Why can’t I fall asleep even when I feel physically tired

Why can’t I fall asleep even when I feel physically tired?

Sometimes I am physically tired but can’t fall asleep. How is that possible?

Are you tired, but for some reason you just can’t fall asleep? Been there, done that, stared at the ceiling, and tossed and turned enough times to prove it. But what does it all mean? Why is it happening? And how do we ‘fix’ it?

Known as the tired but wired syndrome, there are several factors that can have a major influence on our inability to sleep, even when we feel physically tired.

Tired VS Sleepy

In conversation, we tend to use the terms ‘tired’ and ‘sleepy’ interchangeably but in reality they signal very different things. For example, a person might feel exhausted, fatigued or ‘tired’, but not be ready to sleep or go to bed – AKA they are ‘tired’ but not ‘sleepy’. Simply put, or as you may have experienced yourself, feeling tired does not necessarily make sleep inevitable.

It is important to know the difference between being ‘tired’ and feeling ‘sleepy’. As opposed to tired, exhausted, or fatigued, feeling sleepy is when you can barely manage to keep your eyes open or keep yourself awake, even dosing off at times. Feeling sleepy is what is called a ‘discriminative stimulus’ for sleep – it predicts that sleep is about to occur.

Between tired, fatigued, exhausted, and sleepy, how are you supposed to distinguish between these similar, yet different sensations and feelings? How do you know when and if you are really sleepy and not just fatigued?

Some signs of sleepiness include, itchy eyes, a lack of energy, aching muscles, yawning and a tendency to “nod off”. While these signs may seem somewhat vague, they are a good indicator that you are not only tired, but sleepy, and as such can be used as a good frame of reference that it is time to go to sleep.

If you go to bed before you’re ready – tired but not sleepy – or before you experience any of the above signs, it will most likely have the opposite effect, which is you, endlessly tossing and turning, wondering why you just can’t fall asleep. This will eventually turn into you over-analysing and obsessing over the fact that you can’t sleep, triggering a vicious cycle of events that may well leave you wide-eyed and awake, not getting a single second of shut eye all night.

Yes, the sleep struggle is real – and if you’ve experienced it before, whether it be on a mild – moderate level or severe – beyond severe, you know just how frustrating and difficult it can be. Not only on your physical well-being and ability to function on a daily basis, but your mental and emotional state too.

Stress & Anxiety

By far the biggest driving forces behind the ‘tired but wired syndrome’, sleeplessness, and insomniais stress and anxiety. While its no secret that this powerful, yet debilitating duo has a massive impact on almost every aspect of our lives (when triggered), stress and anxiety are an absolute nightmare when it comes to sleep or anything surrounding the topic of sleep.

Even if you’re utterly exhausted AND sleepy, a racing mind can instantly activate the “fight or flight” response / branch of your nervous system, making you fully alert, wide awake, and unable to fall asleep.

Why can’t I fall asleep even when I feel physically tired

Whether you’re thinking about past, current, or future events, or even trivial situations, encounters, and things that hold very little importance or significance, these persistent (and often spiralling) thoughts are enough to keep you awake and alert, irrespective of how tired you may feel. The problem is, the more your thoughts spiral out of control and your mind races, the lower your chances are of actually falling asleep.

It’s fair to say that an onset of anxiety and a racing mind is by no means conducive to peacefully nodding off or getting a good night’s sleep. In fact, sleep disturbances have been identified as a diagnostic symptom for several anxiety disorders. Anxiety also leads to increased arousal and alertness, which can delay sleep even further.

As a rapidly racing mind activates the “fight or flight” branch of your nervous system, resulting in you being awake, aware, and alert, Matthew Walker, a professor of neuroscience and psychology at the University of California, Berkeley, and the author of the best-selling book “Why We Sleep” stated that “In order for us to fall asleep and stay asleep, we need to go in the opposite nervous system direction.” He went on to say that “We need to shift over to the calming branch of the nervous system called the parasympathetic nervous system”, and away from the “fight or flight” branch of our nervous system if we are at all determined to change our sleeping pattern and experience a great night’s sleep.

**Tip: If this is something you struggle with on a nightly basis, there are several exercises and practices you can try to set you up for a better and more restful night’s sleep. Some of these include relaxation exercises before bed to quell your stress and anxiety, breathing exercises and techniques, progressive muscle relaxation, guided meditation, and so much more.

Increased Adrenalin

Often an increase in adrenalin can prevent you from falling asleep even if you’re tired. One of the biggest barriers to sleep / falling and staying asleep / having a great night’s sleep is when/if you associate your bed and bedroom with a heightened sense of stress and anxiety or stressful or anxious situation/event.

If this is the case, the moment you go to bed, you will experience a sudden surge of hyper alertness and awareness, which will make it impossible for you to drop off and actually fall asleep. One of the main reasons this happens is because you spent an extensive amount of time in your bed and bedroom associating and exhibiting negative emotions and feelings towards your environment and space – the very space where you sleep – that your body now perceives, believes, and thinks that you are in danger whenever you enter the space – AKA your bedroom.

**Tip: Your bedroom should be a calm and tranquil environment, perfectly catered to sleep and rest. From the temperature and lighting to the noise control, comfort of your bed, and your surroundings, everything should be conducive to creating a relaxing space where you can peacefully and easily fall asleep.

In essence, this principal is all about establishing / transforming your bedroom into a space that is purely and primarily / ONLY reserved for relaxation, recharging, and SLEEPING! This means no sneaking of your laptop into your bedroom to answer a few emails or finish off a couple of work tasks. No intensive research (work or otherwise). No late-night YouTube watching (yes, we all know the feeling of going down that YouTube rabbit hole). And definitely no Netflix series binging or movie marathons while lying in bed.

Caffeine & Stimulants

Perhaps it’s time to reconsider that afternoon latte or energy drink. Did you know that on average, caffeine has a half-life of 5 hours? It may come as no surprise, then, that research suggests that even 200 milligrams (mg) of caffeine – about 16 ounces of brewed coffee – 16 hours before bed may impact your sleep.

A 2013 study further reported that downing 400 mg of caffeine 6 hours or less before bed had significant effects on sleep disturbance. For this reason, it is recommended that cutting off caffeine consumption 4–6 hours before bedtime is essential.

