Sleep problems

There are several different types of sleep problems or sleep difficulties. One of the most common is so-called, insomnia, also known as insomnia. This is a disorder that affects people all over the world. At any given time, 10-15% of adults in Norway struggle with this, and the number has been increasing over the past 20 years.

It is well documented that the ability to fall asleep or maintain sufficient sleep can have major consequences for both our physical and mental health.

In this article, we will therefore briefly explore the symptoms, causes, and what you can do to cope with insomnia on your own.

Symptoms Insomnia

It is completely natural to have sleep problems from time to time. For example, stressful life circumstances can contribute to short-term periods of poor sleep, which pass on their own.

If the pain continues over time, it is important to take it seriously, as it can significantly affect our functioning in everyday life, and in the longer term can be directly dangerous to our health.

Fortunately, there are several measures and treatments that can help you with your sleep problems.

Common symptoms of insomnia include a long time to fall asleep (over 30 minutes), frequent awakenings during the night, waking up too early in the morning, feeling not fully rested when you wake up, as well as noticing that your cognition and ability to concentrate are affected so that affects one's functioning at, for example, school, work or private life.

You can answer the following form for a simplified survey of your sleep by following this link: https://helse-bergen.no/seksjon/sovno/Documents/bergeninsomniascale1.pdf

Causes of insomnia

Insomnia can have many and varied causes. Mental difficulties such as chronic stress, anxiety, depression, trauma problems, drug use are often associated with sleep.

Studies show that if one is struggling with depression at the same time as having significant sleep problems, treating the sleep problems itself can make a positive contribution to the depressive symptoms.

Chronic diseases, pain problems, side effects of medication, other sleep disorders (such as sleep apnea) and bad sleeping habits are other factors that can contribute to the development and maintenance of insomnia.

It is therefore important to map out exactly what your likely causes of insomnia are so that the treatment can be effective.

Insomnia diagnosis

In order to get an accurate diagnosis and identify any underlying causes, it is important to see a healthcare professional. A psychologist or doctor can carry out a thorough assessment of sleep habits, sleep patterns and any associated symptoms.

The psychologists at Psykologvirke can contribute with this mapping and, in collaboration with you, design proposals for measures.

In some cases, further tests or referral to a sleep specialist may be necessary for one polysomnographic study.

Even if one does not satisfy the diagnosis of insomnia, many may still have a desire to improve sleep. This is often done using the same measures and principles used to treat insomnia.

Treatment of Insomnia

Depending on the cause of the insomnia, there are a number of ways to treat it. In certain cases, insomnia is secondary, i.e. the sleep problem is triggered by other, more underlying emotional difficulties such as personality disorder, trauma, chronic stress, or other psychological conditions and ailments.

Treatments where the sleep difficulties are more primary include, for example

1) Cognitive therapy with the aim of exploring assumptions about one's own sleep and functioning, as well as the relationship between thoughts, feelings and behaviour.

2) Sleep restriction where you map your sleep with a sleep diary, further limit the time you sleep at night and then gradually increase to the desired length of sleep.

3) Develop good sleep habits and limit negative ones.

4) Medicines if other measures do not work.

What can you do yourself?

Regardless of the cause of the sleep difficulties, there is general advice that you can try on your own, which in some cases is sufficient to improve sleep.

There are mainly three factors that have an impact on our sleep, where you can quickly initiate measures yourself; sleep pressure/sleep need (how long one has been awake), circadian rhythm and behavior which affects the body's level of activation

Sleep pressure:

With regard to sleep pressure, it is important to maintain sufficient sleep needs by not sleeping during the day. If you do not struggle with insomnia, a midday nap of up to 20 minutes can make a positive contribution to the rest of the day, but if you struggle with sleep you should avoid this altogether.

Get out of bed when you wake up rather than dozing off. Regular physical activity also contributes positively to sleep pressure.

Circadian rhythm:

When it comes to circadian rhythm, the most important advice is to get up at the same time every day (preferably also on weekends) and get daylight early in the morning, preferably 20-30 minutes outdoors if possible.

This is the clearest signal the body receives to regulate the circadian rhythm. Avoid bright and particularly blue-speckled light in the evening, e.g. from a mobile phone/PC.

As the body temperature is also regulated by the circadian rhythm, it can help to take a hot shower 1 hour before bed. This drop in body temperature can contribute to feelings of sleepiness.

If you have cold feet when you go to bed, socks or a hot water bottle can also help.

Behavior:

In terms of behaviour, it is important to avoid caffeine and nicotine after 5pm, in some cases after 12pm. Avoid eating large meals in the hours before going to bed, and avoid alcohol.

Alcohol can make it easier to fall asleep, but has major negative effects on the quality and depth of sleep. Avoid doing activities that are activating towards bedtime. Activities in bed should be limited to sleep and sex so that the body does not associate the bed and the bedroom with wakefulness.

The bedroom should be cool, well ventilated, dark and quiet. Some benefit from a sleeping mask and earplugs. If you are physically restless, it can be useful to regulate your body using deep breathing, progressive muscle relaxation or meditation.

Don't look at the clock if you can't sleep.

There are a number resources on the internet about this.

If own measures do not lead

We on Psykologvirke is ready to help you in your project to get a better quality of life by improving your sleep.

If the difficulties have persisted over time, it may be important to have guidance and structure to implement the changes needed.

Here you can read more about sleep and sleep problems.

Text by Øystein Nødtvedt (øystein@psykologvirke.no) psychologist