Insomnia can be a frustrating condition, and one that many people face at some point in their lives. Many of us will occasionally have trouble sleeping, but insomnia is much more intense and something that may require medical treatment or help from a qualified professional.

At Augmentive, we aim to provide holistic, tailored mental health support to everyone so they can live their life to the fullest, so if you have questions, we’re here to help. We’re lifting the lid on all things insomnia; what it is, how long it should take you to fall asleep, how long it takes insomniacs to fall asleep, the causes, treatments, and how to cope as it’s happening.

What is insomnia?

Insomnia is a sleep disorder which causes a person to experience difficulty falling asleep, staying asleep or both, while also experiencing fatigue or difficulty concentrating in the daytime. The symptoms may also include waking up early in the morning unintentionally, resisting sleep, impaired attention or memory during the day, and more.

There are two types of insomnia;

Acute insomnia refers to sleep issues lasting a few days or weeks, but never longer than three months.

Chronic insomnia refers to sleep issues at least 3x per week for more than three months.

If chronic insomnia is left untreated, it can lead to mental health issues such as anxiety around sleep or depression, an increased risk of substance abuse, heart disease, and diabetes, so if you believe you have chronic insomnia or your acute insomnia is causing issues in daily life, don’t be afraid to reach out to a medical professional for help.

How common is insomnia?

While sources vary on exactly how many people suffer from insomnia, one 2007 review of population-based studies and a more recent 2016 study both found that around 30% of adults reported one or more insomnia symptoms. Another 2010 review of studies found insomnia symptoms to be present in around 33-50% of the adult population, so it’s safe to say insomnia is unfortunately a very common problem.

How is insomnia different from general trouble sleeping?

Most of us experience a little trouble sleeping every now and then. It is common for babies and young children to struggle with sleep, as well as elderly people, however when you are an adult you should mostly be sleeping through the night.

How much sleep you require will be different for everyone. On average an adult needs between 7 and 9 hours of sleep a night, while a child needs between 9 and 13 hours, and babies and toddlers generally need around 12 to 17 hours of sleep.

Insomnia is different from occasional sleeplessness because we all occasionally have nights where we struggle to get to sleep or worry about something that keeps our brain active overnight. In fact, up to two thirds of people say they occasionally get insomnia-like symptoms, but this does not mean they would be formally diagnosed with long-term insomnia.

What causes insomnia?

There are a number of common causes of insomnia that can affect our sleeping patterns, and most fall into one of the below categories:

Circadian rhythm disturbances

Our circadian rhythms dictate our sleep and wake cycles, and they are highly influenced by the presence or absence of daylight. When dysfunction arises in our circadian system due to things like shift work or jet lag, we may experience circadian rhythm disturbances like delayed sleep phase disorder (DSPD). Sleep clinics have estimated around 5-10% of chronic insomnia patients have DSPD, so in some cases circadian rhythms could be to blame for insomnia.

External surroundings

Sometimes our surroundings at night determine whether or not we are likely to have a good sleep or not. Things like excessive noise, a high room temperature or a lumpy bed could all make for a poor night’s sleep.

Medications

Some prescription medications such as ADHD medications (like stimulants) can cause sleep disturbances. If you are experiencing sleep issues that you think are caused by a change in medication, speak to your GP to find out if they can adjust your dosage or switch to an alternative medication.

Medical conditions

Certain medical conditions can contribute to insomnia symptoms, such as Alzheimer's disease, Parkinson's disease, restless legs syndrome, overactive thyroid, and more. If you have one of these medical conditions you may be able to speak to your doctor about ways to improve sleep.

Drugs and alcohol

It’s no surprise that caffeine can affect sleep, but things like alcohol, nicotine and recreational drugs can also cause insomnia-like symptoms. If you are experiencing this, one of the first things you may want to try is cutting out the above from your routine to see if it makes a difference.

Age-related issues

Up to 75% of older adults experience symptoms of insomnia, which is a natural change that happens as we get older. Similarly, the menopause usually begins between ages 45-55 for women, which can involve hot flashes, night sweats and mood changes. All of these can impact sleep.

High stress and PTSD

Studies on the physiological response to stress have found that it can have a negative effect on sleep quality, and the brain’s response to PTSD (post-traumatic stress disorder) can lead to sleep issues.

Mental health issues

Mental health is so important when it comes to sleep, as anxiety can cause issues such as repetitive thoughts, rumination, panic attacks, night terrors, depression and more, all of which could cause sleep disturbances. People who suffer from psychiatric illnesses may also struggle with sleep; while the prevalence of occasional insomnia in the general population is around 30%, a study found that the prevalence rises to 40% in those with psychiatric illnesses like schizophrenia.

How long should it take me to fall asleep?

