If you have trouble falling asleep or staying asleep, or you find yourself waking up too early and not able to get back to sleep, you may have insomnia. You’re also in good company: The Cleveland Clinic states that 33% to 50% of the adults are affected by insomnia. Besides making you feel tired, insomnia can impact your health — and even make it harder to manage your diabetes. Learn more about insomnia, as well as ways to get some quality sleep.
What is insomnia?
Insomnia is a type of sleep disorder that makes it hard to fall asleep, hard to stay asleep, or causes you to wake up too early and not be able to get back to sleep, according to the Mayo Clinic. When you wake up, you can still feel tired.
Insomnia is one of the most common sleep complaints, and it’s usually linked with other issues that might be going on in your life, such as trying to deal with too much stress.
How do you know if you have insomnia?
Almost everyone has nights when it’s hard to fall asleep. Insomnia can be acute (short-term) or chronic (ongoing). Acute insomnia may happen due to work stress, family problems, or a traumatic event, and it can last for days or weeks.
Chronic insomnia lasts for a month or longer, and it usually results from some kind of problem, such as a health condition, medicines, or other sleep disorders. Caffeine, tobacco, and alcohol are also causes. Long-term stress, emotional issues, travel, and shift work can also lead to chronic insomnia. But you may have chronic insomnia if you notice the following:
- Difficulty falling asleep
- Waking up in the middle of the night
- Difficulty getting back to sleep
- Feeling tired during the day
- Feeling irritable during the day
- Having a hard time paying attention, focusing, or remembering
Who is at risk for insomnia?
Insomnia affects women more than men. Older adults are more prone to insomnia, but it can affect people of all ages. You may also be more likely to have insomnia if you:
- Are African American
- Have a lower income
- Have depression or anxiety
- Have a lot of stress
- Are inactive
- Travel a lot over different time zones
- Work at night or work different shifts
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Health conditions and insomnia
Stress, depression, and anxiety can certainly affect sleep; other medical conditions that can contribute to insomnia are:
- Chronic pain from arthritis or fibromyalgia
- Heartburn and acid reflux disease
- Cancer
- Asthma
- Kidney disease
- Alzheimer’s disease
- Parkinson’s disease
- Other sleep disorders, such as sleep apnea and restless legs syndrome
- Hormonal changes from pregnancy, premenstrual syndrome, or menopause
Medications and insomnia
Along with some health conditions, some medications can make it hard to get a good night’s sleep. These include:
- Antidepressants
- Corticosteroids
- Thyroid hormone
- High blood pressure medications
- Second-generation antihistamines
- Asthma medications
- Statins
- Medications for ADHD (attention deficit hyperactivity disorder)
What are the health impacts of insomnia?
Just like healthy eating and regular physical activity, getting enough good quality sleep is essential for your health. Insomnia and other sleep disorders can lead to both mental and physical issues, as well as a decreased quality of life. Here are other consequences of having insomnia:
- Decreased immunity, making you more susceptible to colds, flu, and other infections
- Increased risk of developing type 2 diabetes
- Increased risk of heart disease and high blood pressure
- Reduced fertility
- Weight gain
- Mental health issues, such as depression, anxiety, or substance abuse
- Accidents, falls, and injuries
How are insomnia and diabetes connected?
Sleep disorders and diabetes are closely linked: a study in the September 2018 issue of the journal Acta Diabetologica found that sleep disturbances and frequent nocturnal awakenings are associated with worsening self-care in adults with type 2 diabetes. Insomnia and sleep disruptions in people with type 2 diabetes can result from:
- Hyperglycemia (high blood sugar)
- Hypoglycemia (low blood sugar)
- Sleep apnea
- Restless legs syndrome
- Peripheral neuropathy
Having a sleep disorder raises the risk of developing type 2 diabetes. That’s because frequent awakening during the night, irregular sleep, and lack of sleep increase insulin resistance, leading to high blood sugars. One explanation is that a lack of sleep affects the balance of two hormones, leptin and ghrelin, leading to increased hunger and overeating, both raising blood sugars and increasing the risk of obesity.
How is insomnia treated?
Treatment of insomnia involves lifestyle changes, counseling, and medicines:
Set up good sleep habits.
This involves creating a peaceful sleeping environment; sticking to a regular sleep schedule; turning off phones, tablets, and television at least an hour before bed; and trying to avoid stressful situations before bedtime.
Stay active.
Fit physical activity into your day but aim to do this at least a few hours before bedtime.
Eat smaller meals, earlier.
Large meals eaten too close to bedtime can cause stomach upset and heartburn.
Avoid or limit naps.
If you need to take a nap, do so before 3 p.m. and limit the duration to 30 minutes.
Avoid caffeine and alcohol before bed.
Stop drinking caffeinated beverages at least six hours before bedtime and avoid the temptation to have a “nightcap” to help you sleep.
Go easy with liquids.
Drinking too many fluids before bed is a surefire way to disrupt your sleep, since you’ll likely need to get up to relieve your bladder. Time your fluid intake for earlier in the day.
Stop smoking.
Nicotine is a stimulant and cause sleep disturbances.
Cognitive-behavioral therapy for insomnia (CBT-I).
CBT-I is a type of therapy that helps you change your thoughts and behaviors that are keeping you from sleeping well.
Medications.
Prescription medication is available that helps you fall asleep, stay asleep, or both. Examples include Lunesta (eszopiclone) and Sonata (zaleplon). Also, nonprescription sleep medications are available. However, these medications are usually not recommended for long-term use, and they can cause daytime sleepiness; some can also be habit-forming.
Let your health care provider know if you are having trouble sleeping. Ask your provider to discuss possible causes with you; this will help them suggest the best type of treatment(s) for you.
Want to learn more about sleeping well with diabetes? Read “Getting the Sleep You Need,” “Eating for Better Sleep” and “Sleep and Diabetes: What’s the Connection.”