Sleep is one of the three pillars of good health, besides nutrition and exercise. The World Health Organization recommends 7-9 hours of sleep per day. Nevertheless, every night, hundreds of millions of people around the world suffer from insomnia, approximately 10-30% of the world's population.
 

• What is insomnia?
• What causes insomnia?
• Who is at risk of insomnia?
• When should you see a doctor?
• How bad is insomnia?
• How is insomnia diagnosed?
• How is insomnia treated?
• How can I prevent insomnia?

What is insomnia?

Insomnia is divided into four types:

• Difficulty falling asleep (initial insomnia)
• Falling asleep, but waking up in the middle of the night and inability to return to sleep (maintenance insomnia)
• Waking up early and inability to fall back asleep (terminal insomnia)
• A combination of the above

Insomnia can be either acute, lasting one night or even a few weeks, or it can be chronic if it affects a person at least three nights a week over three months.

What causes insomnia?

• Environment, shift work, stress, poor sleeping habits
• Physical conditions or underlying diseases including pain, heart or thyroid disease, menopause, depression, dementia, sleep apnea, GERD, restless legs syndrome, etc.
• Certain drugs
• Caffeine, nicotine and alcohol

Who is at risk of insomnia?

Insomnia is more common in women than men. This is because of hormonal changes during menstruation, during pregnancy and after menopause. Health conditions such as depression, anxiety, muscle ache, difficulty holding urine, or a cyst of the ovary can also affect sleep.
Elderly people (over 60 years of age) who experience physical or environmental change or chronic illnesses can also suffer from insomnia.

When should you see a doctor?

Seek for a consultation if you have insomnia at least three nights a week for three consecutive months, or if insomnia affects your daily life, such as feeling fatigued, irritable, lacking concentration and falling asleep during the day.

How bad is insomnia?

People tend to think that insomnia is just a nuisance, but chronic insomnia has a negative impact on your health. It can cause physical and mental health problems, such as:

• Depression, anxiety, irritability
• Memory and cognitive impairment
• Behavioral problems such as hyperactivity or aggression
• Lack of concentration
• Heart disease
• High blood pressure
• Diabetes
• Dementia
• Stroke
• Hypersomnia (excessive sleepiness during the day)
• Sexual dysfunction
• Weight gain and obesity
• Falling asleep during the day, increasing risk for an accident while driving or working

How is insomnia diagnosed?

Your doctor will perform a thorough physical exam and take a detailed history, such as asking questions about your sleep problems and symptoms, underlying medical conditions, and medications that may affect sleep. If you have chronic insomnia or your doctor suspects other sleep-related disorders, such as sleep apnea, they will incorporate a sleep test.

How is insomnia treated?

Short-term insomnia may subside on its own and does not require intervention, but if you suffer from chronic insomnia, your doctor may recommend Cognitive Behavioral Therapy for insomnia (CBTi). This treatment aims to change the way you think as well as your behavior, to educate you on good sleep hygiene, involves relaxation therapy and stimulus control therapy to adjust your sleep. The treatment usually lasts eight weeks.
In some cases, your doctor may use short-term medications to help you sleep.
 

How can I prevent insomnia?

Changing sleep hygiene can help you sleep better:

• Avoid having large meals, or alcoholic or caffeinated beverages before bedtime
• Set a routine, go to bed and wake up around the same time every day
• Do not watch TV, use your mobile phone or computer at least half an hour before bedtime
• Make the bedroom environment dark, and quiet, with a comfortable temperature
• Do physical activities such as exercising during the day
• Sleep in a proper position for insomniacs: lying on your side with your knees tucked towards your chest. It reduces pressure on the spine and helps muscles relax
• Get out of bed when you can't sleep
• Use the bed for sleeping and sexual activity only

Bumrungrad International Hospital’s Comprehensive Sleep Clinic consists of a multidisciplinary team of highly skilled physicians specialized in Sleep Medicine, from pulmonologists (doctors treating lung and respiratory tract diseases), to otolaryngologists, neurologists, psychiatrists and dentists (maxillofacial surgeons) who work as a team to diagnose and treat insomnia. If you suffer from insomnia or suspect a sleep disorder, our team of specialists is ready to provide diagnosis and treatment to restore your quality of life.