Insomnia

Insomnia is an inability to fall asleep or to stay asleep as long as desired. The only way that insomnia can really be diagnosed is through a polysomnogram (sleep study) to show evidence of difficulty in initiating and maintaining sleep. A more practical definition (and a cheaper diagnosis) of insomnia is a positive response to either: “Do you experience difficulty sleeping?” or “Do you have difficulty falling or staying asleep?”

Insomnia can accompany several sleep, medical, and psychiatric disorders characterized by a persistent difficulty falling asleep and/or staying asleep or sleep of poor quality. With this, there is a clear difficulty in functioning during the day. Insomnia can be short term (about a month) or long term (longer than a month). This can lead to memory problems, depression, irritability and an increased risk of heart disease. It will also lead to you being incredibly pissed of and frustrated.

Insomnia can be classified as transient, acute, chronic, and another that I add….CPAP induced insomnia.

Transient insomnia lasts for less than a week. It can be caused by another disorder, by changes in the sleep environment, fighting your natural sleep cycle, depression, or stress. The symptoms of transient insomnia are the same as sleep deprivation.

Acute insomnia is the inability to consistently sleep well for a period of less than a month. Insomnia is present when there is difficulty initiating or maintaining sleep or when the sleep that is obtained is non-refreshing or of poor quality. This occurs despite the insomniac having all the time in the world for sleep along with the right conditions for sleep. Acute insomnia is also known as short term insomnia or stress related insomnia. I’ve suffered from this and have a blog post on the experience….a miserable experience at that!

Chronic insomnia lasts for longer than a month. It can be caused by another disorder, or it can be a primary disorder. In the sleep disorders field, chronic insomnia is very often some form of sleep apnea. The most frustrating of these is UARS (upper airway resistance syndrome) since many labs lack the ability to detect this subtle collapse of the upper airway. This causes the insomniac to go undiagnosed and don’t get the validation that they need to treat their insomnia. People with high levels of stress hormones or shifts in the levels of cytokines are more likely to have chronic insomnia. Some people with chronic insomnia (or sleep apnea) will describe their life as living in a fog.

CPAP induced insomnia is something that the medical community isn’t aware of “officially”, but anyone new to CPAP is well aware of. This could fall into two different categories of insomnia, Acute and Chronic.

The CPAP induced insomnia could be acute if the root of the insomnia is the anxiety over the new diagnosis of “sleep apnea” along with all the lifestyle changes that come with it. These include possible stigmas attached to using PAP therapy as well as feelings of having your private sleep space invaded by a foreign machine and mask. Cognitive behavioral therapy can be very helpful in getting through these negative feelings.

The CPAP induced insomnia could be chronic if the problems sleeping with a PAP machine and mask is caused by your apnea not being treated completely. This is very often from undiagnosed subtle sleep disordered breathing (UARS) that is still persistent though the apneas and hypopneas have been successfully treated.

What to do about your insomnia? First thing to do is exactly what you’re doing….educate yourself. Now that you have a foothold on this you need to take this to your physician for their professional opinion. Depending on the cause of your insomnia, the fix can be phychotherapy for stress, medications to alleviate anxiety, or CPAP therapy if sleep disordered breathing is the cause. A sleep disorders study may be a good option to validate your concerns. In the meantime, you can join our free forum (click the icon below) to discuss your concerns with other people that have been in your shoes and gotten through their bout of insomnia.

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