Insomnia is the inability to stay asleep or to enjoy uninterrupted sleep. One usually awakens feeling unrefreshed. Insomnia can affect your energy level, mood, health, work performance, and quality of life.
It's estimated that 30-50% of the population are affected by insomnia and 10% have chronic insomnia. Insomnia occurs at all age groups, but among adults, insomnia affects more women than men. Insomnia is also more common in those in lower socioeconomic groups, mental health patients, and chronic alcoholics.
Insomnia is a symptom, not a stand-alone diagnosis or disease. It's not defined by number of hours one sleeps, as sleep habits vary.
Classification of Insomnia:
Transient Insomnia - insomnia symptoms lasting less than one week. Examples include: change in shifts at work, uncomfortable bedroom temperature, jet lag, excessive noise, stressful situations, loss of a loved one, exam preparation, acute illness, and withdrawal from medications.
Short-Term Insomnia - insomnia symptoms that last between one and three weeks. Examples include: loss of a loved one, divorce, unemployment, withdrawals from drugs or alcohol.
Chronic Insomnia - insomnia lasting longer than three weeks. Examples include: depression, bipolar disorder, medical conditions, unrelenting stress.
Primary insomnia is insomnia not caused by known mental or physical condition. Stress, anxiety, caffeine, nicotine, and alcohol are examples of things that may cause insomnia.
Secondary insomnia is insomnia caused by medical conditions such as depression, medication side effects, bipolar disorder, post-traumatic stress disorder, and medical issues (asthma, allergies, Parkinson's disease, hyperthyroidism, acid reflux, kidney disease, chronic pain).
Primary Sleep Disorders:
Primary Sleep Disorders are associated with insomnia in absence of other symptoms and can cause chronic or long-term insomnia. These include:
- Idiopathic insomnia - has no known cause but tends to start in childhood and result in life-long sleep problems. Idiopathic insomnia may run in families.
- Central Sleep Apnea - may be primary cause of insomnia or related to other medical conditions.
- Periodic Limb Movement Disorder - involuntary repeated leg movements during sleep.
- Restless Leg Syndrome - creeping sensations in leg during sleep only relieved by moving legs.
- Circadian Rhythm Disorders - conditions with unusual timing of sleep like waking up really early.
- Insufficient Sleep Syndrome - due to lifestyle and environmental situations, the person does not receive enough sleep.
- Inadequate Sleep Hygiene - poor sleep habits lead to insomnia.
Symptoms of Insomnia:
- Difficulty falling asleep even when you feel tired
- Waking up frequently during the night
- Trouble getting back to sleep when awakened
- Relying on sleeping pills or alcohol to fall asleep
- Not feeling well rested after a night’s sleep
- Daytime fatigue or sleepiness
- Poor concentration or focus
- Impaired memory
- Impaired motor coordination
- Irritability and impaired social interaction
- Car accidents due to fatigued drivers
Behavioral Treatment of Insomnia:
- Treat any underlying medical causes.
- Limit caffeine intake.
- Avoid naps during the day.
- Eat regular meals rather than large meals near bedtime.
- Make sure your bedroom is comfortable.
- Go to bed at the same time every night.
- Do not exercise 2 hours before bedtime.
- Try to avoid anxiety stemmed from insomnia by telling yourself you will sleep.
- Use the bed only for sleep and sex.
- Do something relaxing just before bed - reading, taking a hot bath, to avoid worrisome thoughts and anxiety.
- Watching television or playing online may stimulate some people and cause difficulty sleeping.
- If you haven't fallen asleep within half an hour, get up and go to another room. There, engage in a quiet activity before trying to go back to bed.
- If worries keep you up at night, write them down in a journal before bed. That may leave your mind quieter and more apt to fall asleep.
- Do not oversleep - sleep just enough.
- Keep a regular sleep schedule.
- Avoid forcing yourself to go to sleep.
- Stop drinking caffeinated beverages in the afternoon.
- Go to bed when you feel sleepy.
- Avoid large amounts of fluids before bedtime.
- Get room-darkening blinds for your bedroom.
Pharmacological Insomnia Treatments:
- Benzodiazepine Sedatives
- Nonbenzodiazepine Sedatives
Sleep Centers.Org - state by state directory of sleep centers in the United States.
Sleep Foundation - educational, and scientific not-for-profit organization dedicated to improving sleep health and safety through education, public awareness, and advocacy. Links to information about sleep, help finding a sleep professional, and an online community.
The Sleep Aid Guide offers a wealth of information to aid individuals to sleep better.
The American Sleep Association has information on all factors related to sleep health and can assist in locating a sleep lab or doctor.
The Canadian Sleep Society has a national map of sleep centers in Canada.
UKHealthCentre provides a listing of sleep clinics and specialists in Britain.