How to cure insomnia. Definition, Prevalence, Etiology, and Consequences
What is insomnia?
Insomnia is a common sleep disorder that is characterized by difficulty:
What are the symptoms of insomnia?
Chronic insomnia may cause:
What are the types of insomnia?
Insomnia can come and go, or it may be an ongoing, longstanding issue. There is short term insomnia and chronic insomnia:
How common is insomnia?
Sleep disorders are very common. They affect up to 70 million Americans every year.
Insomnia symptoms occur in approximately 33% to 50% of the adult population while Chronic Insomnia disorder that is associated with distress or impairment is estimated at 10% to 15%.
How much sleep do most people need?
Most adults need around seven to nine hours of sleep per night but the amount of sleep needed to function at your best varies between individuals. The quality of your rest matters just as much as the quantity. Tossing and turning and repeatedly awakening is as bad for your health as being unable to fall asleep.
Symptoms and Causes
What causes insomnia?
Many things can contribute to the development of insomnia including environmental, physiological and psychological factors, including:
Anxiety disorders, depression and/or other mental health problems.
Chronic pain due to arthritis, fibromyalgia or other conditions.
Gastrointestinal disorders, such as heartburn.
Other sleep disorders, such as sleep apnea and restless legs syndrome.
What are the risk factors for insomnia?
Insomnia occurs more often in women than in men. Pregnancy and hormonal shifts can disturb sleep. Other hormonal changes, such as premenstrual syndrome (PMS) or menopause, can also can affect sleep. Insomnia becomes more common over the age of 60. Older people may be less likely to sleep soundly because of bodily changes related to aging and because they may have medical conditions or take medications that disturb sleep.
What are the consequences of insomnia?
When you can’t fall asleep or your rest is fitful, you may:
Feel fatigued or low on energy throughout the day.
Have memory problems or difficulty concentrating.
Diagnosis and Tests
How is insomnia diagnosed?
There is no specific test to diagnose insomnia. Your healthcare provider will perform a physical exam and ask questions to learn more about your sleep problems and symptoms. The key information for the diagnosis of insomnia is reviewing your sleep history with your doctor. Your provider will also review your medical history and medications you are taking to see if they may be affecting your ability to sleep. You may also:
Get a blood test: Your doctor may want you do a blood test to rule out certain medical conditions such as thyroid problems or low iron levels that can negatively impact sleep.
Keep a sleep diary: You may be asked to write down your sleep patterns for one to two weeks (bedtime, wake time, naps, caffeine use, etc.) This information can help your provider identify patterns or behaviors that interfere with rest.
Complete a sleep study: Sleep studies (polysomnograms) are not necessary for diagnosing insomnia. If your doctor has concerns that your insomnia may be caused by sleep apnea or another sleep disorder, you may be referred. You may go to a sleep disorders center or do the study at home.
Management and Treatment
What are the complications of insomnia?
Over time, lack of sleep or poor quality sleep can negatively affect your physical and mental health. Insomnia can contribute to:
High blood pressure (hypertension), heart disease and stroke.
Weight gain and obesity.
How is insomnia managed or treated?
Short-term insomnia often gets better on its own. For chronic insomnia, your healthcare provider may recommend:
Cognitive Behavioral Therapy for Insomnia: Therapy (CBT-I): CBT-I is a brief, structured intervention for insomnia that helps you identify and replace thoughts and behaviors that cause or worsen sleep problems with habits that promote sound sleep. Unlike sleeping pills, CBT-I helps you overcome the underlying causes of your sleep problems.
Medications: Behavior and lifestyle changes can best help you improve your sleep over the long term. In some cases, though, taking sleeping pills for a short time can help you sleep. Doctors recommend taking sleep medicines only now and then or only for a short time. They are not the first choice for treating chronic insomnia.
Can melatonin help me sleep?
Your body produces a hormone called melatonin that promotes sleep. Some people take melatonin supplements as a sleep aid. But there’s no proof that these supplements work. Because the U.S. Food and Drug Administration (FDA) doesn’t regulate supplements the same as medications, you should talk to your healthcare provider before taking one.
How can I prevent insomnia?