Day-time Napping

Let’s be honest, we all love a good nap. The only problem is, napping at certain times of the day can make it hard for you to fall asleep at night. But, before you stop napping all together, here’s something that will certainly cheer you up – according to several studies, napping is not inherently bad. In fact, napping has several health benefits.  However, the issue is less about the act of napping itself, and more about the time you choose to take a nap – the wrong nap strategy can keep you up and alert when you should be getting deeper Zzz’s.

Research suggests that long naps and napping later in the afternoon can not only cause you to take longer to fall asleep at night, but negatively affect your sleep quality, resulting in you sleeping poorly, and waking up more frequently during the night.

**Tip: If you’re someone that particularly enjoys their naps, it is recommended that you keep your naps to 20 – 30 minutes (no longer), and nap at the same time every day. That way your body can anticipate it and adjust accordingly.

Other potential causes of poor sleep quality and quantity, not being able to sleep even though you are physically tired, sleep disturbances, and sleeping problems and disorders include:

  • Excessive screen time
  • Unhealthy & unbalanced diet
  • Depression
  • Stimulants that keep you hyper active & alert
  • (an internal timekeeper for everything our bodies do in a 24-hour period) is out of sync
  • Other sleep disorders such as sleep apnea and restless legs syndrome
  • Being overtired

Here’s the great news – Once you identify what might be going on, you can take the necessary action to improve both the quantity and quality of your sleep.

How many ours of sleep do I need

How many hours of sleep do we need?

We all know that sleep is an essential life function. Optimal sleep is not only accompanied by a slew of benefits for your physical, mental, and emotional state, but gives your body and mind the time it needs to recharge, leaving you feeling refreshed and alert when you wake up.

But how many hours of sleep do we need? How much sleep is regarded as not enough sleep? Is there a set amount of sleep we should all be getting to function at our peak? These are just a few frequently asked questions surrounding the topic of sleep.

How many hours of sleep do we need

While many assume the answers to these questions to be simple, without much explanation required, it’s not. In fact, topics such as sleep hygiene, sleep schedule and the required / recommended amount of sleep needed for optimal functioning is far more multifaceted and complex than we think.

From a research perspective, The National Sleep Foundation’s sleep time duration recommendations for healthy people without sleep disorders are as follows:

Age GroupAge RangeRecommended Amount of Sleep per Day
Newborn0-3 months14-17 hours
Infant4-11 months12-15 hours
Toddler1-2 years11-14 hours
Preschool3-5 years10-13 hours
School-age6-13 years9-11 hours
Teen14-17 years8-10 hours
Young Adult18-25 years7-9 hours
Adult26-64 years7-9 hours
Older Adult65 years or older7-8 hours

From the above guidelines 7 – 9 hours of sleep per night is required for most adults to function optimally.

So, the question is, if you are not getting the ‘recommended’ 7 -9 hours of sleep per night as outlined by The National Sleep Foundation, does that mean you are simply not getting enough sleep and can therefore not function at your best?

While it may surprise some, the answer is no, not necessarily.

Although the National Sleep Foundation’s recommended sleep guidelines do take age into account, it fails to consider the fact that no one person is the same. We are all individual, and we are all different. This means that what works for one person, does not necessarily work for another – the same applies to sleep.

While these guidelines may serve as a general broad-spectrum rule-of-thumb for how much sleep we ‘require’ to function, or how much sleep is considered enough/ideal, the amount of sleep each individual person needs to function optimally and perform at their best can vary significantly as well as be based on and/or influenced by a variety of factors.

Simply put, the amount of sleep you need to function at your best can vary greatly from what is regarded as the stereotypical norm. While some people function at their most optimal when they get a consistent 8 hours of sleep every night, others perform at their peak, physically, mentally, and emotionally, with a good 4 – 5 hours of sleep.

Regardless of what category you fall into, what is most important is that the sleep you do get is sufficient enough for you to not only function efficiently, but feel fully rested, refreshed, and recharged. With that being said, it is important to remember that getting a good night’s sleep isn’t just about how many hours of sleep you get, but also about the quality of your sleep.

A simple way to gauge whether or not you are getting the quantity and quality of sleep you need to function at your best is to ask yourself how alert, awake, and active you feel at 10am – 11am in the morning? If you feel exhausted, foggy, and depleted on all levels, it might be time to take a step back, re-assess, and make some changes to either the quantity or quality of your sleep. That said, listen to your body, which has its own natural cycle. Oversleeping just to meet a criteria isn’t beneficial to you or your circadian rhythm and could leave you feeling even more fatigued.

While it may require some trial and error as well as extra effort and time to get it right, once you do, you’ll be beyond happy that you made this vital investment into your sleep and overall sleep hygiene – You’ll be thriving and firing on all cylinders that’s for sure!

Does Sleeping Too Much Shorten Your Life

Does Sleeping Too Much Shorten Your Life?

For many years, we have seen news reports and studies on how a lack of sleep can drastically and negatively affect not only your current quality of life but also long term health, which significantly shortens your lifespan. However, recent research has proven that the reverse is also true: sleeping too much can reduce your overall life expectancy. 

At Zleepy, we know that, as with all things, finding the right balance of not only the amount of sleep (as in hours slept) but the quality of that sleep is essential in supporting a long life and good health.

While we have previously outlined what the lack of sleep can do to your brain (and overall well being), today, we are looking at the risks and repercussions of sleeping more than the recommended daily amount.

How Too Much Sleep Affects You

Sleep is, somewhat counterintuitively, a busy time for the body in which the body can rejuvenate and repair itself. A good night’s sleep boosts productivity, cognitive abilities, and general organ health. The recommendation for sleep duration is between 7 and 9 hours per night, depending on factors such as age and lifestyle. Too much sleep is generally defined as sleeping more than 10 hours per night, while too little sleep is any less than 7 hours. Recent findings show a statistical correlation between oversleeping and various conditions, including: 

  • Psychiatric diseases
  • Depression
  • High(er) BMIs and weight gain
  • Increased incidences of strokes
  • Increased risk of heart disease
  • Chronic fatigue
  • Systemic inflammation
  • Obesity
  • Hypertension
  • Diabetes

Simply put, sleeping too much can put you at risk for several unhealthy conditions, but it can also indicate an underlying condition, i.e. you sleep too much because you are already suffering from one of these (or other) underlying conditions. If you are sleeping too much, a visit to your doctor or medical health professional is strongly encouraged so that you may address the cause(s) and achieve a good sleep balance.

