How Bad Can Insomnia Get?
Work pressure or turmoil in personal life can give anyone a sleepless night or two. But what happens when getting a restful night of sleep becomes an everyday struggle?
Insomnia is sleep disorder that affects billions around the world, taking a huge toll on their health, quality of life and even life-expectancy. People suffering from insomnia find it difficult to fall asleep or even stay asleep. As a result, one gets to sleep for lesser hours than what is required for optimum physical, emotional and mental well-being. Excessive daytime fatigue and sleepiness, low productivity and feeling grumpy is just the tip of the iceberg. Fragile sleep is definitely way more damaging than this.
Chronic sleep deprivation has snowballing effects on our health. It has been associated with increased risk of hypertension, diabetes, obesity, depression, heart attack, stroke, cancer and even death.
What is giving you sleepless nights?
Many factors may interfere with our natural sleep/wake cycle, also known as circadian rhythm, for example:
- Stress, that includes any type of worry, anxiety or fear
- Hormonal disturbances
- Stimulants like coffee, tea and energy drinks
- Use of cell phones, laptops and other electronic gadgets just before going to bed
- Sedentary lifestyle
- Poor sleeping habits
- Certain medications and herbs
- Any disease or illness
How much sleep you need by the way?
It can be challenging to pinpoint how much sleep is really sufficient. It depends on your age, lifestyle, profession and of course how healthy you are. The National Sleep Foundation offers some guidelines on the amount of sleep required at each age .
How bad can insomnia get?
What could long bouts of sleepless nights do anyway? A lot it seems.
Our body is involved in some important restorative functions during sleep. In fact, it goes in an aggressive repair, renewal and detoxification mode when we are sleeping. Let’s look at some of the important back-end activities that occur when we are sleeping, attesting to why a good night’s sleep is so essential after all.
The games that hormones play
Our body releases different hormones when we are sleeping.
There is a higher burst of human growth hormone (HGH) during sleep time. HGH has a myriad of functions; it fuels growth and development in childhood. It is involved in protein synthesis and facilitates repair and maintenance of tissues, muscles and bones throughout our life. HGH also works with other hormones to achieve fat breakdown and muscle building. Another important hormone, called melatonin, is released as we are getting ready to sleep. Melatonin signals that it is time to sleep and acts as a powerful anti-oxidant. It fights free radicals and is even known to fight the side effects caused by cancer therapy drugs .
Sleep regulates the hormone insulin, that helps cells to utilize the glucose floating in the bloodstream. A good night of sleep also keeps a tab on ghrelin and leptin, hunger-regulating hormones. Ever wondered why you feel hungrier and crave for fried, salty and sweet foods when we are up till the wee hours in the night? Sleep deprivation compels the body to secrete more of ghrelin (hormone that promotes hunger) and puts a dampener on leptin (hormone that suppresses appetite).
Cortisol is a stress hormone that has earned quite a bad reputation. But when released at the right time, it plays an important role in promoting alertness to help us deal with stressful situations. It prepares the body for quintessential ‘flight or fight mode’ when required. We just don’t want to be dealing with this hormone when the body is gearing towards the resting mode. That’s why cortisol levels take a dip at bedtime. The hormone, however, peaks in the last stage of sleep, just before it is time to rise and shine – making the body alert and energetic to face the day. Cortisol works via several other mechanisms to regulate metabolism and the immune system too.
Many other hormones are released during sleep such as prolactin and oxytocin; chemicals important in their own right in supporting various body functions.
Sleep strengthens the immune system too
During sleep, our immune system gets into a high gear too – producing special types of immune cells called natural killer cells. These cells support the immune system in fighting infections and keeping chronic diseases including cancer at bay.
What about the brain when you are sleeping? If you think our brain is only busy putting together a show of entertaining dreams, think again. Even during a restful sleep, the brain is highly active in cementing new memories, processing the information you collected the entire day, retaining what may be useful while filtering the irrelevant bits.
Sleep deprivation and health risks
Can you now imagine what many nights of uninterrupted sleep can do? It can put you in a huge sleep debt. So many body processes – working in tandem almost like a smoothly conducted orchestra – get out of whack. Our body doesn’t get enough time to undergo necessary repair and maintenance. It is simply not ready to kick-start the next day with full gusto.
We wake up groggy and feeling disoriented. Our memory and ability to concentrate go on holiday, so does the ability to think rationally and make sensible decisions. There is a build-up of cortisol, keeping the body in a high alert mode all the time. Excessive cortisol is linked with cardiovascular disease, obesity, diabetes and high blood pressure. A disturbed wake-sleep cycle means disruption in other hormones too – including melatonin, insulin, ghrelin, leptin, prolactin – again wreaking havoc on the immune system, metabolism, brain health, and cardiovascular system.
Clearly, long-term sleep deprivation, as often seen in people affected with insomnia, is shown to have long-lasting impact on our health. People with insomnia have been found to have higher levels of inflammatory markers such as C-reactive protein and interleukin-6, impaired metabolism, weakened immune system and disturbed emotional and mental stability.
And studies back these claims.
- A 2015 study published in the journal Hypertension found that people with chronic insomnia may face an increased risk of hypertension .
- A 2014 study found that the chances of stroke are higher in people with insomnia versus those who don't find any difficulty in sleeping .
- A 2014 study strongly suggested that insomnia is associated with risk of death due to cardiovascular disease .
- A 2015 study suggested that sleep disturbances are linked with impaired glucose metabolism, insulin resistance, and risk of developing type 2 diabetes .
- A recent 2016 study shows that insomnia may be associated with a risk of depression .
In a nutshell, chronic sleep loss or insomnia can put you at a higher risk for:
- Premature aging
- Cardiovascular disease
- High blood pressure
- Diabetes, insulin resistance
- Depression, anxiety
- Impaired hormone functions
- Decreased sex drive
- Impaired immunity
So, how can you catch more sleep and high quality of sleep? Stay tuned for our next part where we will discuss natural ways to get some quality shuteye.
- Hirshkowitz et al. National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. Sleep Health. The Journal of National Sleep Foundation. March 2015.
- Ulkan Kilic, et. al., “Melatonin suppresses cisplatin-induced nephrotoxicity via activation of Nrf-2/HO-1 pathway,” Nutrition & Metabolism 2013, 10:7
- Yun Li, Alexandros N. Vgontzas, Julio Fernandez-Mendoza, Edward O. Bixler, Yuanfeng Sun, Junying Zhou, Rong Ren, Tao Li, and Xiangdong Tang. Insomnia With Physiological Hyperarousal Is Associated With Hypertension. Hypertension, January 2015 DOI:
- Ming-Ping Wu, Huey-Juan Lin, Shih-Feng Weng, Chung-Han Ho, Jhi-Joung Wang, and Ya-Wen Hsu. Insomnia Subtypes and the Subsequent Risks of Stroke: Report From a Nationally Representative Cohort. Stroke, April 2014 DOI: 10.1161/STROKEAHA.113.003675
- Sofi F, Cesari F, Casini A, Macchi C, Abbate R, Gensini GF. Insomnia and risk of cardiovascular disease: a meta-analysis. Eur J Prev Cardiol 2014;21:57-64.
- Strand et al. Sleep disturbances and glucose metabolism in older adults: the Cardiovascular Health Study. Diabetes Care 2015;38:2050–2058
- Li L, Wu C, Gan Y, Qu X, Lu Z. Insomnia and the risk of depression: a meta-analysis of prospective cohort studies. BMC Psychiatry. 2016;16:375. doi:10.1186/s12888-016-1075-3.