I’m not sleepy, should I be worried? Causes, symptoms and treatment

Sleep problems are a frequent cause of discomfort. What to do in these cases?

Sleeping is usually linked to satisfaction, being synonymous with rest and physical and mental recovery.It is synonymous with rest and recovery, both physical and mental. However, most of us know how unpleasant it is not to get enough sleep.

And is that sleep is a basic human need, which if not satisfied can have consequences on health and even in case of complete absence for long enough time death. Sleeping difficulties are very annoying for most human beings and some people can become restless in the face of this difficulty. It is not uncommon that thoughts such as "Is there something wrong with me?", "Why do I have such a hard time falling asleep?" may pop into their mind, "I'm not sleepy, should I be worried?".

In order to try to answer some of these questions, in this article we will try to reflect on why sleep deprivation appears, what problems it can cause and how to treat it.

Difficulties in getting enough rest

"I'm not sleepy" is an expression that we use habitually and that usually refers to the fact that our organism remains in a state of activity such that it makes the desire to sleep does not appearor, even if we do, we are not able to fall asleep. 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 restful for at least three nights a week for at least three months.

Sleeping less than we need (which is estimated to be around seven to eight hours a day in adults) has relevant effects on us.

In general, not getting sleep at the right time will mean that we actually sleep less, which means that our body and brain cannot fully repair itself, has problems to finish developing, finds it difficult to reorganize and store the information acquired during the day and is not able to restore the body's energy levels. not be able to restore the energy levels of the organism..

In short, it can cause problems such as tiredness and daytime fatigue, a weakening of the immune system that makes us more vulnerable to infections, physical and/or mental slowing, a decrease in the capacity for attention, judgment and reasoning and an irritable or depressed mood. Also increases the possibility of suffering from diabetes and Cardiovascular diseases.and in the long run can decrease cognitive ability and even life expectancy.

"I'm not sleepy": causes of sleep problems

There are many possible reasons why a person may become sleepless or have difficulty sleeping, and it is usually a multifactorial phenomenon. Among the multiple causal agents that can participate or directly cause sleep problems are the following.

1. People with little need for sleep

Each and every one of us is unique and has a different configuration, and there are people who naturally have less sleep than others. This does not mean that they have insomnia.They do not have problems to catch or maintain sleep nor the difference of hours slept in comparison to others generates them any symptomatology.

However, this implies that there is no sudden change in the ability to sleep, but that sleep generally remains stable (beyond the age-related changes).

2. Anxiety, restlessness and worries

Probably one of the most common causes of most sleep difficulties is worry, stress or anxiety.

The nervousness that we generate certain types of thoughts or situations that we are going to have to thoughts or situations that we are going to have to face or with which we could or with which we could come to meet can generate that the body and mind remain active and there are great difficulties to fall asleep, appearing insomnia.

3. Not associating 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 generally use it to work or study while lying on it, have fun or perform various activities in addition to sleeping or having sex. Thus, since bed is not associated with rest, our mind wanders, not associating bed with rest, our mind wanders and remains active, which means that we are not sleepy.This means that we do not feel sleepy when the time comes.

4. Physical activation

It is a well-known fact that regular exercise helps us sleep better. However, this effect only occurs if the exercise is not done just before sleep, since physical activity can increase the activation of the body and cause problems in falling asleep. This is why it is not advisable to do physical exercise shortly before going to sleep, since the body may have trouble detecting that it is time to sleep due to the physical activation and the synthesis of neurotransmitters. synthesis of neurotransmitters that this causes..

5. Mania

Another common cause of sleep deprivation is in people with bipolar disorder. in people who present bipolarityspecifically when they are in a manic or hypomanic phase. In this state, although they do eventually fall asleep, they tend to perceive a reduced need for sleep and stay awake for much longer.

6. Use of certain drugs

Many drugs have as a side effect some kind of sleep disturbance. While these effects usually involve drowsiness or sedation, other drugs can cause difficulties in falling asleep. Particularly relevant are those that affect the functionality of the autonomic nervous system, such as some psychotropic drugs, antihistamines and corticosteroids..

7. Effects of substance use

In addition to the above, another possibility for the absence of sleep can be found in the effects of substance use, being secondary to its consumption.

Generally, the lack of sleep is associated in these cases with phases of intoxication with psychostimulant substances such as cocaine or amphetamines such as cocaine or amphetamines, or in abstinence or tolerance to depressants such as heroin or opium. Alcohol can also cause insomnia and sleep difficulties within the first few hours after consumption.

Also, the consumption of coffee, tea, soft drinks 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 to the fact of going to sleep. One of them would be the thalamus. Another is in the descending reticular system, a part of the brain that inhibits wakefulness and attention to environmental stimuli and which allows us to sleep. Damage in these areas would cause severe sleeping difficulties, or even the impossibility to sleep. Also excessive or even pathological activation of the amygdala can cause such difficulties.

9. Medical illnesses

Another possible reason to stop having sleep is the suffering of some type of disease which in a secondary way generates disorders of the dream, including the insomnia. Examples of this are 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 rare genetic disorder present in a few families, which starts with the patient having only microsleeps. causing the patient to have only microsleeps and gradually causes a total cessation of sleep, which eventually leads to the death of the sufferer. However, this disease is extremely rare, so in the vast majority of cases there is no cause for alarm.

10. Disadjustment of circadian rhythms

There is not always a real insomnia, but sometimes the problem may lie more in the fact that our circadian rhythms are misaligned, and may conflict with our obligations and social and work demands. This is why it is possible that nocturnal insomnia and daytime sleepiness may appear..

Treatment

The treatment of the lack or difficulties of sleep will depend greatly on the type of causes that generate them. In general, one of the basic steps will be first of all to evaluate where we consider that the lack of sleep is coming from, and if necessary to make a polysomnigraphy to verify if during the dream we enter all the phases of the dream or we have some type of difficulty in some in specific.

At the level of therapy itself, at the psychological and behavioral level it is common to carry out a sleep hygiene, analyzing and using different guidelines through which to promote through our behavior and our habits the existence of a quality sleep. Among them would be the regulation of the schedules of food or sport in relation to the moment to go to sleep, the control of the light and the sound or to use the bed only to sleep or to have sex. Also learning relaxation techniques, mindfulness or meditation can also be useful..

If the cause is anxiety, the above therapies may be useful, along with training in anxiety, frustration and stress management, cognitive restructuring or biofeedback. It is common that the fact of thinking and worrying about the impossibility of falling asleep generates even greater difficulty in falling asleep, something that makes techniques that cut the active search for sleep easier.

In addition, it can also be useful the punctual use or for a time of some type of psychopharmaceutical indicated by the doctor that indicated by the doctor that contributes to facilitate sleep, being generally used sedative-hypnotics such as zolpidem or benzodiazepines. If the cause is organic or derived from the consumption of drugs, the disease should be treated or the possibility of changing treatment should be discussed with the physician. For drugs, intoxication or withdrawal should be treated.

Bibliographic references:

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Fifth edition. DSM-V. Masson, Barcelona.
• Diagnostic Classification Steering Committee of the American Sleep Disorders Association. (1990). International classification of sleep disorders-diagnostic and coding manual. Rochester (MN): American Sleep Disorders Association.
• Santos, J.L. ; García, L.I. ; Calderón, M.A. ; Sanz, L.J.; de los Ríos, P.; Izquierdo, S.; Román, P.; Hernangómez, L.; Navas, E.; Ladrón, A y Álvarez-Cienfuegos, L. (2012). Psicología Clínica. Manual CEDE de Preparación PIR, 02. CEDE. Madrid.