Insomnia

Insomnia is a sleep disorder. It may cause a number of sleep problems including trouble falling asleep, waking in the middle of the night or waking very early in the morning. It may also be a sleep that is not restful. Insomnia can be a short-term problem, or it can be chronic. Chronic insomnia lasts for more than 4 weeks.

  • Causes

    Insomnia can occur for many reasons. Short-term insomnia is often caused by temporary situations or problems with the environment. They may include:

    • A life crisis or stress, including the loss of a life partner, divorce, or loss of a job
    • Environmental noise
    • Extreme temperatures (like a room that is too hot or too cold)
    • Change in the surrounding environment
    • Sleep/wake schedule problems, such as those due to jet lag

    There may be no clear reason for chronic insomnia. It may also be due to other medical or psychiatric conditions. Examples of these conditions that can lead to sleep problems include:

    • Depression
    • Anxiety
    • Arthritis
    • Fibromyalgia
    • Heart disease
    • Asthma
      or
      chronic obstructive pulmonary disease (COPD)
    • Sleep apnea
    • Hyperthyroidism
    • Gastroesophageal reflux disease (GERD)
      or
      ulcer

    Both chronic and short-term insomnia may be due to


    • Behavioral factors, including:


      • Misuse of caffeine,
        alcohol
        ,
        smoking cigarettes
        , or other substances
      • Disrupted sleep/wake cycles from shift work or other nighttime activities
      • Chronic stress
      • Excessive napping in the afternoon or evening

    • Certain medicines such as:

      • Allergy medicines
      • Corticosteroids
      • Blood pressure medicines
      • Psychiatric medicines

  • Definition

    Insomnia is a sleep disorder. It may cause a number of sleep problems including trouble falling asleep, waking in the middle of the night or waking very early in the morning. It may also be a sleep that is not restful. Insomnia can be a short-term problem, or it can be chronic. Chronic insomnia lasts for more than 4 weeks.

  • Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done. You will also be asked about your job, eating habits, and drug and alcohol use.

    The doctor will also ask about your schedule and sleep patterns. You may be asked to keep a sleep diary. This will include information about your naps, bedtime, and how often you wake during the night. Your doctor will review the medicines you take, including over-the-counter medicines and herbal supplements. These questions will help your doctor understand what is causing your insomnia.

  • Prevention

    To reduce your chance of having insomnia:

    • Minimize intake of caffeinated food and drinks after lunch (like coffee, tea, chocolate, cola drinks).
    • Avoid drinking alcohol.
    • Avoid eating too fast or too much. Do not eat too close to bedtime.
    • Avoid drinking fluids before bedtime.
    • Do not smoke.
    • Exercise regularly, but not within less than three hours of bedtime.
    • Use the bedroom only for sleep and sex. Do not use electronics or watch TV while in bed
    • Schedule relaxing bedtime routines. Listen to quiet music or soak in warm water.
    • Make sure that the bedroom is not too cold or too hot.
    • Use a humidifier or dehumidifier as needed.
    • Get sunlight during the day.
    • Use shades or lined drapes; or wear an eye mask to reduce sleep disruption.
    • Use earplugs, or listen to relaxing music or white noise. This helps reduce the disturbing effects of noise.
    • Make sure your mattress is supportive and the bedding is comfortable.
    • Avoid "clock watching" after going to bed.
    • Keep bedtimes and wake-times consistent throughout the week.
    • If you cannot avoid naps, keep them short.

  • Risk Factors

    Factors that increase your chance of getting insomnia include:

    • Age: adults 50 years or older are more likely to have insomnia
    • Sex: female (especially during and after menopause)
    • Stress

    • A history of mental disorders (such as
      anxiety
      ,
      depression
      )
    • Chronic pain
    • Having chronic medical conditions

    • Using
      alcohol
      ,
      drugs
      , or certain medicines
    • Shift work
    • Use of multiple medicines

  • Symptoms

    Symptoms include:

    • Difficulty falling asleep
    • Waking up frequently during the night with difficulty returning to sleep
    • Waking up too early
    • Not feeling refreshed after sleep
    • Daytime sleepiness

    • Irritability,
      anxiety
      , inability to concentrate

  • Treatment