By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.
Frequently poor sleep might be Insomnia Disorder.
Most people have an occasional night with poor sleep. That does not rise to the level of being a diagnosable illness. But if you have those nights often, you just might be having Insomnia Disorder. There are many connections between your physical health, mental health, and biological functions. Sleep is a very important one of these connections.
Poor sleep can be a symptom of a mental or emotional disorder.
Poor sleep often accompanies Major Depressive Disorder. People who are depressed either sleep way too much or they find it hard to sleep at all. High levels of anxiety, any of the anxiety disorders, may interfere with your ability to sleep. Low need for sleep can be a part of bipolar disorders. Lack of sleep now can also be a warning sign that an emotional problem is just around the next bend in the road of life.
Poor sleep can be a primary disorder all by itself.
Poor sleep, if it gets to be a big enough problem, needs to be treated before it disrupts the rest of your life. Treating poor sleep is often a problematic issue. Medical doctors may treat it with medication which is a temporary solution but long-term you need to look at the connection between your sleep disorder and your mental and emotional health.
Counselors often see the connection between your sleep and your anxiety, depression or other mental illness but what may be missing is counseling about how to reduce the impact of your Insomnia or other sleep disorder on your life. Treating both problems at the same time is the recommended approach most of the time.
For a full description of the way Insomnia Disorder gets diagnosed you should look at the DSM-5 but below is my plain language explanation of some of the things that would make a professional think that your sleep problems might justify a separate diagnosis of insomnia disorder.
Can’t fall asleep?
Most people experience occasional times when they have difficulty falling asleep. But if this happens to you a lot you should start looking at why. For many people, this is simply a lack of good sleep skills sometimes referred to as poor sleep hygiene.
Sleep hygiene involves things like having a regular bedtime, avoiding caffeine and other drugs that interfere with sleep close to bedtime, not watching an exciting sports event and then rushing to bed while still all wound up and so on.
Many people can cure their insomnia issues by practicing good sleep skills. Watch for an upcoming post on how you could do this.
If you have an anxiety, Major Depressive Disorder, or another mental illness, getting that emotional issue treated can improve your sleep. Nightmares, Bad dreams, and Sleep Terrors also need treatment. The nightmares that accompany Posttraumatic Stress Disorder (PTSD) especially need treatment. You can treat those nightmares without having to relive all those traumatic life events. More on that also in an upcoming post.
A rough rule of thumb is, if it routinely takes more than a half hour to get to sleep, you need to take a look at why.
Can’t stay asleep, could be Insomnia Disorder.
People with Insomnia Disorder wake up a lot throughout the night. This frequent wakening reduces the quality of their sleep. Awakenings also reduce the total amount of sleep. Get poor quality sleep or too little sleep and you will be tired all day. These sleep deficits pile up over time. Sleeping in on the weekend may feel like it helps a little but just like overdrawing your bank account cost you fees, overdrawing your sleep accounts all week comes with costs that can’t be made up with a few extra minutes on the week-end.
People with Insomnia Disorder will find that even when they stay in bed extra time they can’t sleep anyway.
Is your poor sleep or lack of sleep a problem?
If you find that your concentration is off all day that may be because of sleep issues. Do you find yourself getting sleepy or dozing off during the day? Look at your nighttime sleep. If you are one of those people who can get by on less sleep and still feel fine then you probably will not get a sleep disorder diagnosis. If the number of hours of sleep gets too low and you think you are fine but others tell us you are off the hook we may start looking at a bipolar disorder as a possibility.
Take a hard look at your daytime problems and consider if many of your emotional problems may be connected to your insomnia or other sleep problem.
Insomnia disorder can look like ADHD.
Poor sleep can also impair your attention. Lots of client’s referred for ADHD treatment turn out to have insomnia disorder or another sleep-related problem. I have lost track of the number of people who came in for an assessment, especially teens, and it turned out they were staying up all night on social media, texting or the internet. That is a lack of sleep skills, not ADHD.
Drugs, medications, and foods can keep you from sleeping.
Most people know that street drugs, methamphetamine, and cocaine, will keep you from sleeping. When you are high you don’t sleep. Then when you come down you crash and sleep for a very long time trying to make up for the awake run.
Caffeine from many sources can interfere with sleep. We miss how high the doses of caffeine little children are getting. Most sodas are loaded with caffeine. More and more people are drinking energy drinks and those beverages can also keep you awake long after you wish the effects had worn off.
There are lots of other medications that can mess up your sleep-wake cycle. If you are experiencing insomnia or another sleep problem talk with your doctor about the possibility that something you are talking is causing that. Do not forget to mention over the counter and herbal products also. Remember those over the counter headache pills you take? Some of them are high in caffeine also.
You can’t sleep if you do not go to bed.
Lots of people who complain about insomnia, poor sleep quality, and bad dreams are chronically sleep deprived. They are stressed or anxious about their awake life. Do not expect to fall asleep the second your head hits the pillow. Budget enough hours of your life to getting sleep if you want to have a happy, productive life.
Sleep times and cycles change as we age.
Sorry folks all of us are getting older. When we are young most of us want to stay up all night despite needing more than average sleep. Young kids need more sleep. If they do not get it they get grouchy, irritable and can’t concentrate.
Seniors and the elderly may need less sleep, they may also develop more sleep disorder problems.
What should you do if you have Insomnia Disorder?
Good treatment for most people with Insomnia Disorder involves three things. Talk with your medical doctor and see if there are underlying medical issues. Work on sleep skills, sleep hygiene, relaxation and other skills. Get your mental health issues treated. Nightmares, trauma, anxiety, and depression are all treatable and they all interact with sleep quality.
Thanks for reading all this way. Sleep well and live well.
You might want to take a look at other posts on:
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Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.
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