Insomnia: Everything You Need to Know

Insomnia is estimated to affect up to 30% of adults, making it the world's most common sleep disorder. But what causes insomnia, and most importantly, what can you do to alleviate the condition? Keep reading to find out.

What is insomnia?

Insomnia is a widespread sleep disorder that disrupts the body's natural sleep-wake cycle. Cases may be acute or chronic, and affect roughly 30% of people worldwide (some estimates predict 50–60%), with a greater frequency in the elderly and females.^[1] While it's usual for nearly everyone to experience some form of mild insomnia throughout their life, a medical diagnosis of insomnia usually needs to meet the following criteria:

• Trouble sleeping at least 3 nights a week (lasting three months or longer)
• Trouble sleeping that causes significant disruption to mental and/or physical well-being

Although prevalent and impacting every facet of daily life, there is a positive element to insomnia—most cases resolve themselves with minor lifestyle adjustments. We'll find out what some of those adjustments are shortly, but before we do, let's take a closer look at different types of insomnia and their symptoms.

What are the symptoms of insomnia?

All symptoms associated with insomnia usually fall into one of the two previously mentioned categories: acute or chronic. Short-term insomnia is a brief period of disturbed sleep, typically attributed to a life event or significant lifestyle change. Chronic cases, however, last for months, persisting even in the absence of a meaningful life event.

Primary symptoms of insomnia include:

• Difficulty falling asleep or staying asleep
• Waking earlier than planned
• Unrefreshing sleep or still feeling tired despite a full night of sleep

However, disrupting the body's sleep-wake cycles often leads to myriad mental and physical issues, causing further symptoms such as:

• Mood swings
• Fatigue/excessive daytime tiredness
• Short temper
• Trouble concentrating/poor focus
• Worry or sleep anxiety

Types of insomnia

The definition of insomnia is pretty broad, so to better understand the condition, medical professionals classify cases based on the specificity of symptoms:

• Comorbid insomnia: Used to describe cases of insomnia that share a link with an underlying health condition. For example, it's common for people to experience insomnia as a symptom of depression, but insomnia itself may also contribute to depression.

• Early morning waking/sleep-onset insomnia: These are similar types of insomnia that exist at opposite ends of the sleep cycle. Early morning waking implies trouble going back to sleep or waking much earlier than planned. Sleep-onset insomnia is difficulty getting to sleep at the start of the night.

• Sleep maintenance insomnia: This category describes individuals who wake often throughout the night.

What causes insomnia?

Excluding underlying health conditions, there's a range of potential causes for insomnia. Some may seem insignificant at first, but if they're experienced night after night, that's when insomnia can develop. Possible causes include:

• Excessive noise, temperature, or light exposure: Disturbances to sleep, night after night, can very quickly prompt insomnia. Whether it's noise pollution, a stuffy bedroom, or unwanted light exposure, all three upset your body's sleep-wake cycle.

• Alcohol, caffeine, or other stimulants: Alcohol may overcome cases of sleep-onset insomnia by helping you fall asleep faster, but the benefit is short-lived. Research suggests alcohol causes significant disruption to stage three and REM sleep, causing excessive daytime tiredness.^[2] Caffeine and other stimulants do exactly what they imply—stimulate the body when it should be winding down for the night.

• Shift work or irregular sleep pattern: The body is a hive of biological routines and 24-hour cycles (circadian rhythms) working to balance your mental and physical needs. Unfortunately, the body isn't agile enough to alter processes such as sleep and digestion on a daily basis, which is why shift working or an irregular sleep pattern can cause insomnia.

Does old age contribute to insomnia?

The simple answer is yes; the risk of insomnia is greater in geriatrics.^[3] However, the complicated answer is that while it is more common, it's usually the result of cumulative lifestyle factors.

For example, it's natural for energy levels to diminish as we get older, something a short nap usually solves. However, combine repeated napping with a condition such as osteoarthritis or loss of physical function, and suddenly the potential for developing insomnia increases significantly.