When it comes to finding your sleep sweet spot, Zleepy is here to help. Make sure that you aren’t sleeping too much or too little by contacting us using our contact form or by emailing us at [email protected]. Let’s help you get a full night’s sleep so you can live a longer, healthier life!

Symptoms of insomnia

Do I Have Insomnia Symptoms?

Is it insomnia or just a few nights of bad sleep? If you’ve ever had trouble sleeping, this is without a doubt a question you’ve asked yourself as you’ve tossed and turned, trying desperately to fall asleep for the 3rd night in a row.

Sometimes it can be difficult to distinguish whether you have insomnia or if you’re merely experiencing a few restless nights of not being able to sleep.

We’ve all had those nights where sleep doesn’t come easy, especially if we’re feeling particularly stressed, upset, nervous, or angry, or if our minds are overflowing with thoughts of work, family, friends, finances – the list is endless. But how do we know if our sleep issues are nothing more than a short-term concern that will soon pass, or if it’s a persistent sleeping problem, most likely insomnia?

If it is indeed more serious than a few nights of tossing and turning and endlessly staring at the sealing, it is important to be aware of what the symptoms of insomnia are, and to be proactive about addressing them.

What Are The Symptoms Of Insomnia?

According to the Sleep Foundation, studies have shown that approximately 10% to 30% of adults experience insomnia symptoms. Insomnia is characterised by the persistent difficulty of falling and/or staying asleep on a nightly basis.

While insomnia is often used as a blanket term to refer to all sleeping problems and their symptoms, there are a range of sleeping disorders that exist and the signs and symptoms of insomnia can vary drastically from one person to the next. Whether the insomnia is a chronic or short-term condition will have a big impact on the symptoms you experience.

Chronic Insomnia Symptoms

Chronic insomnia is a long-term pattern of having difficulty sleeping. To receive a chronic insomnia diagnosis, you must experience insomnia symptoms / have trouble falling asleep or staying asleep at least three nights per week for three months or longer. Most people who suffer from chronic insomnia have a long history of difficulty sleeping.

Besides the above criteria, a chronic insomnia diagnosis hinges on two other factors:

1. Experiencing insomnia symptoms despite adequate opportunities for sleep

Having difficulty falling asleep is known as sleep onset insomnia, while difficulty staying asleep is known as sleep maintenance insomnia. However, some people with insomnia have trouble with both sleep onset and sleep maintenance. Periods of sleep latency (the amount of time it takes to fall asleep) or wakefulness during the night can further constitute chronic insomnia if it exceeds 20 minutes for children and young adults, or 30 minutes for adults. People who suffer from chronic insomnia also have a frequent tendency to wake up earlier than they wish. 

2. Resulting daytime impairments due to the severe lack of sleep

Some of the most common symptoms of chronic insomnia and resulting daytime impairments include:

  • Extreme fatigue and overall unease
  • Mood disturbances and irritability
  • Difficulty paying attention, concentrating, or remembering
  • Excessive daytime drowsiness, lethargy, and not feeling fully rested or refreshed
  • Impairments to your professional, social, or academic performance
  • Higher risk of errors and accidents (particularly car accidents)
  • Slowed reaction time and a lack of coordination
  • Increased aggression, hyperactivity, and other behavioural issues
  • Heightened levels of anxiety, stress, and depression
  • Experiencing a general feeling of being physically and/or mentally unwell
  • Gastrointestinal symptoms
  • Low energy, motivation, and drive
  • Being worried or anxious about sleeping / going to sleep (indicator of sleep anxiety)
  • Using alcohol, medication, or other aids to fall asleep
  • Suffering from tension headaches
  • Finding it increasingly difficult to socialise, work, or study

Short-term Insomnia Symptoms

Short-term insomnia, also known as acute or adjustment insomnia, is described as a brief episode of difficulty sleeping. Although the symptoms and diagnostic criteria for short-term insomnia are similar to that of chronic insomnia, there are two key differences:

  1. People with short-term insomnia experience sleep onset or sleep maintenance problems for fewer than three nights per week.
  2. While chronic insomnia persists for three months or longer (oftentimes even exceeding six months), short-term insomnia can last anywhere from a few days or a couple of weeks to one or two months, but never exceeding three months.

As short-term insomnia spans over a much shorter time period, it can easily be confused with disorders characterized by temporary circadian rhythm misalignments and disturbances as well as associated sleep problems resulting from environmental factors. Due to the close resemblance, this can make you think that you have insomnia symptoms or that you are suffering from insomnia, when in actual fact you are not.

First, let’s clarify what your circadian rhythm is. Circadian rhythms are 24-hour cycles that are part of the body’s internal clock. Different systems of the body follow circadian rhythms, all of which are synchronized to a ‘master clock’ in your brain. This ‘master clock’ is directly influenced by various environmental factors and cues, especially light and dark. For this reason, our circadian rhythms are tied to the cycle of day and night. When your circadian rhythm is in-sync and properly aligned it promotes consistent, regulated, and restorative sleep. However, when your circadian rhythm is misaligned or thrown off, it can significantly disrupt your sleep and result in reduced sleep quantity, as well as fragmented, and lower-quality sleep.

Disruption or misalignment of your circadian rhythm can occur as a result of several factors, including: Irregular work schedules or shift work (mostly affects people who work at night); jet lag; irregular sleep schedules and poor sleeping patterns; unhealthy lifestyle habits; stress, to mention just a few.

When your circadian rhythm is disrupted, it can lead to both sleep onset and sleep maintenance difficulties. However, insomnia is merely a symptom of the disruption and not the underlying cause. Short-term insomnia occurs despite a lack of circadian misalignment.

While short-term insomnia can be an isolated condition, there is often an underlying variable that precipitates the insomnia symptoms. Acute situational stress or a stressful life event can trigger short-term insomnia. Some examples include the death/loss of a loved one, starting a new job, a pandemic, urgent work deadlines, exams, or a major job, life, or relationship change. Short-term insomnia may also be comorbid with a mental health disorder, medical condition, or substance abuse. Daytime stressors related to work, family, friends, finances, and day-to-day life can also lead to short-term insomnia symptoms. That said, some people experience short-term insomnia without any precipitating factors.

Many people with short-term insomnia will see their symptoms gradually taper off, especially if their insomnia occurred alongside a distressing event or temporary condition. The associated symptoms will steadily resolve when the particular stressor causing the insomnia is no longer present or when the individual adapts to the stressor and puts effective coping mechanisms in place to deal with the stressful incident/event that gave rise to their temporary sleeping problem in the first place.

