Insomnia

by | Jul 9, 2026 | Sleep

1. GENERAL.

40% of adults, at some stage, suffer from insomnia and it occurs more in females than males, usually older than 40. This leads to significant daytime consequences, including decreased concentration, memory etc. A Sleep Study is contraindicated and is best diagnosed by analysing a sleep diary.

2. PURPOSE OF SLEEP.

  • Rest and repair. It is during sleep that the growth hormone is secreted.
  • Toxins are removed, including amyloid (amyloid is one of the causative substances for Alzheimer's)
  • Memory consolidation.
  • Sleep improves immunity.

3. TYPES OF INSOMNIA.

  • a. Sleep onset. This is when patients battle to initiate sleep.
  • b. Sleep maintenance. This is when people wake regularly throughout the night.
  • c. Early morning waking.

Insomnia can either be primary or acute, for instance, before writing an exam. It can also be secondary or chronic, and this is when insomnia occurs three nights a week for three months.

4. HORMONES.

  • The sleep-promoting hormone is melatonin.
  • The wakefulness hormones are, for instance, Orexin, histamine, and Norepinephrine.

5. THE FOUR P'S OF INSOMNIA.

  • a. Predisposing factors. Genetics or being a perfectionist.
  • b. Precipitating factors. Stressful events, medical conditions such as chronic pain and substance abuse such as caffeine and alcohol.
  • c. Poor sleep habits, going to bed really late. Substance abuse such as nicotine and alcohol (alcohol is initially a depressant and as it is metabolised, becomes a stimulant). Environmental, e.g. lack of a dark room or pets sleeping on your bed.
  • d. Pavlovian. The person develops anxiety at the mere thought of sleep. This will obviously result in insomnia.

6. TREATMENT.

  • a. Non-medical. CBT (Cognitive Behavioural Therapy).
  • b. Sleep hygiene, for instance, keeping a consistent schedule, having regular naps and making sure that your bedroom environment is optimal.
  • c. Exercise. This increases adenosine, which increases sleep pressure.
  • d. Relaxation techniques, e.g. breathing exercises and cricketing.
  • e. Medication. Benzodiazepines (these are dangerous with side effects and can be addictive). Z Drugs, e.g. Stilnox (these are safer and OK for short-term use, but they can be addictive and lose efficacy. Antihistamines. Melatonin. Possibly Cannabinoids.