Chronic insomnia can cause anxiety and depression
Chronic insomnia can cause anxiety and depression
7 min read

If you are suffering from insomnia, I feel your pain.

 

Insomnia is a sleep disorder where you might have trouble falling asleep, staying asleep or waking up too early.

It usually includes tiredness during the day, concentration and memory problems and sometimes anxiety and depression.

Insomnia can exist on its own as a disorder, or it can be a symptom of another disorder.

Common Cause of Insomnia

  • sleep apnea
  • nasal and sinus allergies
  • chronic pain
  • anxiety
  • depression
  • restless leg syndrome
  • medications

Insomnia and Sleep Apnea

Sleep apnea occurs when your airway becomes blocked during sleep. The airway closes which causes you to wake up briefly to take a breath, often without realizing it. This can happen hundreds of times a night, causing you to have a severely disrupted sleep cycle.

Experts estimate between 40% to 60% of people with insomnia also have sleep apnea. A recent review found that 42.5% of patients had obstructive sleep apnea (OSA).

What Happens During Obstructive Sleep Apnea?

OSA happens when there is an actual blockage of the airway, or even just narrowing.
When you sleep, the muscles around the airways relax, creating a “floppy” airway.

The airway can become blocked while you are breathing in, but there is usually enough pressure to open the airway during exhalation.
The blocked airway while breathing in can cause obstructive sleep apnea.

Sleep fragmentation is caused by sleep-related breathing disorders (SRBD). When you have an SRBD, your airway will close partially or many times during the night. As your airway closes and you struggle for breath, it wakes up your brain which causes your sleep to get chopped up. Sometimes the feeling of choking can cause anxiety which makes it difficult to fall back asleep.

What Causes an Insomniac to Wake Up at Night?

A high percentage of people with obstructive sleep apnea (OSA) also suffer from insomnia.

When you have obstructive sleep apnea, pharmacotherapy will not work for insomnia, sleep-aids cannot open your airway.

You can tell your sleep medication is not working for you when 

  • you have tried several sleep aids
  • you  wake up during the night
  • you are drowsy during the day
  • your sleep is not restorative

What Are the Indicators of Obstructive Sleep Apnea (OSA)?

Sleep-disordered breathing occurs while you are asleep and includes:

  • Dry-mouth
    Because you are struggling to breathe, you open your mouth to get more oxygen, which dries your mouth
  • Morning headaches
    A build-up of carbon dioxide can occur in the brain, causing vasodilation and pressure on the arteries in the brain
  • Getting up in the night to pee
  • Snoring
  • Waking up gasping for breath

Insomnia suffers often believe they are having mental health problems like depression and anxiety, in reality, they have obstructive sleep apnea.

People with insomnia are statistically more likely to be suffering from obstructive sleep apnea than psychiatric conditions.

CPAP Machine to Fight Insomnia

The best treatment for sleep apnea is a CPAP machine. CPAP stands for Continuous Positive Airway Pressure. It is a small machine that pushes oxygen through your constricted nasal passages, so airways remain open. Using a CPAP machine, be able to breathe continuously. Steady air pressure should occur which keeps the tissues in your throat open, which prevents snoring.

The entire set-up comprises a small machine that sits next to your bed. CPAP machines nowadays are small. The machine is a pump that pushes air through a tube to a mask you place over your nose and mouth.

A CPAP machine can feel awkward at first, but the benefits outweigh the initial discomfort. There are so many harmful effects of having obstructive sleep apnea and insomnia it is worth the effort of trying it out at least to see if it works for you.

Imagine finding a cure for snoring, anxiety, depression, daytime drowsiness, high blood pressure, troubles falling asleep and snoring all in one go.

The CPAP machine does this for many people.

Talk to your doctor about having a sleep study done to see if you have obstructive sleep apnea.

Allergies and Insomnia

 

Food allergies can cause insomnia because of the discomfort they create.

Wheat allergies and lactose intolerance can cause upset stomach, swelling, and itching, all of which can make it hard to fall asleep.

Some common food sensitivities and allergies that cause insomnia

  • Foods containing gluten such as rye, wheat flour, white flour and oats
  • Whey protein and lactose in dairy
  • Processed foods

Food allergies cause the immune system to set off a bunch of inflammatory processes that can affect many parts of the body, which can drastically affect the ability to sleep:

  • Clashes with hormones such as estrogen which can make PMS worse and cause pain, bloating and irritability.
  • Sinus congestion
  • Inflammation of the skin, causing problems such as rashes and itchiness
  • Headaches and migraines caused by the vasodilation of capillaries in the brain
  • Inflammation interferes with neurotransmitter synthesis
  • The increase in adrenal glen cortisol
  • Inflammation of the gastrointestinal tract which can keep you awake with the discomfort of conditions like irritable bowel syndrome, Chron’s disease, acid reflux, diarrhea, bloating, constipation and gas
  • Inflammation of joints and tissues

Hay fever 

According to medical studies, there is a connection to insomnia and hay fever.

People with hay fever are twice as likely to suffer insomnia than people who have no allergies.

Conditions such as allergic rhinitis, with symptoms including itching, sneezing, and runny nose, cause you to take a longer time to fall asleep.

You are more likely to wake up in the night, nap during the day and get tired easily, which are symptoms of insomnia.