In elderly patients, treating insomnia becomes more about symptom management across all aspects of health, rather than areas purely attributed to sleep hygiene.

How is insomnia treated?

Insomnia treatment should always start with assessing one's lifestyle and sleeping habits. Most cases are treatable with simple lifestyle adjustments, but specific medications and supplements can help for more severe cases.

Medication

Medication for insomnia is available over the counter (OTC) or by prescription. The former may include antihistamines as a short-term aid to promote sleep, while the latter typically consists of prescription drugs eszopiclone or zolpidem.

The caveat to all medications (prescribed or OTC) is that many substances cause unwanted side effects or may not be suitable in the long term. It's essential to discuss the implications with a doctor so they can help you decide the best course of action.

Melatonin

The hormone melatonin is crucial to maintaining a balanced sleep-wake cycle. Although the body generally does a good job of managing melatonin levels, environmental factors such as artificial light exposure can disrupt production, leading to difficulty falling asleep. Taking melatonin supplements is a short-term solution that can bolster your body's natural levels and help to get your sleep back on track.

Natural aids

Encouragingly, there are dozens of natural aids that may help your quest for better-quality sleep:

• Valerian: First discovered by the ancient Greeks, valerian, or more specifically, valerian root, has been found to influence GABA receptors, a chemical messaging system with a key role in sleep regulation.^[4]

• Magnesium: According to researchers from the University of Geneva, Switzerland, balanced magnesium levels "are needed for normal sleep regulation".^[5] Typical magnesium intake varies between men and women, but supplementation could prove helpful in most diets.^[6]

• Lavender oil: Backed by centuries of use, there's a lot of evidence to suggest lavender oil is a potent sleep aid. Some research even goes so far as to propose that lavender increases the "percentage of deep or slow-wave sleep (SWS) in men and women".^[7] Your body uses the slow-wave sleep phase to carry out most of its restorative processes.

• CBD/CBN: Cannabinoids offer a host of potential applications when it comes to sleep. CBD interacts with the ECS, a regulatory system directly involved in functions such as mood, appetite, and sleep. CBN is a lesser-known cannabinoid, but it's already being extensively explored for its potential influence on sleep.

• Chamomile: What's interesting about chamomile isn't its brightly coloured flowers, but the host of chemical compounds beneath the surface. There are roughly 36 flavonoids and 28 terpenes within chamomile, and scientists believe the unique combination of these natural substances encourages the plant’s positive influence on sleep.

Insomnia and CBD

Given CBD's lack of toxicity and limited potential side effects, it's only fitting that we take a closer look at the cannabinoid’s potential relationship with sleep and insomnia. However, to develop a complete picture of the situation, we also need to consider if the compound has any influence on mood, as anxiety and other mood disorders often lead to cases of chronic insomnia.

What does the research say?

Researchers at the University of Calgary, Alberta, reviewed dozens of sleep studies to identify CBD's impact on social anxiety disorder, insomnia, and epilepsy.^[8] The results appear to go hand in hand with a more recent case review of CBD and anxiety, with researchers calling for “controlled clinical studies” on the topic.^[9]

While initial reports point to intriguing findings, sleep disorders are sophisticated conditions. There is rarely a single attributing factor, and any potential treatment would need to address various physical and psychological symptoms.

How to dose CBD for insomnia

Dosing CBD for any purpose remains a complex issue to advise, as there is no “ideal dose”. Factors such as sex, weight, height, age, and reason for use all play a part in how much CBD you need. To that end, the advice for dosing CBD is simple—start low and go slow.

CBD won't get you high and appears well-tolerated in humans, according to the World Health Organization (WHO),^[10] so start with a few drops 2–3 times a day to see how you feel. It's also important to stick to the same schedule for at least two weeks before increasing or decreasing your dose accordingly.

Visit the Cibdol store to explore a complete range of sleep products featuring many of the natural aids highlighted above. Or, to learn more about the importance of sleep for mental and physical health, head over to our CBD Encyclopedia for everything you need to know.