I'm not sleepy, should I be concerned? Causes and symptoms

Sleeping is often linked to satisfaction, being synonymous with rest and recovery both physical and mental. Likewise, many of us know how unpleasant it is not to get enough sleep.

And it is that sleep is a basic need of the human being, which if it is not satisfied it may have consequences on health and even in case of complete absence for long enough the death. Difficulties sleeping are very annoying for most human beings and some people can become restless when faced with this difficulty. It is not uncommon for thoughts such as "is something bad happening to me?", "Why is it so hard for me to fall asleep?" "I'm not sleepy, should I be concerned?".

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

• Related article: "The top 7 sleep disorders"

Difficulty getting enough rest

"I'm not sleepy" is an expression that we use regularly and that usually refers to the fact that our body

remains in a state of activity such that the desire to sleep does not appear, or that despite the fact that these exist we are not able to reconcile it. Although this lack of sleep does not necessarily have to be pathological, it is generally 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 for us.

In general, not being sleepy at the time that we would die will actually make us sleep less, something that will make our body and our brain cannot be completely repaired, has trouble finishing development, has trouble reorganizing and storing the information acquired during the day Y are unable to restore the body's energy levels.

In short, it can cause problems such as daytime fatigue and fatigue, a weakening of the immune system that makes us more vulnerable to infections, physical and / or mental slowing down, decreased attention span, judgment and reasoning, and irritable or depressant. Also increases the possibility of diabetes and cardiovascular disease, and in the long run it can decrease cognitive ability and even life expectancy.

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

There are many possible reasons why a person may become not sleepy or have difficulty sleeping, generally being a multifactorial phenomenon. Among the multiple causative agents that can participate or directly cause sleep problems we find 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 have no problems catching or staying asleep or the difference in hours of sleep compared to others generates any symptoms.

Of course, this implies that there is no abrupt change in the ability to have sleep, but rather that it remains generally stable (beyond the changes inherent to age).

2. Anxiety, restlessness, and worries

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

The nervousness that certain types of thoughts or situations that we will have to face or those that we might come across can cause the body and mind to remain active and have great difficulties in falling asleep, appearing insomnia.

• You may be interested: "Fight insomnia: 10 solutions to sleep better"

3. No association of 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 use it in a general way to work or study lying on it, having fun or doing various activities in addition to sleeping or having sex sexual. A) Yes, by not associating bed with rest our mind wanders and remains active, something that makes us not sleepy when the time comes.

4. Physical activity

Everyone knows that exercising regularly helps you sleep better. However, this effect only occurs if the exercise performed is not done just before sleep, since physical activity can increase the body's activation and cause problems falling asleep. That is why it is not advisable to do physical exercise shortly before going to sleep, since the body may have problems detecting that it is time to sleep due to physical activation and the synthesis of neurotransmitters that it causes.

5. Mania

Another common cause of lack of sleep is in people with bipolarity, specifically when they are in the manic or hypomanic phase. In this state, although they do end up falling asleep, they tend to perceive a less need for sleep and stay awake for much longer.

6. Use of certain drugs

Many medications have some kind of sleep disturbance as a side effect. Although these effects generally involve more drowsiness or sedation, other drugs can cause difficulties in falling asleep. Especially relevant are those that affect the functionality of the autonomic nervous system, What some psychotropic drugs, antihistamines, or 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 something secondary to its consumption.

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

In addition, drinking coffee, tea, soft drinks or chocolate they can have activating effects that make sleep difficult.

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 found 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 to these areas would cause severe sleeping difficulties, or even the inability to do so. Also excessive or even pathological activation of the amygdala can cause these difficulties.

• Related article: "Parts of the human brain (and functions)"

9. Medical illnesses

Another possible reason to stop being sleepy is the suffering of some type of disease which secondarily generates sleep disorders, including insomnia. An example of this are those of 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 that begins causing the patient to only have micro-dreams and gradually causes the total cessation of sleep, something that ends up leading to death to those who suffer it. However, this disease is extremely rare, so in the vast majority of cases there is no cause for alarm.

10. Circadian rhythm maladjustment

There is not always a true insomnia, but sometimes the problem may be rather in the fact that our circadian rhythms are out of adjustment, and may conflict with our obligations and demands socio-labor. Is why nocturnal insomnia and daytime sleepiness may occur.

Treatment

The treatment of the lack or the difficulties of sleep will depend greatly on the type of causes that generate them. In general, one of the basic steps will be to first assess where we consider this lack of sleep comes from, and if necessary perform a polysomnigraphy to check if during sleep we enter all phases of sleep or have some kind of difficulty in any specific one.

At the level of therapy itself, at a psychological and behavioral level, it is common to perform sleep hygiene, analyzing and using different guidelines through which to promote through our behavior and our habits the existence of a dream of quality. Among them would be the regulation of food or sports schedules in relation to the time of going to sleep, the control of light and sound or using the bed only to sleep or have sex. Also learning relaxation, mindfulness or meditation techniques may be helpful.

If the cause is anxiety, the above therapies may be helpful, along with trainings in the management of anxiety, frustration and stress, cognitive restructuring or biofeedback. It is common for thinking and worrying about your inability to fall asleep to still generate greater difficulty in doing it, something that makes techniques that cut off the active search for sleep facilitate.

In addition, it can also be useful the occasional or temporary use of some type of psychotropic drug indicated by the doctor to help facilitate sleep, being generally used hypnotic-sedatives 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 raised with the doctor. As for drugs, intoxication or withdrawal symptoms 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.; Roman, P.; Hernangómez, L.; Navas, E.; Ladrón, A and Álvarez-Cienfuegos, L. (2012). Clinical psychology. CEDE Preparation Manual PIR, 02. CEDE. Madrid.