Embracing the Shortest Night: June 20th as World Insomnia Day

As the summer solstice approaches on June 20, we experience the year's shortest night and longest day. This natural phenomenon, where daylight extends and the darkness is lessened, making it the perfect day to observe World Insomnia Day.

The Paradox of the Shortest Night

While many celebrate the extended daylight hours, for those grappling with insomnia, even the briefest night can feel endless. Insomnia affects millions globally, manifesting as difficulty falling asleep, staying asleep, or waking up too early without being able to return to rest. This condition not only impacts physical health but also mental well-being, leading to fatigue, mood disturbances, and decreased performance in daily activities.

Understanding Insomnia

Most people can relate to having a bad night of sleep or two. Sometimes this is due to illness, childcare, stressful life events, the anticipation of an exam or a big presentation. The sleep disruption likely ends when the stressor ends. Insomnia as a symptom is something that most people have experienced.  When the symptoms persists for many nights and the daytime distress and impairment increases, a diagnosis of insomnia disorder may be considered. Difficulty with falling or staying asleep can be a standalone problem. It can begin as a side effect of medication, life transitions (e.g., perimenopause, retirement) or due to other illnesses. Insomnia or sleep disturbances as are part of a number of sleep and mental health disorders. Many people with mental health concerns, experience co-occurring insomnia disorder and worsening or improvement in one disorder impacts the other.

How common is Insomnia Disorder?

According to the American Academy of Sleep Medicine, approximately 30% of adults experience short-term insomnia, while around 10% of adults suffer from chronic insomnia disorder. Insomnia is more prevalent in women and middle aged and older adults. This condition can be classified based on the duration occurring less than three months, more than three months or recurrent if you have two or more episodes in a year. 

Recognizing the signs early is crucial for effective management. Common symptoms include:

· Persistent difficulty falling asleep

· Frequent nighttime awakenings

· Early morning awakenings

· Daytime fatigue or sleepiness

· Difficulty functioning at work in school or at home

Other Sleep-Wake Disorders

Insomnia disorder can co-occur with other sleep disorders These include:

· Sleep related breathing disorders, such as obstructive sleep apnea, where the airway is restricted and oxygen drops throughout the night. This can often lead to daytime sleepiness and should be evaluated by a medical professional.

· Parasomnias or sleep related behaviors which include things like abnormal movements in sleep, sleep terrors, sleep walking, nightmares, and sleep paralysis. These disorders sometimes respond to behavioral treatments, but would be distinguished from Insomnia Disorder alone. The recommended intervention for insomnia Disorder, cognitive behavioral therapy for insomnia (discussed below can sometimes have an impact on these disorders. Other sleep treatments may also be required.

· Disorders of hypersomnolence like idiopathic hypersomnia and narcolepsy are sleep disorders that cause excessive sleepiness during the day and disrupt functioning. They should be evaluated by a sleep medicine physician. The course of treatment is often medication and combination with behavioral interventions.

· Restless leg syndrome is a medical condition that results in uncontrollable urges to move ones legs. It is most often problematic at sleep onset, but can cause awakenings in the night movement usually resolves the urge, but sleep disruption can persist.

· Nightmares are a parasomnias where individuals experience disturbing, dysphoric dreams that causes awakening, distress, and daytime impairment. Nightmares and insomnia frequently co-occur nightmare disorder is responsible to behavioral intervention, such as cognitive behavioral therapy for nightmares or cognitive behavioral therapy for insomnia.

Assessment and diagnosis

Insomnia disorder can occur with a number of conditions and other factors. This is why it is important to be evaluated for the condition. Evaluation with a behavioral sleep medicine professional will usually include a clinical interview, some self-report measures and the assignment to track your sleep over a one to two week. This can help to confirm a diagnosis of insomnia and/or to address any other sleep disorders.  Most behavioral medicine providers are also trained and assessment diagnosis and treatment of mental health conditions.

