Insomnia

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Definition of Insomnia

Insomnia means difficulty falling asleep, staying asleep or a combination of both. Insomnia is a common sleep disorder and leads a feeling of being tired or not feel refreshed upon awakening.

Episodes of insomnia may come and go or be long-lasting.

The quality of your sleep is as important as how much sleep you get.


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Editor-In-Chief: Prab R. Tumpati M.D.. Founder, WikiMD and W8MD Weight Loss, Sleep and MedSpa Centers.

Dr. Tumpati is board certified physician practicing sleep medicine, obesity medicine, aesthetic medicine and internal medicine. Dr. Tumpati’s passion is prevention rather than cure. As a physician with fellowship training in Obesity Medicine, Dr. Tumpati has a unique approach to wellness, weight loss, aesthetics with a focus on prevention rather than cure. Dr. Tumpati believes in educating the public on the true science and art of medicine, nutrition, wellness and beauty.

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Statistics on Insomnia

  • Approximately one in four Americans develop insomnia each year
  • About 30% of American adults have symptoms of insomnia
  • Up to 10% of American adults are likely to have chronic insomnia
  • Lost productivity related to insomnia costs the US economy about $63 billion a year
  • 83% of those who suffer from depression also experience symptoms of insomnia
  • Insomnia is a major contributing factor to deaths caused by motor vehicle crashes
  • Almost 80% of women experience insomnia during pregnancy
  • Roughly 27% of working women suffer from insomnia, compared to 20% of working men

Types of Insomnia

Acute insomnia - symptoms of insomnia for less than 3 months

Chronic insomnia - symptoms of insomnia for over 3 months

Causes

Sleep habits we learned as children may affect our sleep behaviors as adults. Poor sleep or lifestyle habits that may cause insomnia or make it worse include:

  • Going to bed at a different time each night
  • Daytime napping
  • Poor sleeping environment, such as too much noise or light
  • Spending too much time in bed while awake
  • Working evenings or night shifts
  • Not getting enough exercise
  • Using the television, computer, or a mobile device in bed

The use of some medicines and drugs may also affect sleep, including:

  • Alcohol or other drugs
  • Heavy smoking
  • Too much caffeine throughout the day or drinking caffeine late in the day
  • Getting used to certain types of sleep medicines
  • Some cold medicines and diet pills
  • Other medicines, herbs, or supplements

Physical, social, and mental health issues can affect sleep patterns, including:

  • Bipolar disorder
  • Feeling sad or depressed. (Often, insomnia is the symptom that causes people with depression to seek medical help.)
  • Stress and anxiety, whether it is short-term or long-term. For some people, the stress caused by insomnia makes it even harder to fall asleep.

Health problems may also lead to problems sleeping and insomnia:

sleep patterns tend to change with age. Many people find that aging causes them to have a harder time falling asleep, and that they wake up more often.

Symptoms

The most common complaints or symptoms in people with insomnia are:

  • Trouble falling asleep on most nights
  • Feeling tired during the day or falling asleep during the day
  • Not feeling refreshed when you wake up
  • Waking up several times during sleep

People who have insomnia are sometimes consumed by the thought of getting enough sleep. But the more they try to sleep, the more frustrated and upset they get, and the harder sleep becomes.

Lack of restful sleep can:

  • Make you tired and unfocused, so it is hard to do daily activities.
  • Put you at risk for auto accidents. If you are driving and feel sleepy, pull over and take a break.

Exams and Tests

Your health care provider will do a physical exam and ask about your current medications, drug use, and medical histo

Treatment

Not getting 8 hours of sleep every night does not mean your health is at risk. Different people have different sleep needs. Some people do fine on 6 hours of sleep a night. Others only do well if they get 10 to 11 hours of sleep a night.

If your insomnia is caused by a short-term change in your sleep/wake schedule, such as with jet lag, your sleep schedule will probably return to normal on its own. Treatment often begins by reviewing any drugs or health problems that may be causing or worsen insomnia, such as:

  • Enlarged prostate gland, causing men to wake up at night
  • Pain or discomfort from muscle, joint, or nerve disorders

You should also think about lifestyle and sleep habits that may affect your sleep. This is called sleep hygiene. Making some changes in your sleep habits may improve or solve your insomnia.

Some people may need medicines to help with sleep for a short period of time. But in the long run, making changes in your lifestyle and sleep habits is the best treatment for problems with falling and staying asleep.

  • Most over-the-counter (OTC) sleeping pills contain antihistamines. These medicines are commonly used to treat allergies. Your body quickly becomes used to them.
  • Sleep medicines called hypnotics can be prescribed by your provider to help reduce the time it takes you to fall asleep. Most of these can become habit-forming.
  • Medicines used to treat anxiety or depression can also help with sleep

Different methods of talk therapy may help you gain control over anxiety or depression.

Chronic or long-term insomnia can be treated with steps you can try at home to sleep better, cognitive behavioral therapy (CBT), and prescription medicines.

If insomnia is a symptom or side effect of another health problem, your doctor may recommend treating the other health problem at the same time. When the other health problem is treated, secondary insomnia often goes away on its own. For example, if menopause symptoms, such as hot flashes, are keeping you awake, your doctor might try treating your hot flashes first. Research suggests that older women who use hormone replacement therapy, eat healthy foods based on a Mediterranean diet, and limit how much caffeine and alcohol they drink may have fewer sleep problems than women who did not do those things.20

Talk to your doctor or nurse if you have symptoms of insomnia, and ask about the best ways to treat insomnia.