If you are experiencing any of the above-mentioned insomnia symptoms (irrespective if its only three or four or a whole lot more), it is essential that you properly assess your symptoms and identify what might be triggering them. These symptoms can either be a once-off or temporary experience that will resolve once you address the stressor affecting your ability to sleep, or it can be a precursor for something more serious. Regardless if your short-term insomnia or difficulty sleeping is temporary or not, if it is left unaddressed and unmanaged it can develop into chronic insomnia that requires a more extreme intervention.

What Are The Main Causes Of Insomnia

What Are The Main Causes Of Insomnia

Insomnia can originate from a range of both physical and/or psychological factors. The cause of insomnia can be a temporary problem, such as short-term stress or jetlag. This is typically the case with short-term or acute insomnia. In more severe cases, insomnia may stem from an underlying medical condition or a more deeply rooted issue. This is the case with chronic insomnia.

In many instances, particularly with regards to chronic insomnia, there is no single underlying cause, but rather a combination of factors that contribute to the initiation and exacerbation of insomnia. Sleep deprivation can also trigger or worsen other health conditions, creating a complex chain of cause-and-effect for insomnia.

Some of the most common causes of insomnia include heightened stress levels, having an irregular sleep schedule, an irregular working schedule, dealing with any changes to your body’s internal clock, poor sleeping habits, jetlag, unhealthy lifestyle choices, lack of exercise, pain and physical illnesses, certain types of medications, mental health disorders such as depression and anxiety, neurological problems, and specific sleep disorders, to mention a few.

In this article, we’ll dive deeper into the main causes of insomnia, providing you with all the information you need to know.

Holistic cause of insomnia

On a holistic level, insomnia is believed to be caused by a state of hyperarousal that either disrupts your ability to fall asleep (also known as sleep-onset insomnia), or your ability to stay asleep (also known as sleep maintenance insomnia).  A state of hyperarousal can be both physical and/or mental and can be triggered by a variety of circumstances, internal and external stressors, and health issues.

Insomnia and Stress

What Are The Main Causes Of Insomnia

Stress, along with anxiety and depression, is one of the most common causes of both short-term and chronic insomnia. Stress can provoke a profound reaction in the body that poses a challenge to your quality and quantity of sleep. This stress response can be triggered by a variety of sources, some of which include work, school, family dynamics, financial stressors, social and romantic relationships – depending on the stage of your life.

The body’s physical response to stress contributes to a state of hyperarousal. This is the same effect elicited by mental stress. Being in a state of hyperarousal and heightened mental awareness significantly impacts your ability to sleep. In turn, the inability to sleep may itself become a source of stress. It also has the potential to worsen symptoms of anxiety, stress, and depression, ultimately making it increasingly harder to break the cycle of stress and insomnia.

Exposure to traumatic situations and painful life events can create chronic stress within an individual who has had to endure it. This includes post-traumatic stress disorder (PTSD). Chronic stress can have a dramatic and long-lasting impact on your ability to sleep. If left untreated, it will continue to worsen over time, ultimately impacting the individual’s ability to perform basic daily tasks. It is vital to seek help as soon as possible.

According to research, some individuals are more prone to developing stress-induced sleeping problems. These individuals are considered to have high ‘sleep reactivity’, which is tied to other issues affecting their sleep as well as their physical and mental health.

Insomnia and Irregular Sleep Schedules

Disrupted or irregular sleep schedules is one of the main causes of insomnia worldwide. The body’s internal clock, known as its circadian rhythm, is influenced by a variety of environmental cues, especially light, and is directly tied to the cycle of day and night. Your circadian rhythm plays a vital role in your sleep-wake cycle.

In an ideal world, one’s circadian rhythm closely follows the daily pattern of day and night. However, in reality, a large majority of people adopt sleep schedules that cause minor to severe misalignments of their circadian rhythm. Disrupting your body’s circadian rhythm is a major contributor to developing insomnia.

Two of the most common causes of circadian rhythm disruption is shift work and jet lag. Jet lag disturbs your sleep schedule because your body simply can’t adjust to a rapid change in time zones. Shift work has a big impact on your circadian rhythm as it requires you to work through the night and sleep during the day – This results in a complete disruption to what is regarded as the ‘normal’ circadian rhythm necessary to for you to sleep properly and function optimally throughout the day.

In some individuals, circadian rhythms can be shifted forward or backward without any clear cause or explanation. This can cause persistent difficulties in sleep timing and overall sleep quality.

Alongside irregular sleep schedules, poor sleep habits such as irregular bedtime schedules, taking frequent naps throughout the day, engaging in over-stimulating activities before bed, an uncomfortable sleeping environment, and watching TV, playing video games, and using your computer, smartphone, or other screens just before bed can greatly interfere with your sleep cycle and ability to sleep.

Insomnia and Mental Health Disorders

Mental health conditions such as depression, anxiety, bipolar disorder, anxiety disorders (such as post-traumatic stress disorder), and substance abuse disorders are regarded as some of the top causes of insomnia. It is so severe in fact that Richard J. Schwab, MD at the University of Pennsylvania, Division of Sleep Medicine, estimated that 40% of people with insomniasuffer from some sort of mental health disorder.

Mental health conditions can incite mental hyperarousal as well as pervasive negative thoughts that can drastically disrupt and negatively impact your ability to sleep. Additional studies have indicated that insomnia can further exacerbate mood and anxiety disorders, making symptoms worse and even increasing the risk of suicide in individuals suffering from depression.

Insomnia and Lifestyle

Unhealthy lifestyle habits as well as unhealthy and unsustainable diets (diets that are high in sugars, processed foods, saturated and trans-fats, and low in fibre, essential vitamins and nutrients, fruits, vegetables, legumes, whole grains, and nuts) can greatly increase your risk of insomnia.

Here are a few of the top lifestyle choices and unhealthy habits that can bring about sleeping problems:

  • Keeping your brain stimulated until late in the evening by either working late or using various electronic devices.
  • Frequent napping or napping late in the afternoon can significantly throw off your sleep timing as well as disrupt your body’s internal clock. This will make it much harder to fall asleep at night.
  • Using your bed for activities other than sleeping can create a mental association between your bed and wakefulness. This is problematic as it will not only affect your quality of sleep, but your ability to sleep. Ultimately leading to insomnia.
  • Sleeping in later to try make up for lost sleep can confuse your body’s internal clock (circadian rhythm). This will not only make it increasingly difficult to establish a healthy sleep schedule, but is a major contributor to developing insomnia.

