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Insomnia is a fairly general term that refers to the inability to fall asleep, stay asleep, or get good-quality sleep. Insomnia becomes chronic when it occurs three or more nights a week, lasts more than three months, and can't be fully explained by another condition.
Note that it only counts as insomnia if you have enough time to sleep and a good environment. It is not insomnia, for example, if you keep getting woken up by your neighbor's loud dog at 5 AM.
Most of us experience short-term insomnia that can last for a few days or weeks as a result of stress or changes in our schedule or environment. This includes the well-known phenomenon of not sleeping well the first night in a strange place. It also includes not sleeping because you are anxious about getting up, overly excited about an upcoming event, etc.
Insomnia is only of genuine concern when it becomes chronic.
Other than not getting enough sleep, insomnia can result in the following symptoms:
Feeling sleepy during the day
Lack of energy
Difficulty focusing and paying attention
Not getting enough sleep can have significant consequences, regardless of the cause. Insomnia can cause these problems, as can "burning the candle at both ends." These issues include:
People who have not had enough sleep are more likely to make errors at work, and sometimes these errors can lead to accidents or injury to yourself or others. People who have not got enough sleep are 70% more likely¹ to be involved in workplace accidents. Sleep deprivation contributed to both the Three Mile Island accident and the Chernobyl disaster.
Fatigue has a similar impact on driving ability² to driving drunk. You are three times more likely to be in a car crash if you are fatigued, and about 800 fatalities a year are caused by drowsy driving.
Watch for drowsy-driving symptoms such as:
Difficulty keeping your eyes open
Having issues maintaining speed
There is a possible association³ between sleep disorders and impaired control of the cardiovascular system. Additionally, insufficient sleep is linked to high blood pressure and heart disease. In the case of insomnia, there may be a root cause behind insomnia and certain heart problems, but the lack of sleep from insomnia can elevate your blood pressure and thus increase your risk of a heart attack.
Many of our body's important regulatory processes happen during sleep. Insufficient sleep can, therefore, lead to weight gain, especially in children and adolescents. There's an indication that insufficient sleep can also affect your ability to tell whether or not you are hungry. Bear in mind that children and adolescents need more sleep than adults.
If you don't sleep or don't get enough sleep, your body will not be able to function properly, especially your brain. The "brain fog" that accompanies sleep deprivation is particularly noticeable.
One of the things sleep does to your body is to reduce the amount of cortisol in your body. Cortisol is a stress hormone, and too much can affect, among other things, your:
Skin health (hence the phrase "beauty sleep")
Blood sugar levels
Elevated cortisol can then make it harder to get to sleep.
Another thing that can happen if you get insufficient sleep or insufficient quality of sleep is REM rebound.⁴ This occurs if you don't get enough rapid eye movement (REM) sleep and can cause symptoms that include extremely vivid dreams, nightmares, sleepwalking, and even daytime hallucinations.
Insomnia can lead to heart disease (which can be fatal) or to fatal accidents, but is sleep deprivation itself fatal? The answer is yes. In one study⁵ of rats, all specimens died 11 to 32 days after implementing total sleep deprivation. We do need to sleep eventually.
In humans, a disease called fatal familial insomnia (FFI) can lead to sleep deprivation that ends in death. It is a degenerative brain disorder that starts with mild insomnia and progresses to a complete inability to sleep and sometimes dysfunction of the autonomic nervous system.
As the condition develops, affected individuals go through a phase of getting very little sleep and extremely vivid dreams. Eventually, coma and death occur. FFI is a prion disorder caused by a mutation of the PRNP gene.
So, yes, in humans, sleep deprivation can result in death after a period of physical and mental degeneration.
Plain and simple, yes. Anyone who has ever tried to pull an all-nighter and woken up with their head on their laptop knows that your body can just put you to sleep. If you are tired enough, your body may go into a pattern of microsleep episodes, which last only a second or two and may be undetectable by either you or anyone watching, but can still result in an accident.
Individual sleep needs vary slightly, but most adults need at least seven hours of sleep⁶ per night. Older adults tend to sleep a little less than they did when they were younger. If you need eight hours at the age of fifty, you may only need seven at the age of 65.
Children and teenagers need more sleep, with newborns needing the most and typically sleeping 14 to 17 hours per day.
Insomnia can be treated. Short-term insomnia is generally treated using lifestyle changes to encourage sleep, such as altering your bedroom setup and making sure you go to bed at the same time every night. If your short-term insomnia is related to stress or life events, therapy can help.
Chronic insomnia is most often treated with cognitive behavior therapy (CBT). Your therapist will work with you to improve your sleep hygiene and lifestyle habits and control any anxiety about falling asleep. Many people with insomnia get so worried about falling asleep that they can't fall asleep.
Relaxation techniques can also help, and sleep restriction is sometimes practiced. This means reducing the amount of time you spend in bed so that you, ideally, lie awake less.
Medication is also used to treat insomnia. However, many doctors prescribe medication only if other techniques don't work or for a very short period. Insomnia medications include:
Benzodiazepines: Psychoactive drugs used only for short periods. These drugs are highly habit-forming and also result in dependence, so you lose the ability to sleep without them.
Nonbenzodiazepines such as Ambien: These drugs do not have as high a potential for abuse, but they are still controlled substances. They are also well known for side effects such as sleepwalking.
Ramelteon: This is a melatonin receptor agonist that can help you fall asleep faster but does not help with sleep maintenance.
Suoverexant: An orexin receptor antagonist which affects the neurotransmitters in your body that regulate sleepfulness and wakefulness.
Your doctor might also recommend over-the-counter medications. Melatonin supplements and certain antihistamines can serve as mild sleep aids but always speak to your doctor before trying them.
Whether or not you experience insomnia, there are some things you can do to improve the amount of time you spend asleep and the quality of sleep you get. Here are some basic ways to get a better night's sleep, which can also help prevent acute insomnia:
Keep your bedroom a little on the cool side. As our body temperature lowers when we sleep, we tend to sleep better in a cooler room.
Go to bed at about the same time each night and get up at the same time each morning, even on weekends.
Avoid excessive consumption of alcohol. Alcohol may make you think you got a good night's sleep but reduces sleep quality significantly.
Avoid caffeine later in the day.
Take daytime naps only if you need them. A daytime nap can affect your sleep drive and make it harder to sleep.
Stop using screens about an hour before you go to bed. Use a blue-light reduction app on your phone and computer.
Expose yourself to natural light as early as possible in the day.
If you can't sleep, get up and stretch, read or do something else (that doesn't involve a screen) before trying again.
Exercise regularly and not too late in the day.
While it is possible to die from sleep deprivation, your body will eventually force you to sleep, even if you have insomnia. However, insomnia⁷ can increase your risk of dying from heart disease. It can be treated with a combination of therapy, lifestyle changes, and medication.
If you are unable to get a good night's sleep frequently despite having time to sleep and spending the time in bed, you should talk to your doctor about treatment for insomnia.
Excessive sleepiness and workplace accidents | Sleep Foundation
Drivers are falling asleep behind the wheel | National Safety Council
REM rebound effect | StatPearls
How much sleep do I need? | Center for Disease Control and Prevention
What is insomnia? | National Institute of Health
Insomnia | MedlinePlus
How does sleep affect your heart health? | Center for Disease Control and Prevention
What is cortisol? | EndocrineWeb
The science of sleep: Understanding what happens when you sleep | Johns Hopkins Medicine
Treatments for insomnia | Sleep Foundation