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Insomnia is a condition that affects how well and how much you sleep. It can be caused by stress, changes in your sleep routine or be hereditary.
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Insomnia is a common sleep disorder that makes it difficult to fall or stay asleep. Lack of sleep (or quality sleep) can cause daytime tiredness, irritability and anxiety. Persistent insomnia has also been linked to obesity, metabolic disease , diabetes and depression.
There are two types: primary and secondary. If you have primary insomnia, it’s caused by a lack of melatonin (sleep hormone) and isn’t linked to any other health condition or illness, or medication. Secondary insomnia is when there’s another physical health factor responsible for your lack of sleep. If you have trouble sleeping because you drink a lot of alcohol late at night, for example, this is secondary insomnia. But if you have trouble sleeping due to stress, sensitivity to lights or noises, or changes in your sleep schedule, this is primary insomnia.
Insomnia can last for one night, or go on for months or years. The longer you live with insomnia, untreated, the more likely you are to develop secondary problems, like depression or cardiovascular illness.
Anyone can get insomnia. It’s common in both adults and young people. It’s often linked to lifestyle habits, working conditions or the sleep environment. Anxiety can also cause insomnia.
But primary insomnia is more often experienced by older people over the age of 55. As we get older, our melatonin levels tend to fall naturally. Treatments like Circadin are specifically licensed for the treatment of insomnia in people over 55. When it’s given to people who don’t have primary insomnia or are under 55, it’s an ‘off-label’ use.
Insomnia is a common disorder. Studies show that 30%-40%  of adults will have persistent insomnia at some point in their life. Insomnia is thought to be most common in older people, with one estimate suggesting that almost 50% experience some degree of insomnia.
Teenagers are at risk, with 23% in one study of 16-19 year olds suffering from some type of insomnia. An analysis of pregnant women found that 52% report symptoms of insomnia at some point during their term .
Prevalence of chronic insomnia in adult patients and its correlation with medical comorbidities. Journal of Family Medicine and Primary Care, 5(4), p.780.
Insomnia in the Elderly: A Review. Journal of Clinical Sleep Medicine, 14(06), pp.1017–1024.
Insomnia in Adolescence. Medical Sciences, 6(3), p.72. [Accessed 9 Jul. 2019].
Insomnia in Pregnancy and Factors Related to Insomnia. The Scientific World Journal, 2012, pp.1–8.
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There are a lot of possible causes. Clinicians class insomnia by its causes:
Primary insomnia is often linked to big life events like moving house, starting a new job, changes in routine, or a drop in melatonin.
So for example: the light, noise and temperature in your bedroom can stop you from falling asleep. Changing your sleep schedule can disrupt your sleep. Jet lag, shift work and a new baby can all affect your sleep and cause insomnia. There’s also some suggestion that insomnia could be genetic and run in families.
Older people are more likely to suffer primary insomnia because as you get older less of the sleep hormone melatonin is produced naturally by your body. Melatonin helps to keep your sleep in a regular cycle.
Secondary insomnia is common if you drink caffeine close to bedtime, use recreational drugs or drink alcohol in the evening. Even non-prescription medications like cold and allergy medicine can cause insomnia.
Mental health issues are also linked to insomnia. Insomnia is common in people who have depression, anxiety and ADHD.
Conditions such as hyperthyroidism, sleep apnea and restless leg syndrome can interfere with sleep too, and lead to insomnia.
Symptoms of insomnia include:
Over time, prolonged insomnia can also affect your mental wellbeing and lead to anxiety, depression and irritability.
Studies have suggested that persistent sleep deprivation can lead to a variety of other health issues including obesity, metabolic disease, anxiety and depression. It’s also been theorised that the less someone sleeps, the more at risk they are of developing a secondary illness as a result .
So it’s important if you’re experiencing insomnia to get advice, so that you can minimise the risk of developing a secondary health problem.
The heritability of insomnia: Systematic review and meta-analysis of twin studies. Sleep Med Rev. 2021 Aug.
Extent and health consequences of chronic sleep loss and sleep disorders. nih.gov.
Circadin is a licensed treatment for primary insomnia in people over the age of 55. It contains melatonin, the sleep hormone, which helps the body to shut down when it’s time to sleep. The same medication is also sometimes sold ‘off label’ as a treatment for jet lag.
Usually, before you try Circadin, it’s best to try other ‘natural’ methods. This might be making your sleep routine more regular, changing your sleep environment so you’re more able to sleep (for example eliminating noise or light), or reducing your alcohol, caffeine or stimulant intake before bed.
Talking to your doctor about the medications you’re taking can be helpful too, if these are affecting your sleep. Sometimes they might be able to adjust something or suggest an alternative that doesn’t have the same side effects.
There are other sleep aid medications too, that you can get from a pharmacy. Treatments like Nytol contain an antihistamine and help you to feel drowsy, and others contain herbal medicines. These shouldn’t be used for more than two weeks, so if they haven’t worked during this time, it’s best to chat to a doctor.
The best treatment for insomnia really depends on what’s causing it. If you ask our doctor, they’ll be able to discuss your symptoms and sleep habits, and recommend a treatment if they think it will be effective. It can take some trial and error to develop a sleep schedule that works.
Insomnia doesn’t always need to be treated with medication. There are some self-help measures you can take to improve sleep, like:
If you think a medication you’re taking may have something to do with your insomnia, it’s worth speaking to the person who prescribed this for you. They might be able to discuss other treatment options with you.
Adverse Events Associated with Melatonin for the Treatment of Primary or Secondary Sleep Disorders: A Systematic Review. CNS Drugs, 33(12), pp.1167–1186.
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