Although it’s a factor that is often overlooked, your diet can play a crucial role in the development of sleeping problems and sleep disorders like insomnia.

  • Caffeine: Caffeine is a stimulant that can stay in your system for hours. When consumed in the afternoon and/or evening it can make it difficult to go to sleep, potentially contributing to insomnia. Much like caffeine, nicotine is another stimulant that can negatively affect your ability to sleep.
  • Alcohol: While alcohol is in fact a sedative that can make you feel sleepy, on the flip side, it can actually worsen your sleep by disturbing your sleep cycle and causing fragmented, non-restorative sleep.

In addition to caffeine, nicotine, and alcohol, eating spicy foods or heavy meals can be hard on your digestive system and its processes. Consuming these types of meals late in the evening has the potential to generate sleeping problems.

Insomnia and Neurological Problems

Research studies have found that problems affecting the brain, including neurodevelopmental and neurodegenerative disorders are associated with an elevated risk of insomnia.

Neurodegenerative disorders, such as dementia and Alzheimers dementia, has the ability to throw off and interfere with an individual’s circadian rhythm as well as alter their perception of daily cues which are responsible for driving the sleep-wake cycle. The associated night-time confusion can worsen both sleep quality and quantity.

Neurodevelopmental disorders like attention-deficit hyperactivity disorder (ADHD) can cause a state of hyperarousal, making it harder for an individual to get the sleep they need. Sleeping problems and disorders are very common among children with Autism Spectrum Disorder (ASD) and may persist into adulthood, ultimately resulting in insomnia.

Insomnia, Pain, and Physical Illness

Pain is a major disrupter of sleep. Almost any condition that causes pain can impair your ability to sleep comfortably. By fixating on the pain you are experiencing while lying sleepless in bed, you amplify the situation, only increasing your stress, anxiety, and inability to sleep.

With regards to illness, health complications related to Type II diabetes has been found to be a potential underlying cause of insomnia. This includes increased pain from peripheral neuropathy, rapid blood sugar surges and changes, and more frequent need for hydration and urination, all of which can greatly disrupt one’s sleep. There is also a correlation between diabetes and other health conditions, including obstructive sleep apnea (OSA) and depression. Both of which are known to interfere with sleep.

Other types of physical illnesses, including those affecting the nervous system and respiratory system, may pose various sleeping challenges which can culminate into developing either short-term or chronic insomnia. Examples of physical illnesses and conditions linked with insomnia include cancer, heart disease, chronic pain, asthma, overactive thyroid, gastroesophageal reflux disease (GERD), chronic obstructive pulmonary disease (COPD), Parkinson’s disease and Alzheimer’s disease.

Often, symptoms of another health issue or natural transition can cause difficulty sleeping – contributing to insomnia. For example, during menopause, hormonal changes can lead to severe night sweats, which can interrupt your sleep and sleeping schedule.

In extremely rare and severe cases, some people may have a rare genetic disorder called fatal familial insomnia. This form of insomnia not only prevents sleep but can be life threatening.

Insomnia and Medications

Insomnia and difficulty sleeping can be a side effect of various medications and prescription drugs. Examples of medications that can interfere with sleep include, blood pressure drugs, anti-asthma medications, and antidepressants. Several over-the-counter medications such as certain allergy and cold medications, pain medications, and weight-loss products contain caffeine and other stimulants that can disrupt your sleep. Other drugs/medications may cause daytime drowsiness which can throw off your sleep schedule.

According to the American Association of Retired Persons, the following medications can cause insomnia:

  • corticosteroids
  • statins
  • alpha-blockers
  • beta-blockers
  • selective serotonin reuptake inhibitor, or SSRI, antidepressants
  • angiotensin converting enzyme, or ACE, inhibitors
  • angiotensin II receptor-blockers, or ARBs
  • cholinesterase inhibitors
  • nonsedating H1 agonists
  • a combination of glucosamine and chondroitin

It is not only taking certain medications that can disrupt your sleep, but the opposite applies too.  If you stop taking a particular drug / medication, symptoms of withdrawal as well as other aspects of the body’s reaction system can impair your ability to sleep.

Insomnia and Specific Sleep Disorders / Sleep-related Disorders

Specific sleep disorders or sleep-related disorders can be a big cause of insomnia. Here are a few examples of sleep disorders that can contribute to insomnia:

  • Obstructive sleep apnea: Obstructive sleep apnea can cause numerous breathing lapses / cause you to stop breathing periodically throughout the night, resulting in temporary sleep interruptions. It is said to affect up to 20% of people and can be a major underlying factor causing insomnia as well as daytime sleepiness.
  • Restless Leg Syndrome (RLS): Restless Leg Syndrome causes unpleasant sensations in your legs and an almost irresistible and powerful urge to move your legs. This detracts you from your sleep and may even prevent you from falling and/or staying asleep.
  • Abnormal behaviors during sleep, known as parasomnias, can interfere with your ability to sleep. Some well-known examples include nightmares, night terrors, sleep walking, and sleep paralysis.

What Are The Main Causes of Insomnia in the Elderly?

Insomnia becomes more common with age. According to the National Library of Medicine and the American Academy of Sleep Medicine, insomnia occurs in 30-48% of older adults, who often have struggles with sleep maintenance.

Similarly to the younger population, factors such as stress, mental health problems, pain and physical ailments, unhealthy lifestyle choices, poor sleep habits, and irregular sleeping schedules can all cause insomnia in the elderly. However, unlike their younger counterparts, elderly individuals are often more sensitive to these causes. This is because of the increased prevalence of chronic health conditions, an increased use of multiple prescription drugs, and a greater degree of social isolation.

Further research indicates that people over the age of 60 have a lower sleep efficiency. These individuals spend less time in deep sleep and REM sleep, which makes it easier for their sleep to be disturbed. Elderly individuals, especially those in managed care settings, often experience a significant decrease in daylight exposure as well as reduced environmental cues for sleep and wakefulness. This can affect their circadian rhythm, ultimately contributing to poor sleep quantity and quality, as well as insomnia.

