Insomnia is a sleep disorder that leads to difficulty falling or staying asleep. The condition is very common, particularly among women. Normal sleep, according to the Office of Alcohol and Substance Abuse Services (OASAS) in New York, is between four and nine hours of sleep every 24-hour cycle; restful sleep requires two stages, called rapid eye movement (REM) and non-rapid eye movement (NREM).
People who develop insomnia may struggle to fall asleep if they must get up at an early hour; wake up suddenly and be unable to get back to sleep; wake up several times over the course of the night and struggle to sleep; or feel fatigued when they get up. They experience disruption of the NREM and REM cycles.
Losing sleep for one night is hard enough, but experiencing sleep difficulty over several nights can lead to mood changes, trouble focusing or completing work, and a lower quality of life. About 40 million American adults experience insomnia at some point, with 63 percent of women and 54 percent of men reporting at least a few nights of sleeplessness in a week.
What Is Insomnia?
Many adults in the United States develop acute insomnia, which lasts for several days or even weeks. Acute insomnia is typically the result of a stressful or traumatic life event. Some individuals struggle with chronic insomnia, which lasts for a month or more. This kind of insomnia requires medical treatment, which may involve prescription drugs and behavioral therapy to help the person get an appropriate amount of rest. Sleeplessness can impact brain function if it lasts for long enough; it may also indicate an underlying problem, like a mental health issue, that must be addressed.
- Symptoms of insomnia include:
- Trouble falling asleep at night
- Waking up during the night
- Waking up too early and being unable to get back to sleep
- Not feeling rested after sleeping for a full night
- Daytime sleepiness or exhaustion
- Anxiety, depression, irritability, or mood swings from feeling tired
- Trouble focusing on tasks or remembering important information
- Increased errors during tasks
- Higher risk of accidents, like car accidents
- Ongoing worries about sleeping, which increases the likelihood of sleepiness
- Other medical conditions like chronic pain, acid reflux, heart disease, overactive thyroid, Parkinson’s disease, asthma, and even cancer
- Feeling stressed
- Traveling or having an unusual work schedule
- Poor sleep habits, like getting to bed at different times every night
- Eating too much late in the evening
- Watching TV or using a computer or smartphone in bed
- Some prescription medications like allergy medication
- Abusing prescription medications like Adderall
- Too much caffeine, nicotine, or alcohol
- Illicit drug abuse, such as cocaine or MDMA
- Sleep apnea or related disorders
- Mental illnesses, including depression, anxiety, bipolar disorders, or post-traumatic stress disorder (PTSD)
While many of these insomnia triggers are within one’s control, there are risk factors for developing insomnia that are not within one’s control, such as:
- Gender: Women are more likely to develop insomnia than men.
- Age: People older than 60 years old typically experience many health changes, like chronic pain or hormonal changes, that could trigger bouts of insomnia.
- Mental or physical health problems: Struggling with stress from a physical or mental illness may lead to insomnia.
Irregular schedule or high-stress life: Jobs requiring long or irregular hours, graduate education programs, young children, or traveling a lot can lead to insomnia.
Women and Insomnia: Do Women Need More Sleep?
A study on men’s and women’s sleep needs at Duke University in North Carolina found that women need more sleep than men; however, Snopes points out that women do not generally need more sleep than men due to biological differences, but that the impact of sleeplessness was worse for women, and they often felt the need to sleep longer because of cognitive, memory, and emotional difficulties due to sleeplessness. About 18 percent of women, compared to 8 percent of men, report poor sleep on any given night. The second study’s researchers reported that women multitask more than men, and this means their minds need more rest than men’s at the end of the day.
Women who do not get enough sleep are more likely than men to have higher rates of inflammation, shown in inflammation markers in blood tests. Higher levels of inflammation are linked to higher rates of physical pain, which compounds the woman’s inability to sleep. In comparison, men who do not get enough sleep have lower levels of inflammation markers, so they do not report developing pain because of sleeplessness.
If women and men get the same amount of sleep, women are more likely to feel fatigued. Failing to get enough sleep increases women’s risk of heart disease, depression and other psychological struggles, and blood clotting issues that could lead to a stroke. Because of women’s greater need for sleep, they were more likely to report anger, depression, and hostility early in the morning.
Insomnia in women could have several root causes, including less support at home, stressful but lower-paying jobs, hormonal changes, greater risk of mood disorders that may trigger insomnia, and higher risk for other chronic pain conditions.
Insomnia, Addiction, and Women’s Health
Abusing drugs or struggling with addiction to drugs or alcohol can trigger insomnia, but insomnia can also lead to substance abuse. People who develop chronic insomnia are more likely to abuse alcohol, marijuana, and other central nervous system (CNS) depressants; however, several drugs prescribed to treat insomnia in the short-term, like benzodiazepines, can also lead to addiction.
People who begin to abuse any drug, whether prescription or recreational, to sleep will not feel very rested because the brain still does not complete REM and NREM cycles appropriately. At the same time, those who abuse drugs to fall asleep are more likely to develop compulsive behaviors around drugs because they feel like the substance is their only solution to overcoming insomnia. This sleep disorder is also a common withdrawal symptom, especially for alcohol and benzodiazepines, so people who suddenly stop abusing drugs are more likely to experience insomnia again, which could lead to relapse and overdose.
One study reported that 28 percent of people who complain about insomnia report using alcohol to help them fall asleep; people who reported experiencing insomnia for two or more weeks were more likely to develop alcohol use disorder (AUD) at the one-year follow-up. The Substance Abuse and Mental Health Services Administration (SAMHSA) found that 6 percent of the population receives a medical diagnosis of insomnia, and substance abuse exacerbates the problem. Reported rates of sleep disturbances in treatment for AUD range from 25 percent to 72 percent; those in treatment for marijuana abuse report similar experiences of sleeplessness. Women are more likely to report mood disorders or insomnia than men, so they are more likely to receive prescription medications to treat these conditions; therefore, women are more likely to struggle with addiction to prescription drugs, although women are increasingly abusing alcohol, too.
Co-Occurring Treatment for Addiction and Insomnia
Whether one struggles with drug addiction or not, finding non-pharmaceutical treatments for chronic insomnia is extremely important. While prescription medications like sedative-hypnotic drugs or benzodiazepines can help temporarily, working with a sleep specialist on behavioral and lifestyle changes will work better in the long run. No prescription sleep aid is intended to be taken for more than a few weeks; the risk of physical dependence, tolerance, and abuse is very high.
For people who are working to overcome addiction to alcohol or drugs and who experience insomnia as one of their withdrawal symptoms, it’s important to get an assessment from addiction specialists and a referral to sleep treatment, per SAMHSA. Behavioral approaches like mindfulness meditation, progressive muscle relaxation, regular exercise, limiting drug intake (including caffeine), sleep restriction therapy, light therapy, Cognitive Behavioral Therapy, and biofeedback can all help one learn to manage stress, especially late at night or right before bed. Adding insomnia treatment to an overall addiction recovery plan can benefit those who struggle with the issue, either as an underlying condition leading to addiction or as a withdrawal symptom associated with addiction.