What Is Insomnia?
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Medically reviewed by Daniel More, MD
Insomnia is the most common sleep disorder in the United States. It affects about one-third of the general population and is characterized by difficulty falling or staying asleep. For some people, insomnia lasts only a few days or weeks. Meanwhile, other people experience chronic (long-term) insomnia.
Insomnia can strike anyone, but you’re more likely to experience it if you’re female, older, or have another chronic health condition. Short-term insomnia can affect your memory and concentration. If left untreated, insomnia can increase your risk of health problems such as heart disease, high blood pressure, and depression. Treatment options typically include lifestyle changes, cognitive behavioral therapy, and medication.
Types of Insomnia
There are two primary types of insomnia. They are:
Acute (Short-Term) Insomnia: Short-term insomnia is often triggered by stressful life events and typically resolves on its own without medical treatment.
Chronic (Long-Term) Insomnia: Long-term insomnia is a more severe form of the condition. It occurs at least three nights per week for at least three months. Those with chronic insomnia typically require treatment.
Insomnia Symptoms
If you have insomnia, you may notice one or more of the following symptoms at least three nights per week:
Difficulty falling asleep: You may lie awake for a long time before falling asleep. This symptom is more common in younger adults.
Sleeping for short amounts of time: You may wake up often during the night and/or spend most of the night awake. This is a common symptom and primarily affects older adults.
Waking up too early: You may wake up earlier than you’d like and be unable to fall back to sleep.
Feeling tired during the day: If you have insomnia, your sleep quality may be poor. This causes you to wake up feeling unrested and sleepy during the day. It can also make it difficult to concentrate on daily tasks. You may also feel anxious, depressed, or irritable.
What Causes Insomnia?
Insomnia occurs when you struggle to fall asleep and stay asleep for at least three nights per week. There are many reasons this may happen. Stress or changes in your schedule or environment can make sleeping difficult. Others may follow unhealthy nighttime habits such as using electronic devices in bed or drinking caffeine late in the day. And some people may have chronic conditions such as asthma that keep them awake.
Risk Factors
While anyone can get insomnia, certain factors can increase your risk, including:
Age: Your risk for insomnia increases as you get older.
Sex: Females are more likely to experience insomnia due to hormonal changes during menstruation, pregnancy, and menopause.
Chronic health conditions: Certain chronic health conditions can increase your risk of insomnia. These include asthma, gastroesophageal reflux disease (GERD), arthritis, depression, anxiety, allergies, and thyroid issues.
Genetics: You may be more likely to develop insomnia if other members of your family also experience it.
Lifestyle habits: Certain lifestyle habits such as taking long naps during the day or watching TV close to bedtime can cause sleep problems. Taking caffeine, nicotine, or alcohol too late in the day can also make it difficult to fall asleep.
Environment: You can experience sleep issues if your sleep environment is too hot or cold. Exposure to noise or light at night and traveling to different time zones can also cause problems.
Occupation: Shift or night work can disturb your sleep schedule.
Related:What Is Catastrophizing, and How Do You Stop?
How Is Insomnia Diagnosed?
To diagnose insomnia, your healthcare provider will take your medical history and ask for details about your sleep habits. You may want to keep a sleep diary for one to two weeks and share the information with your them. Write down when you go to sleep, wake up, and take naps each day. In addition, note how sleepy you feel during the day, when you drink caffeine or alcohol, and when you exercise.
Your healthcare provider will also perform a physical exam to determine if other medical problems are affecting your sleep.
In addition, your healthcare provider may recommend the following diagnostic tests:
Sleep study: A sleep study checks for other sleep problems such as circadian rhythm disorders (also known as sleep-wake cycle disorders), sleep apnea (when your breathing starts and stops while you sleep), and narcolepsy (a disorder that causes extreme daytime sleepiness).
Actigraphy: Actigraphy tracks periods of rest and activity and measures how well you sleep.
Blood test: A blood test checks for thyroid problems or other medical conditions that can affect sleep.
Treatments for Insomnia
Treatments for insomnia aim to help people fall asleep more easily and stay asleep throughout the night. Common approaches include:
Healthy Sleep and Lifestyle Habits
Adopting healthy sleep and lifestyle habits may make it easier to fall asleep and stay asleep. These habits include:
Making your bedroom sleep-friendly
Going to sleep and waking up around the same each day
Avoiding caffeine, nicotine, and alcohol close to bedtime
Getting regular physical activity during the day
Avoiding naps
Eating meals on a regular schedule
Managing stress
Related:11 Health Benefits of Sleep
Cognitive Behavioral Therapy for Insomnia
Cognitive behavioral therapy for insomnia (CBT-I) is a six- to eight-week treatment approach that teaches you how to fall asleep faster and stay asleep longer. It includes relaxation techniques, changing negative thoughts and attitudes that affect sleep, and methods that encourage using the bed only for bed and sex. CBT-I is typically led by a doctor, nurse, or therapist.
Prescription Medications
Many prescription medications can be used to treat insomnia, including:
Benzodiazepine receptors agonists
Melatonin receptor agonists
Orexin receptor antagonists
Benzodiazepines
Over-the-Counter Products
Some over-the-counter (OTC) medicines and supplements may be used as sleep aids. Common options include products that contain antihistamines (often used to relieve allergy symptoms) and melatonin supplements (human-made versions of the sleep hormone melatonin). However, OTC products may be unsafe for some people. Talk to your doctor before using them to treat your insomnia.
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How to Prevent Insomnia
You may not be able to change certain risk factors for insomnia, such as age or sex. However, adopting these healthy sleep and lifestyle habits can make it easier to get to sleep and stay asleep every night:
Following a regular sleep schedule
Getting physical activity during the day
Avoiding caffeine, nicotine, and alcohol close to bedtime
Learning how to manage stress can also help prevent insomnia. Incorporating stress management techniques like meditation into your evening routine can help you wind down and relax before bed.
Related Conditions
Chronic insomnia can increase your risk of certain health problems or worsen existing issues. These include:
Asthma: Asthma is a chronic condition that limits the amount of air that flows from your airways when you breathe. It can also make sleep difficult at times.
Heart problems: Over time, poor sleep can lead to unhealthy food and lifestyle habits that increase your risk of heart disease (a catch-all term for conditions that affect how well the heart works) and hypertension.
Diabetes: Poor sleep can affect the hormones that control how you break down food. This may increase your risk of diabetes, a chronic condition where your body doesn’t make enough insulin (a hormone that controls blood sugar levels) or can’t use it well.
Mental health conditions: Lack of sleep can create or worsen mental health conditions such as depression and anxiety. A 2008 study found that 17 to 50% of young adults who had insomnia for at least two weeks experienced a major depressive episode at some point over a 20-year follow-up. A major depressive episode is when a person has a depressed mood or loss of interest or pleasure in daily activities for at least two weeks.
Related:How Much Sleep You Need, According to Experts
Living With Insomnia
Short-term insomnia can be easily resolved if you take immediate steps to address it. If not, short-term insomnia can become chronic and more difficult to treat.
Luckily, CBT-I is often an effective approach for chronic insomnia. In fact, about 70 to 80% of people with chronic insomnia see significant improvements from a structured CBT-I program.
Even if your insomnia improves, it’s important to continue following healthy sleep and lifestyle habits to help prevent insomnia from returning.
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Read the original article on Health.
