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Insomnia

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  Related Treatments
Cognitive Behavioral Therapy (CBT)
Medications

What is it?

There are four basic kinds of insomnia:

  1. Difficulty falling asleep
  2. Difficulty staying asleep
  3. Waking up too early
  4. Poor quality sleep

Someone with insomnia may have the following symptoms:

  • Feeling tired and grumpy during the day
  • Having trouble concentrating at work
  • Falling asleep during the day

You can be tired and grumpy even if you don’t have insomnia. You may be worn-out from staying up too late at night. This does not mean that you have insomnia. Many people are sleepy during the day simply because they went to bed too late the night before. They don’t have a sleep disorder; they just didn't get enough sleep.

Everyone has an occasional night of bad sleep. For most people insomnia lasts only a few days and goes away without treatment. But stress or depression can cause a higher level of insomnia that may last for several weeks. This kind of insomnia may not go away on its own.

Who gets it?

If you have insomnia, then you are not alone. It is a common sleep disorder. About 30% of adults have symptoms of insomnia. Less than 10% of adults are likely to have chronic insomnia. It is more common among elderly people and women. Some medical conditions cause insomnia, or it may be a side effect of a medication.

How do I know if I have it?

  1. Do you have trouble falling asleep or staying asleep, or do you wake up too early or feel unrefreshed after sleeping?

  2. For a child, does the child resist going to sleep or sleeping alone?

  3. Does this problem occur even though you have the opportunity and the time to get a good night’s sleep?

  4. Do you have at least one of the following problems?
  • Low energy
  • Lack of motivation
  • Attention, concentration or memory problems
  • Poor performance at school or work
  • Extreme mood changes
  • Daytime sleepiness
  • Trouble making errors at work or while driving
  • Tension, headaches or stomach aches
  • Frustration or worry about your sleep

If your answer to these questions is yes, then you might have insomnia.

It is also important to know if there is something else that is causing your sleep problems. They may be a result of one of the following:

  • Another sleep disorder
  • A medical condition
  • Medication use
  • A mental health disorder
  • Substance abuse

Do I need to see a sleep specialist?

First, you should try to follow good sleep hygiene. You also may want to discuss your sleep problems with your primary care doctor. If the insomnia causes you distress or daytime sleepiness, then you may want to visit a sleep specialist. He or she can find the cause and treat your insomnia.

What will the doctor need to know?

First, the doctor will need to know when your insomnia started. He or she will also want to know what else has been happening in your life. Finally, your medical history is very important. Be sure to tell the doctor if you are taking any medications. (This includes medicine that you may buy from the drugstore without a prescription.)

Keep a sleep diary for two weeks. Record when you go to sleep and when you wake up, along with how long you were awake during the night. The sleep diary will help the doctor see your sleeping patterns. The sleep diary information gives the doctor clues about what is causing your problem and how to correct it.

Will I need to take any tests?

Doctors do not need any tests to treat most insomnia patients. A sleep specialist may give you a written test to analyze your mental and emotional well-being. The specialist may need to test your blood in the lab if he or she suspects that you have a related medical problem.

You would need an overnight sleep study only if the doctor suspects that you may have sleep apnea or another sleep disorder.

How is it treated?

Many cases of insomnia will respond to changes that you can make on your own. You can often sleep better by simply following the practices of good sleep hygiene.

Sleep hygiene consists of basic habits and tips that help you develop a pattern of healthy sleep. There are also easy ways to make your bed and your bedroom more comfortable. See the Resources section of this site to find out how you can start down the path to better sleep.

When self-treatment does not work, a doctor can provide help. He or she can teach you different ways to improve your sleep. An example of this is to use relaxation exercises when you go to bed.

Your doctor can also help you find ways to take your mind off of sleep. Staying out of bed until you are very, very sleepy is helpful too. These methods are a part of what is known as behavioral therapy.

Your doctor also may want to change any medications that you currently take. These drugs may be related to your sleep problems.

You need to seek help from a therapist if stress or depression is the cause of your sleep problems. The doctor may decide that the symptoms need to be treated with medication.

Many types of medication can help improve your sleep. Some are specifically approved to treat insomnia. These sleeping pills are called hypnotics. Some medications that treat other problems also can help you sleep. Your doctor can decide which one will work best for you. You should only take a medication when supervised by a doctor.

New insomnia medications have become available over the past few years. Others are in the process of being developed. Research continues to study how well these treatments work. This research also will help us learn more about the causes of insomnia.

Reviewed by Sharon L. Schutte-Rodin, MD
Updated May 18, 2006

For more information:
Finding a Cure for Insomnia: A Review of Common Treatments


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