Sleep duration depends on age, health and emotional status; Now, while we sleep, our brain does not rest completely, it remains active controlling our vital functions such as breathing, digestion and circulation, among others. Understanding these processes helps to understand the causes of insomnia.
Throughout sleep, changes occur in our brain and body; in this process We go through stages that ensure that our body returns to function at its full potential. Thus, throughout sleep, various parts of the brain are activated and inhibited.
Sleep has a circadian biological rhythm and has the REM and Non-Rem phase.
REM sleep comes and goes all night. In her the brain is active, we dream but the muscles are very relaxed.
In the non-REM phase, the brain is calm, but the body can move. Hormones are released into the blood and the body repairs itself from the day’s wear and tear.
The non-REM phase consists of four phases: pre-sleep, light sleep, slow-wave sleep, and deep slow-wave sleep. We went through these phases about five times throughout the night.
On the other hand, during the night we wake up one or two minutes every two hours although we do not remember it.
The minimum hours of sleep we need varies depending on age, personal characteristics or circumstances.
The insomnia
insomnia is persistent difficulty in initiating sleep, or affecting its duration, consolidation or quality and that occurs despite the right circumstances for sleeping.
More than 50% of patients in primary care complain of insomnia, and the prevalence of insomnia as a symptom of another illness is very high.
The vast majority of the time insomnia is consequence of another underlying disease.
What causes could be behind insomnia?
Insomnia can be classified according to its etiology, its time of onset at night and its duration.
Depending on its etiology, isomnia can be secondary or primary.
Examples of health disorders that lead to secondary insomnia are poor sleep hygiene, insomnia due to psychiatric disorders insomnia due to chronobiological alterations, insomnia due to medical and neurological diseases, fatal familial insomnia, insomnia due to restless legs syndrome and insomnia due to drugs.
1. Insomnia due to poor sleep hygiene
Harmful habits can disrupt sleep. Routines such as the absence of schedules, eating at odd hours, taking exciting substances, consume alcohol or stimulant drugs. Breaking these bad habits usually ends insomnia.
Sleep hygiene guidelines
To overcome sleeping problems caused by poor sleep hygiene, keep these guidelines in mind:
Avoid stimulating drinks
Light dinner
Do exercise
Avoid long naps
Control medication
Maintain sleep schedules
Avoid bright light
Use the bed only to sleep
Create an ideal environment
Establish a bedtime ritual
2. Insomnia due to psychiatric disorders
Chronic insomnia is usually associated with depression or anxiety although it is related to psychosis and alcohol and drug dependence.
Depression causes a shortening of total sleep due to early awakening, and anxiety makes it difficult to start and maintain sleep.
3. Insomnia due to chronobiological alterations
In these cases it occurs an asynchrony of the periods of wakefulness and sleep with respect to the geophysical day/night cycle. In these situations, the causes are:
Phase advance
Phase delay
Irregular wake-sleep rhythm
Shift work
Jet lag
4. Insomnia due to medical and neurological diseases
This insomnia is related to the symptoms that arise from this type of illness: pain, dyspnea, cough, gastroesophageal reflux, nocturia, etc
Treatments given for some diseases can also cause insomnia, such as steroids, theophyllines, etc.
5. Fatal familial insomnia
This is a prion disease that deteriorates the rapid and progressive cognitive system o It is hereditary and causes uncontrolled insomnia.
This disease gives rise to signs of vegetative hyperactivity, tremor, myoclonus, dystonia and pyramidal signs. Death comes in less than two years.
6. Restless legs syndrome
It is the need that gives rise to an irresistible urge to move your legs or walk. It usually appears at night or during the transition from wakefulness to sleep.
It is associated with iron deficiency, peripheral neuropathies or chronic renal failure. Can be treated with dopaminergic agents
