Insomnia in Health and in Disease

by: Joseph Collins, MD

Insomnia in one form or another accompanies nearly every disorder of the health, but it occurs also individuals who are entirely well. In the majority of instances it is a state of mind founded in fear and apprehension. But frequently it can be ascribed to a direct and immediate physical cause, indigestion for instance, or tooth ache.

Of all the physical causes of insomnia, as distinct from the mental, none is as positive or prevalent as indigestion. We take so many liberties with he functions of our body that we easily forget that the digestive tract is the main road to health and efficiency. Very few have the good fortune to reach middle age without having experienced some disorder maybe not revealed in many ways, but the commonest way, especially in persons with what is popularity called nervous temperament is through disorder of sleep.

Sleep disturbances from indigestion are apt to occur in brain-workers, in persons of a sedentary occupation and in those who are exposed to harassing, anxious and depressing emotional experiences. Anxiety, worry, consternation, taro, and grief, emotions which most are experience at one time or another, have their effect first upon the digestion and then in turn upon various other functions on the body.

Although I purposely reach from enumerating the various diseases which cause insomnia, special mention must be made of the sleeplessness resulting from influenza. In my experience it is most obstinate and taxes the resources of the patient and of the physician.

Insomnia may be, and often is, and accompaniment of certain specific diseases is almost invariably self-limited and ceases when the disease terminates. In other cease insomnia is due to intoxication from poisons arising within the system, such as those accompanying disorders of digestion, gout, rheumatism, diabetes and excessive bodily fatigue. It is much more often, however, the result of poisons taken into the system, such as tobacco, tea, coffee and drugs, such as strychnine and so called nerve tonics of one kind or another all of which contain circulatory excitants. That certain stimulants, particularly tea and coffee, are powerful agencies in the prevention of sleep is undisputed. There are many persons, however, who can drink a cup of strong black coffee and immediately proceed to bed to sleep ad though they had quaffed the cup of Lethe. Probably coffee is a more potent agency in causing wakefulness than tea because it is a more fundamental stimulant and its effect upon the heart and blood vessels is more pronounced. Tea, however, has a unique capacity for causing wakefulness in certain types of nervous people, the intermediate cause being generally flatulent dyspepsia. It may be remarked by the way, that much of the sleeplessness attributed to the after dinner coffee may legitimately be laid to the dinner which preceded the coffee.

Cases of insomnia that are caused by drug addiction, such as opium or cocaine, are particularly obstinate and require the most rigorous kind of treatment. They are as difficulty to conquer as the insomnia presaging and accompanying mental diseases.

The occurrence of insomnia signified that the mental, emotional or somatic machinery is out of order. Before it will run well again the cause of the disorder must be found and overcome.

Sleep is an endowment, like charm or a good disposition. It can be added by the cultivation and effort or it can be shattered. Originally it may have been meted out alike to the rich and the poor, but in the present stage of evolution there would seem to be much discrimination. It is a fact that insomnia is much rarer amongst the poor than amongst the wealthy and it is remarkable how seldom compliant of insomnia is heard from the lower class of hospital patients. The explanation possibly is that insomnia frequently flows out of overfeeding, idleness, self absorption and ennui, and the laboring poor are not beset by any of these ills. It may be that they regard sleeplessness as a minor ailment and do not mention it, but it is more likely that they are less subject to many causes of sleeplessness than their envied brothers.

About the Author

Joseph Collins, MD