The hay fever results from an allergen causing an allergic reaction in the mucous membrane in the nasal passages. The lining expands and cuts down on the flow of oxygen into your system. The result is that you gasp for air, cough, and sneeze which makes it very difficult to fall asleep.

Pinpoint the allergy and seek help from there. You can avoid the source or use medication to treat it. If you cannot pinpoint the source, see an allergist who can run blood and skin tests to figure out what is troubling you specifically.

Restless Leg Syndrome 

Restless leg syndrome (RLS) is a neurological condition that affects 1 in 10 people in their lives. It is the overwhelming need to move the legs while at rest and the discomfort of it causes insomnia. RLS sufferers on average get less than 5.5 hours of sleep a night. The feeling of it can be anywhere between just uncomfortable to painful.

Often, people with restless leg syndrome have elevated glutamate levels.
Drugs are available that reduce glutamate levels.

Maybe both restless leg syndrome and insomnia can be treated simultaneously.

The Link Between Insomnia, Depression and Anxiety 

Chronic insomnia can cause anxiety and depression.
However, anxiety and depression can cause insomnia. 
Anxiety, depression, and insomnia together form a vicious cycle. 

If you have chronic insomnia you should be monitored for developing anxiety and depression.

Chronic insomnia can be a symptom of mental health problems.
Upon detection of insomnia, look closer for emotional disorders which could improve early detection. Treating chronic insomnia can reduce your risk of developing a mental or emotional disorder.

A person with an anxiety disorder will have trouble falling asleep, but will then sleep through the night. Someone with depression can fall asleep, but will sleep lightly and wake up throughout the night.

There are several ways to reduce your anxiety and, your insomnia.

Exercise, meditation, music, extra hours devoted to sleep, talk therapy, cognitive behavior therapy and following a routine can all reduce anxiety and improve symptoms of insomnia.

Another helpful tip is, if you can’t fall asleep in the first 15 minutes of going to bed, get up and do something else until you feel sleepy. It will not help you if you lie in bed feeling increasingly frustrated at your inability to sleep.

Chronic Pain

  • Chronic pain is a common cause of insomnia.
  • 50% to 80% of people who suffer from chronic pain also experience sleep disorders
  • Chronic pain harms your sleep cycle and a damaged sleep cycle can aggravate your pain.
  • Chronic pain can cause mental and emotional distress, another huge factor in insomnia.

At night, when those distractions are unavailable, the perception of the pain becomes worse as you lay with nothing else to think about.
The longer you lay in bed, exposed to the pain, the worse the situation becomes.

Another factor is you will feel distressed thinking about yet another painful night, waiting for exhaustion to overpower the pain, which makes the situation worse.

Opioids are often used to treat chronic pain, but the downside is they can disrupt the sleep cycle and prevent a patient from getting into a deep sleep. Opioids can also cause sleep-related breathing problems.

Waking up several times in the night is common for chronic pain patients.
A sufferer might experience many “micro-arousals” per hour of sleep which leads to waking up.

This causes a massive intrusion into the sleep cycles, leading to non-restorative sleep. This can cause worse pain the next day, tiredness, low mood and lowered energy levels. 

Options for treatment vary, but treating insomnia can reduce your chronic pain.
The first step is to rule out any other conditions that might also aggravate insomnia.

Look for complications such as PTSD, depression, medications or other sleep disorders such as restless leg syndrome.

If you rule out the above, it is time to work on the chronic pain. If a condition, such as sleep apnea, is damaging your sleep you must treat it first. Treating the sleep apnea will improve your sleep and, reduce the chronic pain.

Chronic pain causes insomnia.
Factor in anxiety and depression that chronic pain causes, resulting in the deck stacked against you.

Painful and sleepless nights can improve by talking to your doctor about the symptoms you are experiencing.

Keep a sleep journal to record the hours you sleep, if you are waking up in the night, daytime napping, emotions and the pain you are experiencing.

Medications

Many medications cause insomnia.
If you are experiencing insomnia and you think it might be due to a medication you are on, talk to your doctor or pharmacist.

Sleep is so important to your health, talk to your doctor about altering your dose, switching to a different medication, or exploring an alternative treatment.
The side effects of insomnia might be worse than the condition the medication is treating.

It is hard to maintain a high-quality life if you are suffering from insomnia, so it is worth the effort to consider changing or altering the medications you are taking.

To reduce your chances of being kept awake with insomnia and get a better night’s sleep, some tips from sleep experts are:

  • Don’t look at your clock.
    Seeing the time can reinforce that you are not getting enough sleep which can cause anxiety. Turn the clock so you can’t see it. Only look at the clock if you are keeping a sleep journal.
  • Make sleep a priority and schedule in seven to nine hours.
  • Exercise can contribute to a good night’s sleep.
  • Develop a routine that incorporates your favorite relaxing activities.
    For example, listen to soft music in the bath 30 minutes before you plan to turn off the lights.
  • Do not partake in any stimulating activities right before bed such as watching shows or working.
  • Adjust your sleeping environment, so it is how you like it. Experts recommend that it should be quiet, cool and dark. Use a fan or white noise to drown out the sound.

It is worth it to investigate these conditions and the effect they are having on your quality of sleep because insomnia can cause so many health problems on its own.

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