follows a daily pattern of night and day in an ideal situation. But the reality is that many people’s sleep schedules misalign their circadian rhythm. Shift work and jet lag are the leading causes of this. Shift work requires the individual to sleep during the day and work at night, disrupting their circadian rhythm. 

Caffeine is a stimulant that remains in your system for many hours, making it hard to fall asleep. It would help if you took caffeinated drinks in the early afternoon to give it time to leave your system before you go to bed. Nicotine also has the same effects on sleep as caffeine.

Alcohol is a sedative that initially makes one sleepy, but it can affect your sleep as it disturbs your sleep cycle, causing fragmented non-restorative sleep. Eating heavy meals or spicy foods also generates sleeping problems as the food is hard to digest when eaten late in the evening. 

Mental health conditions such as bipolar disorder, depression, and anxiety often give rise to sleeping problems. Forty percent of the people with insomnia have a mental health condition. These health conditions can provoke negative thoughts that disturb sleep. Further research indicates that this sleep disorder can worsen anxiety and mood disorders, worsening the symptoms and even escalating the risk of suicide for people suffering from depression.

Obstructive sleep apnea, which is a condition that causes breathing lapses and momentary sleep interruptions, is another condition that can cause daytime sleepiness and can lead to insomnia. 

Diagnosis

Your doctor will do a physical exam looking for signs of medical problems associated with the sleeping disorder. Although not common, the doctor may order a blood test to rule out or confirm thyroid problems or other issues related to poor sleep.

Besides inquiring about your sleeping schedule, your doctor can request you to fill out a questionnaire to establish your sleep-wake pattern or ask you to keep a sleep diary for several weeks.

If the above does not give an apparent cause of your poor sleeping, you may be asked to spend the night at a sleep center. While there, the doctor will conduct more tests and monitor and record several activities as you sleep. The activities include body and eye movements, heartbeat, breathing, and brain waves.

Treatment

• A therapist will offer cognitive behavioral therapy to help you change the behaviors and thoughts which are keeping you awake.

• Relaxation therapy to relax your muscles and breathing exercises to minimize anxiety at bedtime. Practicing the techniques helps control mood, muscle tension, heart rate, and breathing to help you relax. 

• Better sleep hygiene includes having a regular sleeping time and waking time, as well as avoiding taking naps during the day. Also, please avoid using the phone or watching TV before bed as their light makes it hard to fall asleep.