For many people with insomnia, the longer they worry about how long it is taking them to fall asleep, the more they will struggle to sleep, and the cycle continues.
According to the Sleep Foundation, healthy people generally fall asleep within 15 to 20 minutes of getting into bed, however this is not the case for everyone. Some people fall asleep almost instantly while others take much longer. A slight variation is normal.

Did you know…?

According to Dr Nerina Ramlakhan, sleep expert and author of Tired But Wired: The Essential Sleep Toolkit, the most important sleep we get is actually the hours before midnight, and it’s all because of those trusty circadian rhythms.

The area in our brains that synchronises our body’s circadian rhythms with the levels of light and darkness around us is activated when the light level drops in the evening, sending a message from the eyes to the pineal gland to encourage sleep. By maximising those key pre-midnight hours, you could improve your overall sleep.

How long does it take insomniacs to fall asleep?

If it takes you longer than the aforementioned average of 15-20 minutes to fall asleep, this doesn’t mean you have insomnia. However, if it is taking you several hours or longer every night, there may be an underlying issue.

There is no specific period of time that determines whether or not you have insomnia, so you will need to judge this based on a comparison with your previous sleeping patterns. One study found sleep quality decreases if it takes longer than a half hour to fall asleep, which shows the importance of addressing insomnia as early as possible.

“We make things worse by our constant value judgments ("I should be asleep"), our ceaseless comparison of ourselves to others ("my wife and kids are asleep, why aren't I?"), and our unrelenting standards for ourselves ("If I don't get eight hours' sleep, I'll be a wreck tomorrow").” - Writer Mark Rice-Oxley, The Guardian

How is insomnia diagnosed?

Insomnia may be diagnosed by asking questions about sleeping habits, medical history, instances of fatigue in the day, how sleep issues are affecting waking life, and more. When diagnosing insomnia, a professional may also ask you to keep a sleep journal for a while to track symptoms, how you are feeling after each night’s sleep, and to see if any patterns emerge. If appropriate or if other options have not helped, a sleep study may be organised to look a little further at the issue.

At Augmentive, our practitioners can diagnose insomnia and advise on the best course of treatment. You can book in a free 15 minute consultation to help guide you towards a specialist who can help.

How to cope with sleep issues in the moment

Some techniques can help speed up the process of getting to sleep, or help you get back to sleep easier if you wake up. Here are a few tips:

Breathing

One study found slow, deep breathing can help you fall asleep faster, and make it easier to go back to sleep if you wake up.

Music

A study split 93 participants with sleep issues into 3 groups; those listening to classical music, those listening to an audiobook, and those attempting to sleep as normal. The only group to see improvements in their sleep quality were the participants who listened to classical music.

Progressive Muscle Relaxation

This technique involves tensing each muscle in the body one by one, and then relaxing. While there hasn't been a lot of scientific investigation into this method, some studies (like this one in Covid-19 patients) have found that people with sleep issues took less time to fall asleep after engaging in 20 minutes of progressive muscle relaxation each day.

Get up out of bed

This may seem counterintuitive, but sleep experts recommend getting out of bed if you have been trying to fall asleep for more than 20 minutes. Leave your bedroom, read a book or do something relaxing, but don’t turn on any bright lights or screens to limit blue light exposure. When you start to feel tired, head back to your room and try sleeping again.

How to cope with long-term insomnia

If you have been living with insomnia for a while it can be frustrating, and could cause other health and mental health issues. It is important to get help for insomnia when it starts to negatively affect your day-to-day life, but first you can try to implement good sleeping habits to see if they help, such as:

• Going to bed and waking up at the same time every night/morning
• Avoiding the use of devices with screens before bed
• Doing relaxing activities before bed, like having a bath
• Charging devices outside your bedroom
• Keeping light and noise to a minimum by using an eye mask, earplugs or blackout/sound absorption curtains
• Keeping your bedroom temperature low (65°F / 18.3°C is optimal for good sleep)
• Exercising regularly, but not right before bed
• Avoiding napping during the day

If you haven’t seen improvements in your sleep within a few months, or you are finding the day-to-day management of insomnia distressing, you can seek help from your doctor or reach out to a qualified professional who can help.

Treatment options include various talking therapies including  cognitive behavioural therapy (CBT), psychodynamic therapy, integrative therapy, as well as art therapies. It can also include sleep medications to promote sleep. Our Augmentive practitioners can help diagnose and treat sleep issues like insomnia, and we offer a free 15 minute consultation to help guide you towards a specialist who can help.

Whether you’re feeling off-kilter or want to shake up your routine, our state-of-the-art mental wellbeing platform gives you quick and seamless access to world-class support on your terms, from private mental health assessments and reviews, to finding qualified and approved mental health professionals for the support you need: join us today.