Sleep is a set of physical and behavioral states.
The duration of sleep depends on age, health and emotional state; however, while we sleep, our brain does not fully rest, it remains active controlling our vital functions such as breathing, digestion, and circulation, among others. Understanding these processes helps to understand the causes of insomnia.
The stages of sleep
Throughout sleep there are changes in our brain and body; in this process we go through stages that ensure our body is working to its full potential again. Thus, various parts of the brain are activated and inhibited throughout sleep.
Sleep has a circadian biological rhythm and has REM and Non-Rem phase.
The REM phase comes and goes throughout the night. In her the brain is active, we dreambut the muscles are very relaxed.
In the non-REM phase, the brain is quiet, but the body can move. Hormones are released into the bloodstream and the body repairs the wear and tear of the day.
The non-REM phase includes four phases: pre-sleep, light sleep, slow-wave sleep, and deep slow-wave sleep. We go through these phases about five times during the night.
On the other hand, At night we woke up one or two minutes every two hourseven if we remember it.
Sleep problems affect all spheres of life.
The minimum number of hours of sleep we need varies according to age, personal characteristics or circumstances.
- The newborn sleeps most of the day with 50% REM sleep.
- Boys and girls from age 4 through adolescence need about 10 hours of sleep.
- In young people and adults the normal duration is 5 to 9 hours, ideally around 7 or 8 hours
- In old age, nocturnal sleep is greatly reduced, with frequent episodes of awakening.
Insomnia is persistent difficulty in initiating sleep, or affecting its duration, consolidation, or qualityand this happens despite the circumstances conducive to sleep.
More than 50% of primary care patients complain of insomnia, and the prevalence of insomnia as a symptom of another disease is very high.
Most of the time, insomnia is as a result of another underlying disease.
What causes insomnia?
Insomnia can be categorized by its etiology, time of nighttime onset, and duration.
Depending on its etiology, insomnia can be secondary or primary.
- Primary: the patient has always slept badly
- Secondary: insomnia occurs as a result of other clinical conditions.
Examples of health conditions that lead to secondary insomnia are poor sleep hygiene, insomnia due to psychiatric disordersinsomnia due to chronobiological disorders, insomnia due to medical and neurological diseases, fatal familial insomnia, insomnia due to restless legs syndrome and insomnia due to medication.
1. Insomnia due to poor sleep hygiene
Bad habits can disrupt sleep. They don’t help juggle sleep routines like lack of schedules, eating late, taking stimulating substances, consuming alcohol or stimulants. Breaking these bad habits often leads to insomnia.
Sleep hygiene guidelines
To overcome sleep problems caused by poor sleep hygiene, consider these guidelines:
- Avoid stimulating drinks
- Light dinner
- Avoid long naps
- Control medication
- Maintain sleep schedules
- Avoid bright light
- Use the bed only for sleeping
- Create an ideal environment
- Establish a bedtime ritual
2. Insomnia due to psychiatric disorders
Chronic insomnia is often associated with depression or anxietyalthough it is linked to psychosis and addiction to alcohol and drugs.
Depression causes sleep to shorten due to waking up early, and anxiety makes it difficult to start and maintain sleep.
3. Insomnia due to chronobiological alterations
In these cases, it occurs an asynchrony of the periods of wakefulness and sleep with respect to the geophysical day/night cycle. In these situations, the causes are:
- Phase advance
- Phase delay
- Irregular sleep-wake rhythm
- I work in a team
- Jet lag
4. Insomnia due to medical and neurological diseases
This insomnia is linked to the symptoms of this type of disease: pain, dyspnea, cough, gastroesophageal reflux, nocturia, etc.
Treatments for certain illnesses can also cause insomnia, such as steroids, theophylline, etc.
5. Deadly family insomnia
It is a prion disease that deteriorates the cognitive system quickly and graduallyo It is hereditary in nature and leads to uncontrolled insomnia.
This disease results in signs of vegetative hyperactivity, tremors, myoclonias, dystonias and pyramidal signs. Death occurs in less than two years.
6. Restless Leg Syndrome
It is the need that arouses an irresistible urge to move your legs or walk. It usually appears at night or after sleep.
It is associated with iron deficiency, peripheral neuropathies or chronic renal failure. It can be treated with dopaminergic agents