Nishant looked at the clock. It was 2:07AM. He had been tossing and turning for 3 hours in bed and had become so frustrated at not being able to sleep that he got up and went to watch TV. Even the infomercials weren’t boring enough to make him the least bit drowsy. Around 4 o’clock in the morning, he stumbled back into his room and tried to get three hours of sleep before he had to get up for work.
This was the third week in a row that he had trouble falling asleep. During the day he was exhausted from the lack of sleep and would compensate by drinking extra caffeine to drive around and complete his assignments during the day. After work, he would go to the gym to engage in his usual exercise routine. However, he soon noticed that he was working out inefficiently because his body was so tired. Instead of feeling refreshed and recharged after the workout, he felt more drained and exhausted. Regardless, he pushed himself to try and stay in shape, thinking that he was doing everything in his power to keep himself healthy.
His dinner, which used to consist of homemade food, had slowly turned into junk and fast food. He seemed to feel less motivated to cook, partly because by the time he got home from the gym, his body was ready to give out and partly because he did not feel as interested in cooking. Despite his physical exhaustion, his mind was always alert. He would eat his unhealthy dinner in front of the TV, get ready for bed and then spend hours wide awake in bed. Around 2AM he would get up, watch TV for a couple of hours and the cycle would repeat itself the next day.
This continued for over one week and one day his co-worker, Aasif, asked him during lunch, “Hey are you ok? You haven’t seemed yourself lately.”
“Ya I’m fine,” Nishant said rubbing his eyes. “I just haven’t been sleeping well lately.”
“Anything on your mind?” Aasif inquired.
“No not much, I just can’t sleep. I don’t know why,” said Nishant.
“But are you feeling ok? I don’t just mean physically?” Aasif asked carefully.
“What do you mean?” Nishant starting to feel a little defensive.
“You just seem like you’ve been feeling down lately. You don’t seem as excited when you talk about upcoming baseball games that you have planned to watch. You just seem….down. Like you’re sad or depressed or something.” Aasif looked carefully at Nishant to see if he had crossed a line with his question.
“Hmm…maybe.” Nishant didn’t know what else to say but what Aasif said struck a cord with him. He did feel lower in mood and nothing really seemed to excite him lately.
Insomnia comes in two forms: 1) where you have trouble falling asleep or 2) where once you wake up in the middle of the night, you have trouble falling back asleep. Until now, research has assumed that insomnia is one of the symptoms of depression. (A smaller percentage experience hypersomnia – excessive sleeping – when depressed.)
However, a study published in February 2011 is finding that insomnia might actually be a factor that causes depression. In fact, they concluded that in people who were not depressed, experiencing insomnia resulted in a twofold risk to develop depression than people with no sleep problems. In addition, people who were depressed in the past had a higher risk of recurring depression than people who were depressed in the past but don’t have sleep problems. In fact, research by sleep researcher, Michael Perlis, Ph.D found that insomnia, especially if it gets worse, is often a reliable warning sign of an upcoming depressive episode.
Common causes of insomnia include:
- Stress and Anxiety – Anything from the day-to-day stress to grieving a loss of a loved one causes stress and can increase sleep problems.
- Depression – Chemical imbalances in the brain, poor eating habits or lack of exercise which all come with being depressed can have negative effects on sleep.
- Medications – This includes some antidepressants, heart and blood pressure medications, allergy medications, stimulants (such as Ritalin), corticosteroids and over the counter decongestants
- Caffeine – Any stimulant such as coffee, soda or an energy drink changes your body's rhythm and can keep you awake at night.
- Nicotine – This is also a stimulant and can keep your body wired and make sleep difficult.
- Alcohol – While alcohol is a sedative, it prevents the brain from achieving deep sleep which is crucial for sleep health. Without deep sleep, you are more likely to awaken in the middle of the night.
- Poor sleep habits – Irregular sleep patterns, engaging in stimulating activities before bed (e.g. exercising or arguing), or using the bed for anything other than sleep or sex are sings of poor sleep hygiene which promotes sleep problems and insomnia.
- Eating too much late in the evening – Close to bedtime, your body needs to slow down. Having a large meal right before bed may make lying down uncomfortable, making sleep difficult. Heartburn is also more likely to occur, keeping you awake.
- “Learned Insomnia” – This is when you worry about sleeping or falling asleep so much it prevents you from sleeping
Treating the insomnia can prevent a first or recurrent depressive episode so if you notice a pattern in sleep problems, consider talking to a mental health professional to discuss the causes of your insomnia and identifying a treatment to remove them.
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