INSOMNIA

Overview and Facts:

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.

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.

There are two types of insomnia based on duration. Acute insomnia is more common than chronic insomnia:

Acute Insomnia: This type of insomnia lasts for a short time – from several nights up to three weeks – and goes away on its on without treatment. 

Chronic Insomnia: Insomnia that lasts more than three weeks is classified as chronic insomnia. Nearly 1 in 10 people have chronic insomnia, which often requires some form of treatment to go away.

Symptoms & Causes

Symptoms and causes of insomnia are different for every patient. Insomnia symptoms may include:

• Daytime sleepiness
  
• Frustration or worry about your sleep
  
• Problems with attention, concentration or memory (cognitive impairment)
  
• Extreme mood changes or irritability
  
• Lack of energy or motivation
  
• Poor performance at school or work
  
• Tension, headaches or stomach aches
  

Insomnia is most often associated with something else. Insomnia that is not caused or worsened by other factors is rare. These factors may include:

Stress

This varies from relatively minor things like work or personal stress, to more severe changes such as death, divorce or job loss.

Other sleep disorders

Some sleep disorders can cause insomnia or make it worse. For instance, people with obstructive sleep apnea may wake up often and be unable to fall back asleep, or they may have trouble falling asleep. Restless legs syndrome may make it hard to go to sleep, because you feel like you have to move your legs and you may feel burning or itching inside your legs.

Medical conditions

Many physical illnesses can cause insomnia. People who experience pain, discomfort or limited mobility from medical problems may have difficulty falling asleep or staying asleep. Insomnia due to medical conditions is most common in older adults because people tend to have more chronic health problems as they age. Conditions such as pregnancy, particularly the third trimester, and menopause can cause sleep problems. The severity and duration of insomnia often varies with the related health condition.

Mental disorders

The relationship between sleep and mental health is complex. Insomnia is sometimes caused by a mental health disorder. Often a mental health disorder will be found after a complaint of insomnia. Depression is one of the most common mental illnesses in the United States and a frequent cause of insomnia. People with depression often have trouble falling asleep or staying asleep. Difficulty falling asleep is also common in people with anxiety disorders. Other mood disorders such as bipolar disorder may also cause sleep problems.

Medication or substance use or abuse

Insomnia can be an unwanted side effect of many prescription or over-the-counter medications. Common cold and allergy medicines contain pseudoephedrine and can make it difficult to fall asleep. Antidepressants and medications to treat ADHD, high blood pressure or Parkinson's disease can also cause insomnia.

It may sound wrong, but alcohol and sleeping pills are also common causes of insomnia. At first, these depressants may help you fall asleep faster. But alcohol can cause frequent awakenings during the night. Over time, your body builds up a tolerance to many sleeping pills, and insomnia can occur when you stop using the medications.

Caffeine and other stimulants can prevent you from falling asleep. Controlled stimulants such as amphetamines or cocaine can harm your sleep in similar ways. Stimulants also cause frequent awakenings during the night.

Some people are sensitive to certain foods and may be allergic to them. This can result in insomnia and disrupted sleep.

Environmental factors

The environment where you sleep can cause insomnia. Disruptive factors such as noise, light or extreme temperatures can interfere with sleep. Bed partners who are loud snorers and pets have also been shown to cause sleep disruption. Extended exposure to environmental toxins and chemicals may prevent you from being able to fall asleep or stay asleep.

Habits or lifestyles

Irregular sleep schedules can cause insomnia in workers who try to sleep during the day when there is excessive light and noise in their sleep environment and circadian rhythms fail to promote restful sleep.

Diagnosis & Self-Tests:

If you think you may have insomnia, ask yourself the following questions:

• Do you wake up during the night and find that you cannot fall back asleep?
  
• Do you lie in bed, tossing and turning for hours each night?
  
• Do you dread going to bed because you feel like you never get a good night's sleep?
  
• Do you wake up feeling unrefreshed after sleeping?
  
• Does the problem occur even though you have the opportunity and the time to get a good night's sleep?
  

If you answered "yes" to any of the above questions, then you may have insomnia.

If you've had insomnia for more than three weeks (chronic insomnia), consider booking an appointment with a board certified sleep physician at an {AASM Accredited Sleep Center}. If you have had insomnia for fewer than three weeks, you may have acute or temporary insomnia. Try to follow good sleep hygiene, and if the problem does not go away before three weeks talk to a sleep physician.

A board-certified sleep physician can help to diagnose and work with the sleep team to treat your insomnia. Before your appointment, the doctor will ask you to keep a sleep diary for two weeks. By recording when you go to sleep and when you wake up, along with how long you were awake during the night, a sleep diary will help your sleep medicine physician see your habits. This may give your physicians clues about what is causing your insomnia and what course of treatment to take.

The board-certified sleep physician will need to know your medical history and whether you are taking any medications, including over-the-counter drugs. He will also want to know whether anything else has happened in your life, such as any event that is causing stress or trauma. The physician may give you a written test to analyze your mental and emotional wellbeing. You may also receive a blood test if the physician suspects a related medical problem is causing insomnia.