Determine the cause of insomnia Determine the cause of insomnia

Difficulty sleeping or waking up at night without being able to fall asleep again can become a real nightmare without timely treatment.

Medical Advisor Alejandro Villarraga – Clinical neurologist

Getting a peaceful night’s sleep (the recommended seven hours) or even trying to do so, turns out to not be an easy habit for at least 59% of Colombians and for 50% of the world’s population. Sleep disorders are common, insomnia being one of the most common forms of nightmares to good sleep. As Alejandro Villarraga indicates, clinical neurologist and head of the Neuroscience Institute at the Las Américas Clinic in Medellín, insomnia manifests in two different ways: when a person cannot fall asleep or when they wake up at night.

“Human beings are diurnal beings by nature because our species is designed to function during the day. Our ancestors used daytime to hunt in order to make sure they would survive, and at night, they would seek protection from their surrounding predators, taking advantage of that time to rest and recover their energy to continue their activities the next day.”

Sleep is therefore a physiological need. The brain itself must disengage from stimuli such as noise and light in order to restore its processes and to consolidate memory and the information it receives throughout the day during the different stages of sleep.

Practicing sleep hygiene is key and if your lack lack of rest is causing you to have strenuous days, irritability and is leading you to have bad interpersonal relationships, it is especially important to see a specialist as soon as possible.

Dealing with insomnia

The first step is to identify is the underlying cause of the insomnia. According to our neurologist, the cause of insomnia is not always directly related to sleep but to other conditions such as an overactive bladder, sleep apnea, respiratory problems or mental health issues. Through performing a polysomnography, a diagnosis can be made and the treatment that should follow can be determined. A polysomnography is a study in which a patient spends a night in a clinic with electrodes and sensors connected to their scalp to record brain activity and to measure breathing movements, snoring, and oxygen levels in the blood, for example.

Melatonin can also be taken to suplement the absence of this substance secreted by the brain during the day. Consult with a specialist before consuming it. Treatment can include a combination of medication, alternative medicine and therapy.

Determine what type of insomnia you have

Clinical neurologist Alejandro Villarraga explains the four types of insomnia:

  1. Onset insomnia: This form of insomnia is divided into primary and secondary. There are no causes to primary onset insomnia, it is simply a condition in which it is not possible to fall asleep quickly. In secondary onset insomnia, the factors that are associated with it include physical activity, stress, mental health conditions or experiencing some sense of pain or suffering that prevents rest.
  2.  Maintenance insomnia: This is usually related to emotional situations or poor breathing along with episodes of snoring, especially in people who are overweight. It also manifests with Restless Legs Syndrome, which is usually related to feelings of anxiety, such as when someone is getting ready for a long-awaited trip and cannot stop looking at the alarm, waiting for it to be time to get up.
  3.  Mid-sleep awakening: This occurs when the person wakes up and has a hard time getting back to sleep again. It is usually caused by metabolic reactions or emotional situations.
  4. Fragmented sleep: Occurs when the individual wakes up several times at night for physiological reasons, but manages to go back to sleep.

Get quality sleep

The Colombian Association of Sleep Medicine (ACMES), provides the following guidelines to make sleep hygiene a daily practice.

  • Try to go to bed and wake up at the same time.
  • Sleep in a dark, comfortable and silent room. Do not sleep with electronic equipment, including cell phones.
  • Do not go to bed hungry or too full.
  • If you do exercise, do not go to bed until at least two hours after finishing your workout.
  • Avoid caffinated beverages: coffee, tea, hot chocolate and energy drinks.
  • If you cannot fall asleep after going to bed, get out of bed and do something to help you relax. Then, try to fall asleep again.


Obstructive sleep apnea (OSA): Occurs when the upper muscles of the throat relax too much while you are sleeping, which restricts the passage of oxygen. This causes the individual to wake up and interrupts their sleep cycle, which makes the person wake up frequently. People often do not remember these episodes. Symptoms: Shortness of breath, and loud and frequent snoring. Risk factors: Those who are obese and are at risk of cardiovascular disease.

Restless Legs Syndrome (RLS): This is the frequent movement of the limbs while sleeping. This makes the person wake up and get out of bed to relax, therefore making it difficult to fall asleep. Symptoms: Difficulty falling asleep due to the feeling of restlessness, an uncontrollable movement of the legs, having relatives who suffer from RLS. Risk factors: Pregnant women and people with eating disorders, kidney failure, diabetes and anemia.

Parasomnias: Abnormal or unusual behavior during sleep, including somnambulism (sleepwalking), somnilochia (talking in your sleep), bruxism (teeth grinding), sleep myoclonus (loss of muscle control), sexsomnia (having sex while asleep), and nightmares (night terrors), among others. Risk factors: The onset of parasomnias is most common before the age of 18.

Narcolepsy: Extreme drowsiness during the day. Symptoms: Sleep paralysis and in some cases, hallucinations. Risk factors: This is an inherited disorder, however anyone can have  it, regardless of age.