How does cognitive behavioral therapy help treat insomnia?

Research shows that cognitive behavioral therapy (CBT) works as well as prescription medicine for many people who have chronic or long-term insomnia.21 CBT helps you change thoughts and actions that may get in the way of sleep.

This type of therapy is also used to treat conditions such as depression, anxiety disorders, and eating disorders. For success with CBT, you may need to see a therapist weekly for two months or more.21 CBT may involve:

  • Keeping a diary to track your sleep
  • Replacing negative thoughts about sleep with positive thinking. This includes linking being in bed to being asleep and not to the problems you have falling asleep.
  • Talking with a therapist alone or in group sessions. This can help you identify and change any unhelpful thoughts and behaviors about sleep.
  • Learning habits that can help you sleep better.

What prescription medicines treat insomnia?

Prescription medicines can help treat short-term or long-term insomnia.2 But your doctor or nurse may have you try cognitive behavioral therapy first rather than medicine to treat insomnia.2

The types of prescription medicines used to treat insomnia include sedatives and certain kinds of antidepressants.22 Prescription sleep medicines can have serious side effects, including sleepiness during the daytime and increased risk of falls for older adults.2,17 They can also affect women differently than men. In 2013, the Food and Drug Administration (FDA) required drug companies to lower the recommended dose for women of certain prescription sleep medicines with zolpidem, because women's bodies do not break down the medicine as quickly as men's bodies do.23

If you decide to use a prescription sleep medicine:

  • Ask your doctor, nurse, or pharmacist about any warnings and potential side effects of the medicine.
  • Take the medicine at the time of day your doctor tells you to.
  • Do not drive or do other activities that require you to be alert and sober.
  • Take only the amount of medicine prescribed by your doctor.
  • Tell your doctor, nurse, or pharmacist about all other medicines you take, both over-the-counter and prescription.
  • Call your doctor or nurse right away if you have any problems while using the medicine.
  • Do not drink alcohol.
  • Do not take medicines that your doctor has not prescribed to you.
  • Talk to your doctor or nurse if you want to stop using the sleep medicine. You need to stop taking some sleep medicines gradually (a little at a time).

When taking sleep medicine, make sure to give yourself enough time to get a full night of sleep. A full night of sleep is usually at least seven hours. Ask your doctor or pharmacist to tell you about any side effects of taking sleep medicine, such as grogginess that may make it difficult to drive. Talk to your doctor or nurse if your insomnia symptoms continue longer than four weeks.

Can I take an over-the-counter (OTC) medicine for insomnia?

OTC medicines, or sleep aids, may help some people with insomnia symptoms, but they are not meant for regular or long-term use. Many OTC sleep medicines contain antihistamines that are usually used to treat allergies.

If you decide to use an OTC sleep medicine:

  • Ask your doctor, nurse, or pharmacist about any warnings and potential side effects of the medicine.
  • Take the medicine at the time of day your doctor tells you to.
  • Do not drive or do other activities that require you to be alert and sober.
  • Take only the amount of medicine suggested by your doctor.
  • Tell your doctor, nurse, or pharmacist about all other medicines you take, both over-the-counter and prescription.
  • Call your doctor or nurse right away if you have any problems while using the medicine.
  • Do not drink alcohol.
  • Do not use drugs that your doctor has not prescribed to you.

Can I take a supplement or natural product for insomnia?

Some dietary supplements also claim to help people sleep. Manufacturers may label dietary supplements like melatonin as "natural" products.

The Food and Drug Administration (FDA) does not regulate dietary supplements in the same way it regulates medicines. The FDA does not test supplements for safety or effectiveness (to see if the supplement is safe for humans and works in the way it's supposed to). The FDA can remove supplements from the market if they are found to be unsafe.

Learn more about complementary and alternative sleep aids.

Do complementary or alternative sleep aids work?

There isn't enough scientific evidence to say whether most complementary and alternative sleep aids help treat insomnia.24

  • Certain relaxation techniques may be safe and effective in treating long-term insomnia. These techniques include using music, meditation, and yoga to relax the mind and body before sleeping.24
  • Some dietary supplements also claim to help people sleep. Manufacturers may label dietary supplements like melatonin as a "natural" product. Most of these products have not been proven to help people with insomnia. Melatonin may be useful for treating short-term insomnia for shift workers or people who have jet lag, but you should probably not take it long-term.24

The Food and Drug Administration (FDA) does not regulate dietary supplements like vitamins, minerals, and herbs in the same way it regulates medicines. Use this Understanding Drug-Supplement Interactions tool to learn how dietary supplements may interact with the prescription and over-the-counter medicines you take.

Why is sleep important?

Sleep is essential for good health. During sleep, our bodies and brains repair themselves. Some research suggests our brains use the time during sleep to clear away toxins that build up during the day.25 Sleep is also important to our ability to learn and form memories. Not getting enough sleep puts people at risk for health problems, including high blood pressure, obesity, and depression.

Outlook (Prognosis)

Most people are able to sleep by practicing good sleep hygiene.

When to Contact a Medical Professional

Call your provider if insomnia has become a problem.

Alternative Names

Sleep disorder - insomnia; Sleep issues; Difficulty falling asleep; Sleep hygiene - insomnia

Category:Sleep disorders

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