Lifestyle changes and improvements to your bedtime routine and bedroom setup can often help you sleep better:
Cut back on caffeine, including coffee, sodas and chocolate, throughout the day and especially at night.
Unwind with soothing music, a good book or meditation.
What is the prognosis (outlook) for people who have insomnia?
Some people with insomnia sleep better after changing daytime and nighttime behaviors. When these changes don’t help, therapy or medications can improve slumber.
When should I call my healthcare provider?
You should call your healthcare provider if you experience:
What should I ask my healthcare provider about insomnia?
If you have insomnia, you may want to ask your healthcare provider:
If you’re suffering from insomnia, don’t hesitate to reach out to your healthcare provider for help. They may offer tips for managing issues that interfere with your sleep. Many people with insomnia rest better after changing their diet, lifestyle and nighttime routines. Or they may also recommend medications or cognitive behavioral therapy.
Everything You Need to Know About Insomnia
Insomnia is a type of sleep disorder. Individuals with insomnia find it difficult to fall asleep, stay asleep, or both.
People with insomnia often don’t feel refreshed when they wake up from sleeping, either. This can lead to fatigue and other symptoms.
Insomnia is the most common of all sleep disorders, according to the American Psychiatric Association (APA).
In fact, the APA states that about one-third of all adults report insomnia symptoms. Between 6 to 10 percent of all adults have symptoms severe enough for them to be diagnosed with insomnia disorder.
The APA defines insomnia as a disorder in which people have trouble falling asleep or staying asleep. Doctors make a clinical diagnosis of insomnia if both of these criteria apply:
Sleep difficulties occurring at least three nights a week for a minimum of 3 months.
Keep reading to learn all about the:
The causes of your insomnia will depend on the type of sleeplessness you experience.
Short-term insomnia, or acute insomnia, may be caused by a number of things including:
an upsetting or traumatic event
Chronic insomnia lasts for at least 3 months and can be primary or secondary. Primary insomnia has no known cause. Secondary insomnia occurs with another condition that can include:
medical conditions that make it harder to sleep, such as arthritis or back pain
psychological issues, such as anxiety or depression
high levels of stress
emotional disorders, such as depression or distress related to a life event
changes in work hours or working night shifts
Having certain medical conditions, such as obesity and cardiovascular disease, can also lead to insomnia. Menopause can lead to insomnia as well.
People who experience insomnia usually report at least one of these symptoms:
These symptoms of insomnia can lead to other symptoms, including:
You may also have difficulty concentrating on tasks during the day.
There are both pharmaceutical and nonpharmaceutical treatments for insomnia.
Your doctor can talk to you about what treatments might be appropriate. You may need to try a number of different treatments before finding the one that’s most effective for you.
The American College of Physicians (ACP) recommends cognitive behavioral therapy (CBT) as a first-line treatment for chronic insomnia in adults.
Sleep hygiene training may also be recommended. Sometimes, behaviors that interfere with sleep cause insomnia. Sleep hygiene training can help you change some of these disruptive behaviors.
Suggested changes may include:
avoiding caffeinated beverages near bedtime
If there’s an underlying psychological or medical disorder contributing to your insomnia, getting appropriate treatment for it can alleviate sleep difficulties.
Sometimes, medications are used to treat insomnia.
An example of an over-the-counter (OTC) medication that can be used for sleep is an antihistamine, such as diphenhydramine (Benadryl).
Medications like this can have side effects, especially long term, so it’s important to talk to a doctor before starting yourself on an OTC medication for insomnia.
Prescription medications that may be used to treat insomnia include:
Talk with your doctor before using any medications or supplements to treat your insomnia.
There might be dangerous side effects or drug interactions. Not every “sleep aid” is appropriate for everyone.
Making lifestyle changes or trying home remedies can help effectively manage many cases of insomnia.
Warm milk, herbal tea, and valerian are just a few of the natural sleep aids you can try.
Meditation is a natural, easy, drug-free method for treating insomnia.
According to a 2015 study, meditation can help improve the quality of your sleep, as well as make it easier to fall asleep and stay asleep.
Per the Mayo Clinic, meditation can also help with symptoms of conditions that may contribute to insomnia. These include:
Many apps and videos are available to help you practice meditation.