As you get older, you may also experience:

  • Changes in sleep patterns: Sleep becomes less restful as you age. Your internal clock often advances as you get older – this means you tend to get tired earlier in the evening and wake up earlier in the morning.
  • Changes in health: Elderly individuals typically experience/suffer from higher levels of chronic pain due to various illnesses as well as physical and mental health conditions. All of which can interfere with their ability to sleep. Other issues like prostate or bladder problems, which increases the need to urinate during the night, can greatly disrupt their sleep schedule. Sleep apnea and restless leg syndrome also become more common with age.
  • Changes in activity: As you get older, you may become less physically or socially active. Regular physical activity is vital to optimal sleep. The less active you are, the more daily naps you are likely to take, which ultimately interferes with your ability to sleep at night.
  • More medications: Older people typically use more prescription drugs and medication, which increases the chance of insomnia associated with medications.

What Are The Main Causes of Insomnia In Teens?

According to the National Library of Medicine and the Advocate Children’s Hospital, insomnia has been estimated to affect up to 23.8% of teens, with that number only escalating. Research indicates that various biological changes have pushed teens towards adapting a later, “night owl” sleep schedule. This means that they go to bed/fall asleep at a much later hour, however, they are unable to get the necessary/optimal amount of sleep they need due to early school start times.

To further add to their lack of sleep, teens may be especially susceptible to overscheduling and stress from schoolwork, parental pressures, school sport, extra-mural commitments, and social obligations. Teens are also more likely to use various electronic devices at all hours of the day and night, with heightened night-time screen time being of particular concern. Each of these factors contributes to a high rate of insomnia during adolescence.

What Are the Causes of Insomnia During Pregnancy?

Studies have found that more than 50% of pregnant women report experiencing sleeping problems that are consistent with insomnia. During the first trimester of pregnancy, women tend to sleep more total hours, however, the quality of their sleep significantly decreases. Following the first trimester, the quantity of sleep / the amount of total sleep they are getting drastically decreases, with the most significant sleeping problems occurring during the third trimester of pregnancy.

There are multiple factors that can contribute to and cause insomnia during pregnancy. The main causes of insomnia during pregnancy include:

  • Discomfort: The changed body composition and increased weight associated with pregnancy can affect your positioning and comfort in bed, making it harder to either fall asleep and/or stay asleep.
  • Reflux: Slower digestion often associated with pregnancy can prompt disruptive gastroesophageal reflux in the evening – affecting your ability to sleep.
  • Disrupted Breathing: During the various stages of pregnancy, the growth of your uterus may place increased pressure on your lungs, which can create a potential for breathing problems during sleep. Hormonal changes experienced during pregnancy can also increase your snoring, and, more importantly, increase your risk of central sleep apnea, which involves brief lapses in your breathing.
  • Restless Leg Syndrome: Pregnant women have a greater risk of developing Restless Leg Syndrome (RLS), even if they have never experienced symptoms before.
  • Nocturia: Nocturia refers to the need to go to the bathroom more frequently. Greater urinary frequency results in a greater disruption to one’s sleep and sleep schedule.

What is Insomnia

Insomnia is regarded as the most common sleep disorder, affecting millions of people worldwide. It can be defined as the repeated difficulty with sleep initiation, maintenance, or quality that occurs despite having adequate time and opportunity for sleep. Insomnia can make it exceptionally difficult to fall asleep, stay asleep, or cause you to wake up too early and not be able to go back to sleep.

While many consider ‘insomnia’ to be a blanket term that encompasses all forms of sleeping disorders and sleeping problems, there are several types and severities of sleeping disorders that exist. Insomnia can either be short term (acute) or long term (chronic).

Short term or acute insomnia is the most common type of insomnia and is described as a brief episode of difficulty sleeping. This type of insomnia can last anywhere from a few days to a couple of weeks.

Chronic insomnia is a long-term pattern of having difficulty sleeping. Insomnia is considered chronic if you have trouble falling asleep or staying asleep at least three nights per week for three months or longer. Chronic insomnia can have serious long-term effects if not addressed and managed properly.

What is Insomnia - Man yawning

Although insomnia is primarily classified as either short-term or chronic, insomnia can manifest itself in several distinct ways. In rare cases, individuals may exhibit insomnia symptoms without meeting the criteria for either chronic or acute insomnia. This is known as other insomnia. Most forms of insomnia can fall into one of the following four categories:

  1. Sleep-onset insomnia: Sleep-onset insomnia refers to difficulty falling asleep. This form of insomnia is most common among individuals who find it difficult to quiet their mind and relax in bed. Sleep-onset insomnia typically manifests in people whose circadian rhythm is not in sync due to factors like irregular work schedules and jetlag. It is most commonly associated with the idea of tossing and turning without actually being able to fall asleep.
  2. Seep maintenance insomnia: This type of insomnia refers to having difficulty staying asleep after you have initially fallen asleep. It typically involves waking up at least once (or several times in more severe cases) during the night and then struggling to go back to sleep thereafter. Sleep maintenance insomnia is most common among the elderly population, as well as those who consume caffeine, alcohol, or tobacco before bed. Other conditions/disorders such as periodic limb movement disorder and sleep apnea can result in sleep maintenance insomnia. The fragmented sleep associated with poor sleep maintenance means a decrease in both sleep quantity and quality.
  3. Mixed insomnia: Some individuals can have mixed insomnia which involves both sleep-onset and sleep maintenance difficulties. Those suffering from chronic insomnia may find that these symptoms can shift over time. Mixed insomnia is typically used to describe people who have overlapping sleeping problems.
  4. Early Morning Awakening Insomnia: Early morning awakening insomnia refers to a type of insomnia where an individual wakes up in the morning well before they intend to or plan to wake up.

It is worth noting that these forms of insomnia are primarily used informally or as a way for researchers to better understand, categorize and analyse the various ways that insomnia can present and manifest itself in different people.

In addition to different types of insomnia, how an individual is affected by insomnia can also vary significantly based on its cause, severity, and how it is influenced by underlying health conditions.

What is Insomnia - women sleeping

Insomnia can lead to issues such as:

  • Increased daytime fatigue, sleepiness, and lethargy.
  • Difficulty concentrating and focusing on tasks.
  • A general feeling of being physically and/or mentally unwell.
  • Irritability, mood changes, and anxiety.