Insomnia in Children: Recognizing and Addressing Early Sleep Challenges

While insomnia is often associated with adults, it can also affect children, impacting their development and overall well-being. Insomnia and children can also impact entire households as loved ones are often needed to aid the child. Insomnia in children may manifest differently compared to adults, making it essential for parents and caregivers to attend to sleep patterns and behaviors.

Common Signs of Insomnia in Children

· Difficulty falling asleep at bedtime

· Frequent awakenings during the night

· Resistance to going to bed or staying in bed

· Early morning awakenings and inability to return to sleep

· Daytime irritability, mood swings, or hyperactivity

· Trouble concentrating at school or during activities

Causes of Insomnia in Children

Children's insomnia can be triggered by various factors, including:

• Stress or anxiety: School-related pressures, family changes, or social challenges
• Medical conditions: Asthma, allergies, gastrointestinal issues, seizures, obstructive sleep apnea
• Mental health concerns, such as anxiety disorders, depression, or ADHD
• Poor sleep habits: Irregular bedtime routines, excessive screen time before bed, or stimulating environments
• Environmental factors: Noise, light, or uncomfortable sleeping conditions

Supporting Better Sleep in Children

Early intervention can prevent short-term sleep difficulties from becoming chronic. Strategies include:

• Consistent bedtime routines: Establish calming activities before bed, such as reading or gentle music.
• Screen-free wind-down time: Limit exposure to electronic devices at least an hour before sleep.
• Comfortable sleep environment: Ensure the child’s room is quiet, dark, and at a comfortable temperature.
• Addressing underlying issues: Consult with healthcare professionals to identify and manage any medical or psychological concerns.

Professional Help for Persistent Sleep Issues

If insomnia persists despite lifestyle changes, consulting a sleep specialist or behavioral health provider is advisable. Cognitive Behavioral Therapy for Insomnia (CBT-I) has proven effective for older children and adolescents, focusing on modifying unhelpful sleep-related thoughts and behaviors, and Supportive Parenting for Anxious Childhood Emotions (SPACE) is a therapy that helps parents of children younger than 5 learn and implement sleep strategies to help regulate the sleep of babies and younger children.

The Health Impact of Insomnia

Chronic insomnia is more than just a nighttime nuisance. Studies show that persistent sleep disturbances can increase the risk of hypertension, heart disease, diabetes, and mental health disorders. In fact, individuals with insomnia are twice as likely to develop depression compared to those without sleep issues.

Moreover, the Centers for Disease Control and Prevention (CDC) identifies insufficient sleep as a public health epidemic, highlighting that 1 in 3 adults in the U.S. do not get enough sleep on a regular basis.

Treatment Options at Upward Behavioral Health

At Upward Behavioral Health, we are dedicated to helping individuals reclaim restful nights. One of our specialized treatment options is Cognitive Behavioral Therapy for Insomnia (CBT-I); in fact, Upward is one of the only practices in Alabama that offers CBT-I.. This evidence-based approach focuses on identifying and changing thoughts and behaviors that contribute to sleep difficulties. CBT-I helps patients develop healthier sleep habits and coping strategies, offering long-term relief without reliance on medication.

Why Choose CBT-I?

Non-pharmacological: Reduces dependency on sleep medications. Behavioral sleep medicine professionals partner with prescribing providers for medically supervised tapers as needed.

Effective: Research shows that 70% to 80% of individuals with insomnia experience significant improvements with CBT-I.

Sustainable: Benefits of CBT-I often persist long after treatment ends, unlike medication, which may lose effectiveness over time.

Personalized: Tailored strategies to meet individual needs. CBT-I can be personalized for individuals at different life stages, to account for other sleep disorders and mental health concerns. It is safe and effective for most people with other medical conditions

A Night to Reflect and Take Action

As we admire the extended daylight on June 20, let’s also shine a light on the silent struggles faced by those with insomnia. If sleep eludes you or someone you love, know that help is available. Upward Behavioral Health is here to support your journey towards peaceful, restorative sleep.

Reach out today to learn more about our insomnia treatment program or other behavioral sleep services, and start your path to better sleep health.

Here’s to embracing both the light of day and the serenity of the night.