The naturally produces the hormone melatonin during the sleep cycle. People often take melatonin supplements in hopes of improving their sleep.
Studies are inconclusive
regarding whether melatonin can actually help treat insomnia in adults.
There’s some evidence that supplements may slightly decrease the time it takes you to fall asleep, but more research is needed.
Melatonin is generally thought to be safe for a short period of time, but its long-term safety has yet to be confirmed.
It’s always best to work with your doctor when considering taking melatonin.
Essential oils are strong aromatic liquids made from a variety of:
People treat a variety of conditions by inhaling oils or massaging them into the skin. This practice is called aromatherapy.
Essential oils that are thought to help you sleep include:
A review of 12 studies published in 2015 found aromatherapy to be beneficial in promoting sleep.
Another study found lavender to be especially useful in promoting and sustaining sleep. The study reported that a mixture of essential oils reduced sleep disturbance and increased well-being in older adults.
Essential oils don’t generally cause side effects when used as directed. The Food and Drug Administration (FDA)
has classified most essential oils GRAS (generally recognized as safe).
However, in the United States, no laws are in place to regulate aromatherapy, and no license is required for practice. Therefore, it’s important to select practitioners and products carefully.
Insomnia is common during pregnancy, especially in the first and third trimesters.
Fluctuating hormones, nausea, and an increased need to urinate are some of the bodily changes that may keep you awake in early pregnancy.
You may face emotional stressors, such as anxiety about the increasing responsibilities you’ll face as a mother. Pain — such as cramps and back discomfort — may also keep you awake.
Your body is undergoing many changes, like an active metabolism and increase in progesterone, to accommodate the new life growing in you. It’s normal for your sleep patterns to change, too.
Lifestyle changes that may help include:
keeping active during your pregnancy
maintaining a healthy diet
practicing relaxation techniques during the day or taking a warm bath before bedtime, if you have anxiety
Contact your doctor about any new exercise routines, medications, or supplements you might be interested in. You’ll want to ensure that they’re safe for someone who’s pregnant.
The good news is that pregnancy-related insomnia usually passes, and it doesn’t affect your baby’s development.
In order to arrive at a diagnosis, your doctor will ask questions about your:
This information can help them determine the underlying causes of your sleep problems. You might be asked to:
A sleep log will give your doctor a picture of your sleep patterns. The doctor may also order medical tests or blood work to rule out medical problems that can interfere with your sleep.
Sometimes a sleep study is recommended not for the diagnosis of insomnia but for confirmation if the clinician suspects an underlying sleep disorder such as obstructive sleep apnea.
There are two ways a sleep study may be carried out. One option involves an overnight stay at a sleep center. The second option would allow you to do the study at home, in your own bed.
Both sleep study options involve having electrodes placed on your body in various places, including your head.
The electrodes are used to record your brainwaves to help categorize the states of sleep. They’ll also help detect body movements while you’re asleep.
The results of your sleep study will provide your doctor with important neuroelectrical and physiological information.
Children can have insomnia, too — often for the same reasons as adults. These reasons might include:
If your child has trouble falling asleep or staying asleep, or if they wake up too early, insomnia may be the reason.
According to the Cleveland Clinic, symptoms of insomnia in children may include:
Treatment for children is often the same as treatments for adults.
Children will benefit from a consistent sleep schedule and good sleep hygiene. Reducing stress and avoiding screen time near bedtime will help as well.
Anxiety can cause insomnia, and insomnia can cause anxiety. This can result in a self-perpetuating cycle that may lead to chronic insomnia.
Short-term anxiety develops when you worry frequently about the same specific issue, such as work or your personal relationships.
Short-term anxiety usually goes away once the issue is resolved. Your sleep should return to normal as well.
People can also be diagnosed with an anxiety disorder, such as generalized anxiety disorder (GAD) or panic disorder. These disorders can result in varying degrees of insomnia.
The causes of anxiety disorders aren’t completely understood. Treatment is usually long term and includes a combination of therapy and medications.
The same lifestyle and behavioral practices recommended for other forms of insomnia help diminish anxiety-related insomnia, such as restricting stressful topics of conversation to the daytime.