Insomnia can also play a role in the development of chronic diseases such as:

  • Diabetes
  • Cardiovascular disease
  • Obesity
  • Depression (as well as other mental health conditions)
What Does Lack Of Sleep Do For Your Brain

What Does Lack Of Sleep Do For Your Brain

If you’ve ever spent a night tossing and turning, you already know how you’ll feel the next day – tired, cranky, and out of sorts. Not getting the recommended 7 – 9 hours of sleep per night does more than give you brain fog and make you feel groggy and grumpy. The long-term effects of sleep deprivation can have a detrimental impact on your brain, overall mental state, and cognitive functioning. In fact, the associated effects of sleep deprivation on your brain are regarded among the most dangerous.

Sleep plays a vital role in optimal cognitive functioning, learning, and memory, with the brain activity patterns associated with newly acquired information being “replayed” during certain stages of sleep to consolidate it. During sleep, your brain forms important connections that help you process and remember new information. Sleep also embeds the things that you have learned and experienced over the course of the day into your short-term memory. A lack of sleep negatively impacts various brain functions, including your short- and long-term memory, and your ability to filter out, process, and retain information. Ultimately resulting in memory issues.

As sleep deprivation prevents your brain cells from functioning optimally, not getting the recommended amount of sleep you need to function at your best makes it difficult for your brain cells to communicate effectively. This, in turn, can lead to temporary mental lapses which further impairs your memory.

A sufficient amount of sleep is necessary for optimal learning to take place. Sleep deprivation can affect your ability to learn in two ways; A lack of sleep impairs your ability to focus, making it incredibly difficult for your brain to pick up and retain any information, which ultimately impairs your ability to learn efficiently. Secondly, as mentioned above, sleep deprivation affects your memory and your ability to make new memories. Memory is essential for learning to take place.

Besides memory and learning, findings suggest that a lack of sleep has the potential to interfere with the ability of neurons in your brain to encode information and translate visual input into conscious thought. This has a profound effect on your visual perception. An example of this is when a sleep-deprived driver sees a pedestrian stepping in front of his/her car. It may take longer for the driver to realize what he or she is seeing because the very act of seeing the pedestrian slows down in the driver’s overtired brain.

One of the biggest dangers of sleep deprivation is slowed reaction time and impaired alertness. The negative impact of sleep deprivation on these crucial functions has been linked to an increased risk of car accidents as well as injuries from other causes. The National Highway Traffic Safety Administration conservatively estimates that at least 100,000 crashes reported to police each year are due to driver fatigue. Other estimates put that number at approximately 1 million – 20% of all crashes. The truth is, you don’t need to physically fall asleep at the wheel for you to be a danger to both yourself and other drivers. The drowsiness and impaired alertness associated with a lack of sleep alone can be equally as dangerous as driving drunk. In fact, it is reported that driving while tired is like driving with a blood alcohol level of .08% – Which is over the legal limit in many states.

Sleep deprivation also significantly effects your ability to concentrate, think clearly, and focus. A lack of sleep can impair what is known as “selective attention”. Selective attention is your ability to focus on specific information when other things are occurring at the same time. As a result, you are more likely to be forgetful, unfocussed, and get distracted easily. Insufficient sleep also greatly impairs your decision making and problem-solving skills as well as your level of concentration throughout the day and degree of creativity.

Sleep is essential for maintaining good overall brain health. The brain does most of its ‘housekeeping’ while we sleep. One ‘housekeeping’ duty that is of particular importance – waste disposal – is acutely sensitive to a lack of sleep. The brain disposes of its waste via the glymphatic system, which is thought to consist of a network of vessels that runs alongside blood vessels in the scalp. The glymphatic system is responsible for draining waste-filled cerebrospinal fluid from the organ. Waste products cleared away by this system include insoluble clumps of misfolded proteins which are deposited in the brain. These waste product deposits occur as a normal part of the aging process, as well as various neurodegenerative diseases.

What Does Lack Of Sleep Do For Your Brain

One of these neurodegenerative diseases is Alzheimer’s disease which involves the deposition of two such proteins: Amyloid-beta, which aggregates to form plaque around your brain cells, and tau, which forms tangles inside your brain cells. As the glymphatic system works at its best while we sleep (getting rid of all the waste depositions), a lack of sleep and poor sleep ‘hygiene’ significantly reduces the efficiency of the brain’s waste disposal system. This means that all the insoluble protein clumps that would normally be cleared away by the glymphatic system remains in place. If you endure prolonged periods of sleep deprivation, these insoluble protein clumps can accumulate to toxic levels, which, in turn, can drastically worsen your sleeping difficulties, ultimately resulting in a vicious cycle. Beside Alzheimer’s disease, a lack of sleep is associated with various other neurodegenerative diseases and psychiatric disorders.

Sleep deprivation has a detrimental effect on your mental abilities, overall well-being (mentally, emotionally, and physically), as well as your mood (resulting in noticeable mood changes). Not getting enough sleep can make you irritable, moody, emotional, and quick-tempered. Chronic sleep deprivation has a more dramatic effect on your mood and mental state and can result in heightened levels of stress, as well as lessen your ability to cope with stress. If left untreated, chronic sleep deprivation may lead to long-term mood and mental health disorders like depression and anxiety.

Chronic sleep deprivation affects the prefrontal cortex of your brain which handles reasoning. It also slows down your thought processes. This hampers your ability to perform tasks that require logical reasoning or complex thought. A lack of sleep also impairs your judgement, significantly affecting your ability to make decisions as you are unable to effectively assess a situation or distinguish between right and wrong.

Sleep deprivation further affects the amygdala of the brain which deals with emotion. A study published in 2009  showed that sleep deprivation alters functional connections between the prefrontal cortex and the brain’s reward- and emotion-processing centers, impairing our so-called executive functions. As a result, our emotional responses are heightened, we become hypersensitive to rewarding stimuli, and we start acting irrationally. Without sleep, we essentially become emotionally irrational and the emotional centers of our brain dramatically overreacts to various situations and experiences.

“When we’re sleep deprived, it’s really as if the brain is reverting to more primitive behavior, regressing in terms of the control humans normally have over their emotions,” – Researcher Matthew Walker, a neuroscientist at the University of California, Berkeley.

Beyond our heightened emotional response, a lack of sleep has the ability to influence/affect how we interact, assess, and respond to the world around us as well as our environment. According to research conducted by senior study author Dr. Itzhak Fried, a professor of neurosurgery at the University of California, Los Angeles (UCLA), starving the body of sleep (chronic sleep deprivation) robs the neurons in your brain of the ability to function properly and optimally. This paves the way for cognitive lapses in how we perceive and react to the world around us.

