Question: how does insomnia work

Ioana Grigoras answered on 13 Mar 2020:

Hi! Insomnia refers to any difficulties someone might encounter when sleeping and it includes difficulties falling asleep, waking up a few times a night, waking up early and being unable to go back to sleep or waking up tired even if you slept for enough time.
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There are a lot of reasons why people get insomnia and they are all related to something called hyperarousal. A state of arousal is when you are awake, but hyperarousal is being ‘took awake’ and then finding it very hard to fall asleep. This is linked to a decrease in the brain chemicals that would facilitate sleep (like melatonine, serotonine or adenosine) or an increase in the brain chemicals that keep you awake (like orexin or cathecolamines).
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Very rarely, it can be a genetic condition. There is a genetic disease called fatal familial insomnia where people have progressive insomnia (so they sleep less and less) and they eventually die because they can’t sleep.This is an *extremely* rare condition, with only about 50 cases worldwide. These people have less neurons in the areas of their brain that would allow them to sleep.
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More often, it is caused by environmental factor and bad sleep hygiene. This means people who would have stimulants before they go to bed (like coffee), who don’t have regular sleeping hours or sometimes, when people are going through a hard time, they find it hard to fall asleep because they keep thinking about the concerning thoughts they are having.
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Evolutionary, insomnia probably appeared as a mechanism to keep you safe when you were in an unsafe environment, which is why people find it so hard to fall asleep when they don’t feel completely safe and comfortable. That includes when they’re worried about something going on in their lives.
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I hope that answers your question! Happy to answer any further questions if you have more!