Sleepless nation: Hidden dangers of ignoring insomnia

Insomnia is a sleep disorder characterised by the inability to fall asleep, stay asleep, or waking up early in the morning for a prolonged period. [Courtesy]

Many people struggle with inadequate sleep at some point in their lives. Yet, because the problem does not always affect their daily functioning, many never consult a doctor, therapist, or seek treatment.

Insomnia is a sleep disorder characterised by the inability to fall asleep, stay asleep, or waking up early in the morning for a prolonged period. It is a very common disorder, affecting between 6 and 40 per cent of the population. Insomnia can affect quality of life just like conditions such as depression and heart failure, and so it should not be left unattended. Untreated insomnia can also lead to or worsen other mental disorders, and impact physical health by increasing predisposition to accidents and appetite.

Inadequate sleep should be thoroughly investigated. Issues such as duration and frequency of sleep, bedtime schedule, time taken to fall asleep, awakenings, rising time, sleep environment, and triggers such as stress or shift work should be assessed, as well as behaviours during sleep, past medical history, and past treatment history. Medication such as caffeine can last up to six hours, so coffee use and other caffeinated products should be clarified. Nicotine also impacts sleep and this history should be investigated. Physical sleep disorders such as apnoea and obstruction should be ruled out, ideally by specialists in Ear, Nose and Throat (ENT).

Ideally, the first option for treatment of insomnia is psychotherapy, specifically Cognitive Behavioural Therapy for Insomnia (CBT-I), offered either face-to-face or via digital platforms. For adults where CBT-I is unsuitable or ineffective, medication treatment for long-term chronic insomnia is recommended, provided that its use is for the shortest possible duration and reassessed within three months.

CBT-I uses different methods such as learning about sleep, changing habits, and altering thought patterns. CBT-I works well for people with or without other health problems, so it is advisable that those with insomnia are assessed by qualified professionals.

If someone suspects that they have insomnia, they should seek assessment by the nearest medical provider or counsellor. Untreated insomnia can result in both physical and psychological complications, complicate existing medical conditions, and even indicate another underlying condition.

It is therefore wrong to buy over-the-counter medication for the treatment of insomnia, or to use alcohol or other substances of abuse to manage it. It is also important for counsellors and other frontline workers to refer cases of insomnia that are not improving for further investigations by the relevant specialists. Use of “herbal” products has become rampant, yet it is often difficult to know what is contained in those herbs. Use of such products without professional involvement is therefore strongly discouraged.

The writer is a mental health advocate with 25 years of medical practice experience