Insomnia

What is Insomnia

Insomnia is a sleep disorder that makes it difficult to fall asleep or stay asleep. Insomnia can cause fatigue, low energy, difficulty concentrating, mood swings, and poor performance at work or school.

There are three different ways to classify insomnia:

  • Difficulty falling asleep.
  • Difficulty staying asleep.
  • Waking up too early in the morning.

Any type of insomnia can be long-term (chronic) or short-term (acute). Both are common. Short-term insomnia usually lasts for three months or less. Chronic insomnia occurs at least three times a week for longer than three months.

What are the causes?

Insomnia may be caused by another condition, situation, or substance, such as:

  • Anxiety.
  • Certain medicines.
  • Gastroesophageal reflux disease (GERD) or other gastrointestinal conditions.
  • Asthma or other breathing conditions.
  • Restless legs syndrome, sleep apnea, or other sleep disorders.
  • Chronic pain.
  • Menopause.
  • Stroke.
  • Abuse of alcohol, tobacco, or illegal drugs.
  • Mental health conditions, such as depression.
  • Caffeine.
  • Neurological disorders, such as Alzheimer’s disease.
  • An overactive thyroid (hyperthyroidism).

Sometimes, the cause of insomnia may not be known.

What increases the risk of Insomnia?

Risk factors for insomnia include:

  • Gender. Women are affected more often than men.
  • Age. Insomnia is more common as you get older.
  • Stress.
  • Lack of exercise.
  • Irregular work schedule or working night shifts.
  • Traveling between different time zones.
  • Certain medical and mental health conditions.

What are the symptoms of Insomnia?

If you have insomnia, the main symptom is having trouble falling asleep or having trouble staying asleep. This may lead to other symptoms, such as:

  • Feeling fatigued or having low energy.
  • Feeling nervous about going to sleep.
  • Not feeling rested in the morning.
  • Having trouble concentrating.
  • Feeling irritable, anxious, or depressed.

How is this diagnosed?

This condition may be diagnosed based on:

  • Your symptoms and medical history. Your health care provider may ask about:
    • Your sleep habits.
    • Any medical conditions you have.
    • Your mental health.
  • A physical exam.

How is this treated?

Treatment for insomnia depends on the cause. Treatment may focus on treating an underlying condition that is causing insomnia. Treatment may also include:

  • Medicines to help you sleep.
  • Counseling or therapy.
  • Lifestyle adjustments to help you sleep better.

Follow these instructions at home:

Eating and drinking

  • Limit or avoid alcohol, caffeinated beverages, and cigarettes, especially close to bedtime. These can disrupt your sleep.
  • Do not eat a large meal or eat spicy foods right before bedtime. This can lead to digestive discomfort that can make it hard for you to sleep.

Sleep habits

  • Keep a sleep diary to help you and your health care provider figure out what could be causing your insomnia. Write down:
    • When you sleep.
    • When you wake up during the night.
    • How well you sleep.
    • How rested you feel the next day.
    • Any side effects of medicines you are taking.
    • What you eat and drink.
  • Make your bedroom a dark, comfortable place where it is easy to fall asleep.
    • Put up shades or blackout curtains to block light from outside.
    • Use a white noise machine to block noise.
    • Keep the temperature cool.
  • Limit screen use before bedtime. This includes:
    • Watching TV.
    • Using your smartphone, tablet, or computer.
  • Stick to a routine that includes going to bed and waking up at the same times every day and night. This can help you fall asleep faster. Consider making a quiet activity, such as reading, part of your nighttime routine.
  • Try to avoid taking naps during the day so that you sleep better at night.
  • Get out of bed if you are still awake after 15 minutes of trying to sleep. Keep the lights down, but try reading or doing a quiet activity. When you feel sleepy, go back to bed.

General instructions

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Exercise regularly, as told by your health care provider. Avoid exercise starting several hours before bedtime.
  • Use relaxation techniques to manage stress. Ask your health care provider to suggest some techniques that may work well for you. These may include:
    • Breathing exercises.
    • Routines to release muscle tension.
    • Visualizing peaceful scenes.
  • Make sure that you drive carefully. Avoid driving if you feel very sleepy.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You are tired throughout the day.
  • You have trouble in your daily routine due to sleepiness.
  • You continue to have sleep problems, or your sleep problems get worse.

Get help right away if:

  • You have serious thoughts about hurting yourself or someone else.

If you ever feel like you may hurt yourself or others, or have thoughts about taking your own life, get help right away. You can go to your nearest emergency department or call:

  • Your local emergency services (911 in the U.S.).
  • A suicide crisis helpline, such as the National Suicide Prevention Lifeline at 1-800-273-8255. This is open 24 hours a day.

Summary

  • Insomnia is a sleep disorder that makes it difficult to fall asleep or stay asleep.
  • Insomnia can be long-term (chronic) or short-term (acute).
  • Treatment for insomnia depends on the cause. Treatment may focus on treating an underlying condition that is causing insomnia.
  • Keep a sleep diary to help you and your health care provider figure out what could be causing your insomnia.

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