At a more advanced level, chronic sleep deprivation can over-stimulate parts of the brain and even lead to permanent brain damage, according to a report on sleep deprivation among students published by The Guardian. This is primarily due to the brain’s ‘neural plasticity’, which is the brain’s ability to adapt to new situations. If the brain is forced to operate in a different state on a regular basis (due to chronic sleep deprivation), it permanently alters itself, resulting in permanent changes and even damage.

If the effects on your brain caused by a lack of sleep is left untreated, it can develop into a chronic way of life which will ultimately impact various aspects of both your personal and professional life.

Different types of insomnia

What Are The Three Types Of Insomnia

Insomnia can be defined as repeated difficulty with sleep initiation, maintenance, or quality that occurs despite having adequate time and opportunity for sleep. Despite the blanket term of ‘insomnia’ most people use to refer to chronic sleep deprivation or the inability to either fall asleep or stay asleep, not all cases of insomnia are identical. Not only are there different types of insomnia, but insomnia can affect people in different ways. Understanding and distinguishing between the various forms of insomnia and its unique effect on individuals, is useful for both health professionals and the person suffering from insomnia.

Different types of Insomnia

There are three main types of insomnia:

  • Acute Insomnia
  • Transient Insomnia
  • Chronic Insomnia

While there are several factors that have an impact on the development of insomnia, each type of insomnia can be categorized according to the following criteria:

  • How long it lasts
  • How it affects your sleep
  • The underlying cause of the insomnia
What Are The Three Types Of Insomnia

1. Acute Insomnia

Acute insomnia, also referred to as short-term insomnia or adjustment insomnia, is the most common type of insomnia. It is described as a brief episode of difficulty sleeping. This type of insomnia can last anywhere from a few days to a couple of weeks. In more severe cases, acute insomnia can last up to one or two months, but never exceeding three months.

Acute or short-term insomnia mainly occurs due to acute situational stress or as a result of a stressful life event. Some examples include the death/loss of a loved one, starting a new job, a disconcerting medical diagnosis, a pandemic, urgent work deadlines, exams, a major job or relationship change.

Acute insomnia typically resolves when the stressor is no longer present. The associated symptoms begin to fade as the individual adapts to the stressor and puts successful coping mechanisms in place to deal with the stressful incident/event that gave rise to their sleeping problems (AKA acute insomnia) in the first place. However, short-term insomnia can be both relentless and persistent, and if it is not dealt with effectively and efficiently it can develop into chronic insomnia.

Acute insomnia can affect both adults and children of all ages. It is more common in women than in men, and it can arise during pregnancy as well as menopause.

Along with stress, acute insomnia can be caused by:

  • Sleeping in an unfamiliar bed or unknown surroundings such as a hotel or a new home.
  • Environmental factors that disrupt your sleep, such as light or noise.
  • Certain medications can significantly disrupt your sleeping patterns and ability to fall or stay asleep.
  • Physical discomfort, such as pain or being unable to assume a comfortable position.
  • Certain illnesses have the potential to contribute towards developing acute insomnia.
  • Jet lag.
What Are The Three Types Of Insomnia

2. Transient Insomnia

Transient insomnia is a type of insomnia that does not last very long. Transient insomnia typically lasts for less than one week, and, in many cases, only lasts for a few days. Transient insomnia or temporary insomnia can often times involve a single episode of poor-quality or unrefreshing sleep or recurring episodes of insomnia separated by periods of normal sleep.

One of the great things about transient insomnia is that it does not recur. If it does recur, the insomnia is considered intermittent. However, if the insomnia continues, affecting your ability to either fall asleep or stay asleep most nights, and continues to persist for a month or more, it is considered chronic insomnia.

Transient insomnia (provided that it does not progress) typically does not require any treatment. This type of insomnia is most often caused by some kind of interruption or change in your sleep schedule or environment, stress, depression, jet lag, or an outside stressor.

What Are The Three Types Of Insomnia

3. Chronic Insomnia

Chronic insomnia is a long-term pattern of having difficulty sleeping. Insomnia is considered chronic if you have trouble falling asleep or staying asleep at least three nights per week for three months or longer, and, in many cases, even exceeding 6 months. Most individuals who suffer from/experience chronic insomnia have a long history of difficulty sleeping. Depending on the individual and their circumstances, the sleep deprivation and inability to get the sleep they need may be persistent or go away and recur with months-long episodes at a time.

Depending on the underlying cause, patient history, and a myriad of other factors, chronic insomnia can either be primary or secondary. Primary chronic insomnia, also called idiopathic insomnia, does not have any obvious cause or underlying medical condition or co-existing disease that is responsible for triggering the insomnia. Much like acute insomnia, primary chronic insomnia can be linked to various potential causes. Some of these causes include stressful situations, severe stress-inducing experiences, irregular sleep schedules, poor sleep hygiene, persistent nightmares, the death/loss of a loved one, any major job or relationship changes, extreme life-altering events, to mention a few.

Secondary chronic insomnia, also called comorbid insomnia, is a more common form of chronic insomnia. Comorbid insomnia is when chronic insomnia exists in conjunction with another medical or psychiatric condition. Comorbid insomnia does not have to be caused by or change with the co-existing disorder and/or medical or psychiatric condition. While secondary chronic insomnia or comorbid insomnia may not be caused by the co-existing condition or disorder, it can in many cases make the medical or psychiatric condition worse and hinder its treatment. For example, if an individual suffers from both depression and insomnia, they may not respond as well to the depression treatment as a depressed individual without insomnia would.

Common causes of secondary chronic insomnia include:

  • Mental health conditions: This includes mental health conditions such as depression, anxiety, and attention deficit hyperactivity disorder (ADHD).
  • Chronic medical conditions: Conditions such diabetes, Parkinson’s disease, hyperthyroidism, and obstructive and central sleep apnea.
  • Various medications: Chemotherapy drugs, antidepressants, and beta blockers.
  • Caffeine and other stimulants: Alcohol, nicotine, and other drugs can trigger secondary chronic insomnia.
  • Lifestyle factors: Frequent travel and jet lag, rotating shift work, and frequent napping.

Other Ways of Describing Insomnia

While insomnia is primarily classified as either short-term, transient, or chronic, there are several other terms that can be used to describe insomnia:

  • Sleep-onset insomnia
  • Sleep maintenance insomnia
  • Mixed insomnia
  • Early morning awakening insomnia
What Are The Three Types Of Insomnia