There is a fair bit of misunderstanding of what exactly constitutes a sleep disorder – more commonly referred to as insomnia. In this article, I’ll attempt to shine some light on this subject – it affects a lot of people in some very serious ways. It affects a lot more people in an irritating, “why can’t I just sleep like a normal person” kind of way.
Insomnia – A Definition
OK, to start off there isn’t a plain and simple definition of insomnia. It’s generally interpreted to be a positive or yes answer to either of these questions:
- Do you have difficulty falling asleep at night?
- Do you have difficulty staying asleep at night?
If you’ve answered yes to either or both of these questions (as it is with me), then you have to ask yourself the question:
- Do I really have a hard time falling or staying asleep?
- How do I know?
It’s been shown that people are very poor percievers of their own sleep (ie: they believe that “I got no sleep last night” when a polysomnigraph shows that they slept for 5 hours)!
I believe that, if you can’t actually measure the insomnia, the better subjective attitude would be:
- How do I feel the next day? Am I unfocused, tired, confused, otherwise compromised?
Some people really suffer with this, and the effects of insomnia are basically an inability to function. They may hallucinate, have difficulty doing simple tasks (like driving or cooking) – it generally ruins their quality of life.
It’s quite normal to experience a few days or a couple of weeks of poor sleep once in a while. Often, it’s brought on by some psychological or physical trauma of some sort – a death in the family, a bankruptcy, a looming deadline – anything. Once the event passes or the shock wears off, the sleeplessness goes away. We’d call this ttransient or acute insomnia. If it lasts much longer than about three weeks, we transition into chronic or long term insomnia.
There Are Two Types of Insomnia
So, now that we’ve defined insomnia, it’s important to differentiate between the two types – primary and co-morbid (or secondary.
- Primary insomnia is basically the condition you have when no other “causes” for the sleeplessness are there, or can be found. Once all the other medical, medication, substance or sleep disorder (sleep apnea) causes are eliminated, this is what’s left. If the insomnia was “caused” by some depression or anxiety without a real medical issue present – than this is what you have.
- Co-morbid or secondary insomnia is a type that is brought on or amplified by the use of some other factor – and it could be almost anything. Medications, nicotine, caffeine, alcohol, illicit drugs, pain, stress, rheumatoid arthritis, hyperthyroidism, brain trauma, anything. It’s important that we get these medical issue resolved first, or the insomnia issue may never go away.
So the important lesson here is to find out whether the cause of your insomnia has got a third-party contributor – something that can be controlled. I’d say that things like “jet lag” are pretty hard to control, and so that would be considered short-term, primary insomnia. Something like taking amphetamines or your arthritis causing pain all night would be co-morbid.
Some Insomnia Statistics
I was really surprised when I started to look at these statistics, and when I started to talk about my sleeping problems. Seems that this issue is a lot bigger than I ever imagined. Rather than using some arbitrary source of sleep statistics, these all come from a 2002 study done by the Government of Canada:
- 13% (about 1 in 7) of people over the age of 15 have insomnia – a hard time either getting to sleep or staying asleep (or both). This “getting to sleep or staying asleep” was the question they asked – and those that said “most of time” or “all of the time” were the one’s considered insomniacs.
- 18% of these insomniacs reported sleeping less than 5 hours a night.
- 29% of them said that they had taken some kind of sleep medication during the previous 12 months (versus 7% of people who fall out of the “insomniac” camp).
- Medical conditions like asthma, arthritis, diabetes and back problems seemed to affect about 20% of the sleepless.
- Almost a third of people reported insomnia along with their anxiety or mood disorders – versus about 12% who didn’t report these issues.
- 23% of people who reported their lives as “stressful” suffered from insomnia – about double the people who reported “little or no” stress.
- 16% of heavy drinkers reported insomnia. It’s pretty much taken as fact now that alcohol may help you get to sleep, but the quality of that sleep is really poor.
- 18% of people who use cannabis (marijuana) were sleepless. This is surprising to me – as I always thought it would enhance sleep.
- Heave/obese people have a higher prevalence of insomnia than people of normal weight. This may be linked to sleep apnea, but this wasn’t investigated. The lowest reported episodes of insomnia were people of a normal (not too low, not too high) weight.
- Insomnia rises with age – about 10% at age 15-24, to about 20% at age 75 or older.
- Women are more likely to report insomnia than are men – 15% versus 12%.
- There seems to be a socio-economic angle to this too – those with high school education or lower report a higher incidence of insomnia than more educated groups. Lower education generally translates into a lower standard of living (they looked at this as well).
- 17% of insomniacs rated their ability to cope with difficult (family or personal) problems as fair or poor. 8.5% of those without insomnia answered the same way.
The Stats-Canada Study Conclusions
The Stats-Canada Study is really interesting, and worth a read. Most of their conclusions from the study reinforce many of the things about sleep that we’ve been told. As they say it better than I ever could – here it is:
Physical and psychological problems can interfere with sleep. Painful conditions such as arthritis, migraine and fibromyalgia were associated with insomnia, as were anxiety and mood disorders and stressful life events. As well, alcohol and cannabis use were significant factors. Obesity, too, was related to having problems with sleep.On the other hand, moderate physical activity and a bit of work stress were protective. The lack of a positive association between work stress and insomnia may reflect the relatively large proportion of insomniacs who do not work.Some less obvious factors were associated with insomnia. When physical and mental health status, lifestyle, and demographic and socio-economic variables were controlled for, being female, middleaged, widowed, and having a low education were significantly related to insomnia.Even allowing for a series of physical, mental, lifestyle and socio-economic factors, insomnia was related to some adverse situations. Relatively large percentages of insomniacs had difficulty coping with day-to-day demands and unexpected problems. They were also more likely than other people to have had a recent disability day and to express overall dissatisfaction with life. As well, a significantly large proportion of people in the prime working age range who suffered from insomnia were not employed.
So there you have it – some things about sleep you may not have known!