Insomnia

What is Insomnia?

Insomnia is a sleep disorder that is characterized by difficulty falling and/or staying asleep. People with insomnia have one or more of the following symptoms:

  • Difficulty falling asleep
  • Waking up often during the night and having trouble going back to sleep
  • Waking up too early in the morning
  • Feeling tired upon waking

TIP: Get regular exercise. Try not to exercise close to bedtime because it may stimulate you and raise your core body temperature and make it hard to fall asleep.

Types of Insomnia

There are two types of insomnia: primary insomnia and secondary insomnia.

  • Primary insomnia
    Primary insomnia means that a person is having sleep problems that are not directly associated with any other health condition or problem.
  • Secondary insomnia
    Secondary insomnia means that a person is having sleep problems because of something else, such as a health condition (like asthma, depression, arthritis, cancer, heartburn, or pain), medication they are taking, or a substance they are using (like alcohol).

Acute vs. Chronic Insomnia

Insomnia also varies in how long it lasts and how often it occurs. It can be short-term (acute insomnia) or can last a long time (chronic insomnia). It can also come and go with periods of time when a person has no sleep problems. Acute insomnia can last from one night to a few weeks. Insomnia is called chronic when a person has insomnia at least three nights a week for a month or longer.

What causes insomnia?

Causes of acute insomnia can include:

  • Significant life stress (job loss or change, death of a loved one, divorce, moving).
  • Illness.
  • Emotional or physical discomfort.
  • Environmental factors like noise, light, or extreme temperatures (hot or cold) that interfere with sleep.
  • Some medications (for example those used to treat colds, allergies, depression, high blood pressure and asthma) may interfere with sleep.
  • Interferences in normal sleep schedule (jet lag or switching from a day to night shift, for example).

Causes of chronic insomnia include:

  • Depression and/or anxiety.
  • Chronic stress.
  • Pain or discomfort at night.
  • Poor habits (what sleep specialists call “sleep hygiene”): These habits start as strategies that patients enlist to help themselves through bouts of acute insomnia, but which actually perpetuate and exacerbate the problem, e.g. bringing a TV into the bedroom or spending more time in bed.

What are the symptoms of insomnia?

Symptoms of insomnia include:

  • Sleepiness during the day.
  • General tiredness.
  • Irritability.
  • Problems with concentration or memory.
  • Worrying during the day about the upcoming night’s sleep.

Who is affected by insomnia?

Insomnia can affect children as well as adults. It does become more prevalent as we age. Women are more affected then men. They report insomnia symptoms twice as often. At any given moment, nearly 50% of the American population report insomnia; 10% have chronic insomnia that lasts for more than 1 month. Usually they have had insomnia for years.

How is insomnia diagnosed?

If you think you have insomnia, talk to your doctor. Often it is prudent to have a consultation with an insomnia specialist because often other sleep disorders can masquerade as insomnia. An evaluation may include a physical exam, a medical history, and a sleep history. You may be asked to keep a sleep diary for a week or two, keeping track of your sleep patterns and how you feel during the day. The sleep doctor may want to interview your bed partner about the quantity and quality of your sleep. In some cases, you may be referred to a sleep center for special tests, such as an overnight sleep study if the doctor thinks that your symptoms suggest that another sleep disorder is present.

How is insomnia treated?

Acute insomnia may not require treatment. Mild insomnia often can be prevented or cured by practicing good sleep habits (see below). If your insomnia makes it hard for you to function during the day because you are sleepy and tired, your doctor may prescribe sleeping pills for a limited time. Rapid onset, short-acting medications can help you avoid effects such as drowsiness the following day. Avoid using over-the-counter sleeping pills for insomnia since they may have undesired side effects and tend to lose their effectiveness over time.

Treatment for chronic insomnia includes first treating any underlying conditions or health problems that are causing the insomnia. If insomnia continues, your sleep specialist may suggest cognitive behavioral therapy. Behavioral approaches help you to change habits that may worsen insomnia and to learn new behaviors to help promote sleep. Techniques such as relaxation, exercise, sleep restriction therapy, stimulus control and reconditioning may be useful.

What habits promote a good night’s sleep?

Check out Tips to Promote a Good Night’s Sleep >>

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