Stress and insomnia – A vicious circle

Abstract

Insomnia is experiencing unsatisfactory sleep, typically characterised by difficulties initiating or maintaining sleep. Individuals with insomnia are dissatisfied with their sleep quality and perceive it as hindering their ability to perform well in work, school and social settings. The common symptoms of insomnia include fatigue, decreased mood, irritability, general discomfort and cognitive difficulties. On the other hand, stress results from emotional or physical tension triggered by various events that can make a person feel frustrated, angry or anxious. Stress is the body’s response to a challenge or demand, accompanied by the release of hormones. The specific physiological response to stress depends on factors such as the type of stress, the individual’s characteristics, their neuroendocrine system and the combination of these elements, collectively determining how the brain and body react to a particular stressor. The activation of the hypothalamic–pituitary–adrenal axis is a response mechanism triggered by stress. Disturbed sleep, particularly insomnia, is a common side effect of stress, varying in intensity. Sleep plays a crucial role in maintaining both physical and mental well-being, making the physiological connections between sleep and stress vital in understanding the development of stress-induced pathophysiology. Current treatments for insomnia include cognitive behavioural therapy, improving sleep hygiene and employing psychological and pharmacological interventions. However, these approaches aim to improve insomnia symptoms rather than address its underlying cause. In the context of homoeopathy, the concept of constitution refers to an individual’s unique structure, composition, nature and physical makeup, influenced by both inherited qualities and environmental factors. Therefore, it is essential to individualise each case and administer a simillimum remedy, the remedy most likely to restore health, and achieve complete healing according to homoeopathic principles. This review explores the physiological and neuroendocrine changes that occur due to the interplay between stress and the development of insomnia.