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Everyone has the occasional night of poor sleep. In many cases this is due to staying up too late or waking up too early. This does not mean you have insomnia, it means you didn’t get enough sleep.
Anyone may have insomnia. As many as 30 percent of adults complain of insomnia. It is more common in groups such as older adults, women, people under stress and people with certain medical and mental health problems such as depression.
Insomnia is a common sleep disorder. If you have insomnia, you may:
Lack of or poor quality sleep causes other symptoms that can affect daytime function. You may feel very sleepy and have low energy throughout the day. You may have trouble thinking clearly or staying focused. Or, you might feel depressed or irritable. Insomnia is defined as short and poor quality sleep that affects your functioning during the day. Although the amount of sleep a person needs varies, most people need between 7 and 8 hours of sleep a night to feel refreshed.
Insomnia can be mild to severe and varies in how often it occurs and how long it lasts. Acute insomnia is a short-term sleep problem that is generally related to a stressful or traumatic life event and lasts from a few days to a few weeks. Acute insomnia might happen from time to time. With chronic insomnia, sleep problems occur at least 3 nights a week for more than a month. Insomnia tends to increase as women and men age.
What are the different types of insomnia and what causes them?
There are 2 types of insomnia:
Primary insomnia is not a symptom or side-effect of another medical condition. It is its own disorder. It may be life-long or triggered by travel, shift work, stressful life events, or other factors that disrupt your sleep routine. Primary insomnia may end once the issue is resolved, or can last for years. Some people tend to be prone to primary insomnia.
Secondary insomnia has an underlying cause, so it’s a symptom or side-effect of something else. It is the most common type. Secondary insomnia may have a medical cause, such as:
Secondary insomnia also can result from:
Some medicines, such as those that treat asthma, heart problems, allergies, and colds. Caffeine, tobacco, and alcohol
Poor sleep environment (such as too much light or noise, or a bed partner who snores) Secondary insomnia often goes away once the underlying cause is treated, but may become a primary insomnia. Some people with primary or secondary insomnia form habits to deal with the lack of sleep, such as worrying about sleep or going to bed too early. These habits can make insomnia worse or last longer.
Do more women than men have insomnia?
Women are more likely to have insomnia than men. One reason is that hormonal changes during the menstrual cycle and menopause can affect sleep. During perimenopause, women may have trouble falling asleep and staying asleep. Hot flashes and night sweats often can disturb sleep. During pregnancy, hormonal, physical, and emotional changes can disturb sleep. Pregnant women, especially in the third trimester, may wake up frequently due to discomfort, leg cramps, or needing to use the bathroom.
Some medical conditions that can cause secondary insomnia also are more common in women than men. These include depression, anxiety, fibromyalgia, and some sleep disorders, such as restless leg syndrome.
How is insomnia diagnosed?
Talk to your doctor if you are having problems falling or staying asleep, especially if lack of sleep is affecting your daily activities. Keep a sleep diary for 2 weeks before you see your doctor. Note the time of day you fall asleep and wake up, changes in your daily sleep routine, your bedtime routine, and how you feel during the day.
Your doctor may do a physical exam and take medical and sleep histories. He or she may also want to talk to your bed partner about how much and how well you are sleeping. In some cases, you may be referred to a specialist or a sleep center for special tests.
How is insomnia treated?
If insomnia is caused by a short-term change in the sleep/wake schedule, as with jet lag, your sleep schedule may return to normal on its own. Making lifestyle changes to help you sleep better can also help. If your insomnia makes it hard for you to function during the day, talk to your doctor.
Treatment for chronic insomnia begins by:
Finding and treating any medical or mental health problems
Stopping or reducing behaviors that may lead to the insomnia or make it worse, like drinking moderate to large amounts of alcohol at night
Other treatments are:
Research shows that CBT is an effective and lasting treatment of insomnia. CBT helps you change thoughts and actions that get in the way of sleep. This type of therapy is also used to treat conditions such as depression, anxiety, and eating disorders.
CBT consists of one or more approaches. These are:
Cognitive control and psychotherapy — Controlling or stopping negative thoughts and worries that keep you awake.
Sleep hygiene — Taking steps to make quality sleep more likely, such as going to bed and waking up at the same time each day, not smoking, avoiding drinking too much coffee or alcohol late in the day, and getting regular exercise.
Sleep restriction — Matching the time spent in bed with the amount of sleep you need. This is achieved by limiting the amount of time spent in your bed not sleeping. You go to bed later and get up earlier then you would normally, and then slowly increase the time in bed until you are able to sleep all night.
Stimulus control — Conditioning a positive response with getting into bed. For example, using the bed only for sleep and sex.
Relaxation training — Reducing stress and body tension. This can include meditation, hypnosis, or muscle relaxation.
Biofeedback — Measuring body actions, such as muscle tension and brain wave frequency, to help you control them.
Remain passively awake — Trying not to fall asleep, thereby stopping any worries you might have about falling asleep easily.
In some cases, insomnia is treated with medicine:
Prescription sleep medicines — Prescription sleep medicines can help some people get much-needed rest. Most sleep medicines are used for short-term treatment, though some people with severe chronic insomnia may benefit from longer treatment. It is important to understand the risks before using a sleep medicine. In some cases, sleep medicines may:
Some dietary supplements claim to help people sleep. Some are “natural” products like melatonin (mel-uh-TOH-nuhn). Others are food supplements such as valerian (an herb) teas or extracts. The U.S. Food and Drug Administration does not regulate dietary supplements as it does medicine. It is unclear if these products are safe or if they actually work.
Talk to your doctor about sleep problems before using an OTC sleep aid. You may have a medical issue that needs to be treated. Also, the insomnia may be better treated in other ways.
If you decide to use a sleep medicine, experts advise you to:
What can I do to sleep better?
Insomnia is the most common sleep complaint. It occurs when you have trouble falling asleep or staying asleep or do not feel refreshed in the morning even though you had the opportunity to get a full night of sleep. The causes, symptom and severity of insomnia vary from person to person. Insomnia may include: * Difficulty falling asleep * Difficulty staying asleep throughout the night
* Waking up too early in the morning * Poor quality of sleep, or feeling tired in the morning The effects of insomnia can impact nearly every aspect of your life. Studies show that insomnia negatively affects work performance, impairs decision-making and can damage relationships. In most cases, people with insomnia report a worse overall quality of life.