Insomnia is a formidable foe

Insomnia is one of the most frequent disorders. Studies have shown that sometimes it affects as many as half of the adult population, while more than 90% of people have experienced insomnia at least once in their lives.

Sleep is one of the main human needs, such as water and food. We spend one third of our lives sleeping and this is precious time for our brain to refresh its functions and for our body to strengthen. It is therefore worrying that only each fifth citizen of Europe sleeps without interruption at night, while only each third one warns that she/he sleeps much worse than before the Covid 19 pandemic.

‘By definition, insomnia is a disorder in which falling asleep there is difficulty falling asleep, difficulty maintaining sleep during the night, early awakening or dissatisfaction with the quality and quantity of the overnight sleep. Most people need 7.5 to 8 hours of sleep for a good night’s recovery. Those from the so-called ‘long sleepers’ group need between 10 and 11 hours of sleep. There are also extreme cases; it is known that Nikola Tesla used to sleep for 2.5 to 3 hours, but this can certainly be no parameter for the wider population’, says primarius Slavko Janković, Dr. Med. Sci, neuropsychiatrist, Chairman of Serbian Sleep Society and a member of the European Sleep Research Society (ESRS).

Why can’t I fall asleep?

There are two types of insomnia: primary and secondary. The primary insomnia means that your sleeping problems are not related to any other health problem, while the secondary insomnia is exactly a consequence of a disease/disorder that you have or maybe medicines that you take.

‘The most frequent causes of insomnia are of psychological/psychiatric nature. Depression, for example, is always coupled with a sleep disorder as a symptom. However, many organic diseases also cause insomnia, such as hyperthyroidism or increased function of the thyroid gland, arthritis, or joint inflammation, cardiac or renal failure, chronic pulmonary disease, neurological disorders, sleep apnoea, etc. Painful syndromes of various origin also result in insomnia, as well as certain medicines or substances that cause insomnia: alcohol, nicotine, central nervous system stimulants, beta blockers, bronchodilators, corticosteroids, stimulating antidepressants, thyroid hormone, and other’, explains our interviewee.

The modern, busy lifestyle with progressive escalation of stress in many workplaces, as well as the frequent use of technology and electronic devices that usually keep people awake at night, are also closely related with a worse quality and shorter than necessary sleep.

Insomnia increases the risk of myocardial infarction

Insomnia is related to a large number of negative consequences, both for mental and physical health. Lack of sleep also affects obesity. Research from the University of Chicago found that disturbed sleep leads to an increase in the production of leptin, the hormone that triggers hunger, but also to a decrease in ghrelin, the hormone that stops hunger.

‘Insomnia is closely related to an increased feeling of hunger, and increased food and calorie intake, to provide energy for extended waking hours, by far exceeds the normal eating. Insomnia is a complex stress that raises the level of cortisol, which accelerates atherosclerosis. A reduced length of sleep is also associated with an increased degree of insulin resistance, and due to the negative metabolic effect, insomnia carries an increased risk of cardiovascular diseases and even a 69% higher risk of heart attack compared to people who sleep well. People who sleep less than five hours have the highest risk of heart attack, and in diabetics with insomnia, the risk is doubled’, warns Dr. Janković, once a long-time Head of the Sleep Research Laboratory of the University Clinical Centre Neurology Clinic, and now the Head of Sleep Laboratory of the Acibadem BelMedic General Hospital.

Dr. Janković further points out that a treatment of insomnia is complicated and complex.

‘Doctors have always known that insomnia, as well as all other sleep disorders, are a sign of presence of a disease; however, the knowledge that primary sleep disorders are common and serious, and that they can be treated, emerged only in the second half of 20th century. Treatment of insomnia nowadays is less concerned with the use of medicines and pharmacotherapy, and more with applying psychological/psychiatric techniques, such as cognitive behavioural therapy, which is more successful. Basically, what should be treated is the cause that led to insomnia, such as depression. However, with the essential insomnia, the cause is unknown, so this form of insomnia is the most difficult to treat’, says Dr. Slavko Janković.

Our Nobel laureate was also plagued by insomnia
Ivo Andrić suffered from insomnia for years: ‘My only trouble is that I can hardly fall asleep or that I cannot sleep, and another, a new one, is that my sleep is getting shorter and lighter, as if the boundary between the sleep and insomnia is imperceptibly but constantly getting erased and lost. Even in my sleep it happens that I dream that I can't fall asleep, that I'm awake and struggling. That rigour finally wakes me up and only then do I see that I have been sleeping until then and that the real torture and real insomnia is only now beginning.’