What is
insomnia?
It
is not unusual to have sleep troubles from time to time. But,
if you feel that you do not get enough sleep or satisfying sleep,
you may have insomnia, a sleep disorder. People with insomnia
have one or more of the following:
difficulty
falling asleep;
waking
up often during the night and having trouble going back to sleep;
waking
up too early in the morning;
unrefreshing
sleep.
Insomnia
can cause problems during the day, such as sleepiness, fatigue,
difficulty concentrating, and irritability. A person with insomnia
may also have another sleep disorder such as sleep apnea, narcolepsy,
and restless legs syndrome.
Insomnia
is not defined by the number of hours you sleep every night. The
amount of sleep a person needs varies. While most people need
between 7 and 8 hours of sleep a night, some people do well with
less, and some need more.
About
60 million Americans each year suffer from insomnia, which can
lead to serious sleep deficits and problems. Insomnia tends to
increase with age and affects about 40 percent of women and 30
percent of men.
What are the
different types of insomnia and what causes them?
A
person can have primary or secondary 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 means that a person is having sleep problems because
of something else, such as a health condition (like depression,
heartburn, cancer, asthma, arthritis), pain, medication they are
taking, or a substance they are using (like alcohol). Insomnia
can vary in how long it lasts and how often it occurs. Insomnia
can be short-term (called acute insomnia) or last a long time
(called chronic insomnia). It can also come and go (or be intermittent),
with periods of time when a person has no sleep problems. Acute
(short-term) insomnia can last from one night to a few weeks.
It is often caused by emotional or physical discomfort, and can
be related to a single specific event. Causes of acute insomnia
can include:
significant
life stress (job loss or change, death of a loved one, moving);
illness;
environmental
factors like noise, light, or extreme temperatures (hot or cold)
that interfere with sleep;
things
that throw off a normal sleep schedule (like jet lag or switching
from a day to night shift).
Chronic
(long-term) insomnia is when a person has insomnia at least 3
nights a week for 1 month or longer. It can be caused by many
things and often occurs along with other health problems. Common
causes of chronic insomnia are depression, chronic stress, and
pain or discomfort at night.
How is
insomnia diagnosed?
If
you think you have insomnia, talk to your health care provider.
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. Your health care provider 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.
How is insomnia
treated?
Acute,
or short-term insomnia may not require treatment. But if your
insomnia makes it hard to function during the day because you
are sleepy and tired, your health care provider may prescribe
sleeping pills for a limited time. The rapid onset, short-acting
medications now available avoid many of the earlier problems with
continuing effects (like feeling drowsy or groggy) the following
day. Some medications may be less effective after several weeks
of nightly use, however, and long-term safety and effectiveness
has not yet been established. Side effects of sleeping pills (and
over-the-counter sleep medicines) can be a problem, too. Mild
insomnia often can be prevented or cured by practicing good sleep
habits (see below).
Treatment
for chronic (long-term) insomnia includes first treating any underlying
conditions or health problems that are causing the insomnia. If
insomnia continues, your health care provider may suggest behavioral
therapy or medication. Most medicines that are used for sleep
have side effects and must be used with caution. It is not recommended
to use over-the-counter sleeping pills for insomnia. Behavioral
approaches to treatment focus on changing behaviors that may worsen
insomnia and learning new behaviors to promote sleep. Techniques
such as relaxation exercises, sleep restriction therapy, and reconditioning
may be useful.
What habits
promote a good night's sleep?
Good
sleep habits can help you get a good night's sleep. For example:
Try
to go to sleep at the same time each night and get up at the same
time each morning. Try not to take naps during the day because
naps may make you less sleepy at night.
Avoid
caffeine, nicotine, and alcohol late in the day. Caffeine and
nicotine are stimulants and can keep you from falling asleep.
Alcohol can cause waking in the night and interferes with sleep
quality.
Get
regular exercise. Try not to exercise close to bedtime because
it may stimulate you and make it hard to fall asleep. Experts
suggest not exercising for 3 hours before the time you go to sleep.
Don't
eat a heavy meal late in the day. A light snack before bedtime,
however, may help you sleep.
Make
your sleeping place comfortable. Be sure that it is dark, quiet,
and not too warm or too cold. If light is a problem, try a sleeping
mask. If noise is a problem, try earplugs, a fan, or a "white
noise" machine to cover up the sounds.
Follow
a routine to help relax and wind down before sleep, such as reading
a book, listening to music, or taking a bath.
Avoid
using your bed for anything other than sleep or sex.
If
you can't fall asleep and don't feel drowsy, get up and read or
do something that is not overly stimulating until you feel sleepy.
If
you have trouble lying awake worrying about things, try making
a to-do list before you go to bed. This may help you to "let
go" of those worries overnight.
See
your health care provider if you think that you have insomnia
or another sleep disorder.
For more information…
For more information on insomnia contact the National Women's
Health Information Center at (800) 994-9662 or the following organizations:
National Center on Sleep Disorders Research (NCSDR) (NHLBI)
Phone Number(s): (301) 435-0199
Internet Address: http://www.nhlbi.nih.gov/sleep
National Heart, Lung, and Blood Institute
Phone Number(s): (301) 592-8573
Internet Address: http://www.nhlbi.nih.gov
American Academy of Sleep Medicine
Phone Number(s): (708) 492-0930
Internet Address: http://www.aasmnet.org
National Sleep Foundation
Phone Number(s): (202) 347-3471
Internet Address: http://www.sleepfoundation.org
The information in this FAQ was adapted from materials from the
National Institutes of Health (NIH), including: National Heart,
Lung, and Blood Institute, the National Institute of Neurological
Disorders and Stroke, and the National Institute on Aging.
