“The fact of sleeping is usually linked to satisfaction, being synonymous with rest and recovery both physical and mental. Also, a lot of people know how unpleasant it is to not get enough sleep.”
Sleep is a basic need of the human being, which if not satisfied can have consequences on health and even in case of complete absence during the long enough time death. The difficulties to sleep are something very annoying for the majority of human beings and some people can get to feel restless before this difficulty. It is not uncommon for thoughts to come up in your mind, such as “Is something bad happening to me?”, “Why is it so hard for me to fall asleep?”, “I’m not sleepy, should I worry?”
In order to try to answer some of these questions, in this article we will try to reflect on why the lack of sleep appears, what problems it can bring and how to treat it.
Difficulty getting enough rest
“I’m not sleepy” is an expression that we usually use and that usually refers to the fact that our body remains in a state of activity such that it does not appear the desire to sleep, or even though these exist not be able to reconcile it. Although this lack of sleep does not necessarily have to be pathological, it is usually associated with the existence of insomnia, which is defined as the inability to initiate or maintain sleep or the fact that it is not restorative for at least three nights weekly for at least three months.
Sleeping less than we need (estimated at around seven or eight hours a day in adults) has significant effects for us.
In general, not having sleep at the time that pertocaría will actually make us sleep less, something that will make our body and our brain can not be repaired completely, have problems to finish developing, it is difficult to reorganize and store the information acquired during the day and is not able to restore the body’s energy levels.
It can cause problems such as fatigue and diurnal fatigue, a weakening of the immune system that makes us more vulnerable to infections, in physical and / or mental slowness, a decrease in the capacity for attention, judgment and reasoning and an irritable mood or depressive. It also increases the possibility of suffering from diabetes and cardiovascular diseases, and in the long run can diminish the cognitive capacity and even the life expectancy.
“I’m not sleepy”: causes of sleeping problems
There are many possible reasons why a person can become sleepless or have difficulty sleeping, being usually a multifactorial phenomenon. Among the multiple causative agents that can participate or directly cause sleep problems we find the following.
1. People with little need for sleep
Each and every one of us is unique and we have a different configuration, there are people who naturally have a smaller amount of sleep than others. This does not mean that they have insomnia: they have no problems to catch or maintain sleep or the difference in sleeping hours compared to others generates no symptoms.
It implies that there is no abrupt change in the ability to be sleepy, if not that it remains generally stable (beyond the changes of age).
2. Anxiety, restlessness and worries
Probably one of the most common causes of most sleep difficulties is worry, stress or anxiety.
The nervousness generated by certain types of thoughts or situations that we will have to face or with which we could find can cause the body and mind to remain active and have great difficulty in falling asleep, with insomnia.
3. No association of the bed as a specific place to sleep
Many people have trouble sleeping because they are unable to associate sleep with the specific place they use for it: the bed. This may be due to the fact that they use it in a general way to work or study lying on it, have fun or do various activities besides sleeping or having sex. Thus, not associate bed to rest our mind wanders and remains active, something that makes us not sleep when the time comes.
4. Physical activation
Everyone knows that exercising regularly helps you sleep better. However, this effect only occurs if the exercise performed is not done just before the dream, since physical activity can increase the activation of the body and generate problems to fall asleep. That is why it is not advisable to perform physical exercise shortly before going to sleep, since the body may have trouble detecting that it is time to sleep before the physical activation and synthesis of neurotransmitters that this causes.
Another habitual cause of the absence of sleep occurs in people who present bipolarity, specifically when they are in a manic or hypomanic phase. In this state, although they do end up falling asleep, they usually perceive a lower need for sleep and stay awake for much longer.
6. Use of certain drugs
Many medications have some type of sleep effect as a side effect. Although these effects usually involve somnolence or sedation, other drugs can cause difficulties in falling asleep. Especially relevant are those that affect the functionality of the autonomic nervous system, such as some psychotropic drugs, antihistamines or corticosteroids.
7. Effects of substance use
In addition to the previous ones, another possibility for the absence of sleep can be found in the effects of the consumption of substances, being something secondary to their consumption.
Generally, lack of sleep is associated in these cases with phases of intoxication in psychostimulant substances such as cocaine or amphetamines, or in abstinence or tolerance of depressant substances such as heroin or opium. Also alcohol can cause insomnia and difficulty sleeping after the first hours after consumption.
Also, drinking coffee, tea, soda or chocolate can have activating effects that make it difficult to sleep.
8. Possible brain damage
The absence of sleep can have as one of its causes the existence of damage in different parts of the brain linked to wakefulness or the fact of going to sleep. One of them would be the thalamus. Another is found in the descending reticular system, a part of the brain that inhibits wakefulness and attention to medium stimuli and which allows us to sleep.
Damages in these areas would cause severe difficulties to sleep, or even the impossibility to do so. Excessive or even pathological activation of the amygdala can also cause these difficulties.
9. Medical diseases
Another possible reason to stop having sleep is the suffering of some type of illness which secondarily causes sleep disorders, including insomnia. Examples of this are those of people with diseases associated with pain, or diseases of genetic origin.
Probably the clearest and most serious case is that of fatal familial insomnia, a strange genetic disorder present in a few families that begins with the patient only having micro-dreams and gradually causes the total cessation of sleep, something that ends up leading to death to who suffers it. However, this disease is extremely rare, so in the vast majority of cases there is no cause for alarm.
10. Mismatch of circadian rhythms
There is not always a real insomnia, but sometimes the problem may be rather in the fact that our circadian rhythms are out of adjustment, may enter into conflicts with our obligations and social and labor demands. This is why it is possible for nocturnal insomnia and daytime sleepiness to appear.
The treatment of the lack or difficulties of sleep will depend enormously on the type of causes that generate them. In general, one of the basic steps will be to first assess where we think this lack of sleep comes from, and if necessary to perform a polysomnigraphy to check whether during sleep we enter all phases of sleep or have some kind of difficulty in some specific.
At the level of therapy itself, at the psychological and behavioral level it is usual to carry out a sleep hygiene, analyzing and using different guidelines through which to favor through our behavior and our habits the existence of a quality dream. Among them would be the regulation of meal or sports schedules in relation to the time to go to sleep, the control of light and sound or use the bed only to sleep or have sex. It may also be useful to learn relaxation techniques, mindfulness or meditation.
In case the cause is anxiety, previous therapies may be useful, along with training in the management of anxiety, frustration and stress, cognitive restructuring or biofeedback.
It is usual that the fact of thinking and worrying about the inability to fall asleep generates even more difficulty to do it, something that makes techniques that cut off the active search for sleep easier.
In addition, it may also be useful to use punctually or for a time some type of psychotropic drug indicated by the doctor that contributes to facilitate sleep, being generally employed hypnotic-sedatives such as zolpidem or benzodiazepines. If the cause is organic or derived from drug use, the disease should be treated or the doctor should be able to change treatment. Regarding drugs, poisoning or withdrawal syndrome should be treated.