What is insomnia?

Having insomnia means you often have trouble falling asleep, or it’s hard to go back to sleep when you wake up too early. Insomnia can be either a short-term or a long-term problem.

Insomnia is very common. It is more often a problem for older adults.

Often insomnia lasts for just a few nights. If you cannot sleep almost every night for 2 weeks, tell your healthcare provider. Insomnia that lasts this long usually is a problem until the cause is found and treated.

What is the cause?

Causes of insomnia include:

  • Changes in sleep patterns because of shift work or travel (jet lag)
  • Depression, anxiety, or other mental health problems
  • Problems caused by an illness, such as arthritis or Alzheimer’s disease
  • Poor sleep habits, including going to bed at different times or in a noisy environment, eating or working in bed before sleeping, or taking long daytime naps
  • Restless leg syndrome, which means that the muscles in your lower legs twitch or tense up during sleep
  • Shortness of breath caused by lung disease or heart failure
  • Stress caused by a big event, a deadline at work, a money problem, or a sick family member
  • Use of alcohol or sedatives, which can relax you but lead to shallow sleep where you wake often
  • Use of caffeine or other stimulants
  • Medicines, such as those used to treat asthma, allergies, or thyroid disease
  • Sleep apnea, which is stopping breathing for more than 10 seconds at a time many times while you sleep. If you have sleep apnea, your body gets less oxygen when you sleep and you don’t sleep well.

What are the symptoms?

Symptoms include:

  • Trouble falling asleep (taking longer than 45 minutes)
  • Waking up often when you are trying to sleep
  • Waking up early and being unable to go back to sleep
  • Not feeling rested after you wake up or feeling tired throughout your day
  • Restlessness or anxiety as it gets close to bedtime

How is it diagnosed?

Your healthcare provider will ask about your:

  • Sleep patterns
  • Use of caffeine, alcohol, medicine, and other drugs
  • Eating and exercise habits
  • Mental and physical health
  • Your family’s medical history
  • Job and travel patterns

Your healthcare provider may also ask others who live with you about your sleep habits. You may have a physical exam and blood tests.

Your healthcare provider may ask you to take notes after you wake each day about:

  • How long you were in bed
  • How much time you think you actually slept
  • How many times and what times you woke up
  • What time you got up
  • Your thoughts about how well you slept
  • Recent stresses

Your healthcare provider may suggest that you sleep overnight in a sleep center, especially if you have signs of sleep apnea. At the sleep center you will have a continuous, all-night recording of your breathing, eye movements, muscle tone, blood oxygen levels, heart rate and rhythm, and brain waves.

How is it treated?

If a medical problem is causing your insomnia, your provider will treat you for it. If drug or alcohol abuse is the cause of your insomnia, you will need to stop using these substances. If medicine is causing the problem, your provider may change your medicine schedule.

Your healthcare provider may recommend relaxation techniques, changes in diet, cutting out caffeine, and a healthy lifestyle that includes regular exercise. Your provider may talk to you about good sleep habits and a regular sleep routine.

Cognitive behavioral therapy (CBT) is often an effective treatment for insomnia. It can help you deal with anxiety and help you manage stress that may cause or contribute to your insomnia. CBT is a way to help you identify and change views you have of yourself, the world, and the future. CBT can make you aware of unhealthy ways of thinking. It can also help you learn new ways to think and act.

You may want to take nonprescription pills to help you sleep. In some cases, your healthcare provider may prescribe medicine to help you sleep. If you need sleep medicine every night for 2 weeks, talk to your healthcare provider. This includes prescription sleeping pills. You may become dependent on them or build up your tolerance to them so that they no longer work as well.

Drinking alcohol is a bad way to try to treat insomnia. Although alcohol makes you sleepy, it can cause you to wake up often, and can make sleep apnea worse.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. Ask your healthcare provider:

  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

How can I help prevent insomnia?

  • Talk to your healthcare provider about your concerns and your lifestyle habits. This may help you to identify causes for your sleep problem and will help you know what you can do to help prevent insomnia. Avoid daily use of sleep medicines. You may become dependent on them or build up your tolerance to them so that they no longer work as well. Most sleeping pills should not be used for more than 2 weeks.
  • Keep the room dark and the temperature comfortable.
  • Consider listening to white noise, such as a fan blowing. Soft music may help.
  • Try not to focus on falling asleep. For example, don’t keep checking the clock and worry about why you are not asleep yet. If you have been in bed for more than 30 minutes and cannot fall asleep, get out of bed and read or watch TV until you are sleepy.
  • Avoid drinking a lot of fluids before bedtime. Don’t drink alcohol within 6 hours of bedtime. Avoid caffeine late in the day.
  • Don’t eat a heavy meal late at night
  • If you smoke, try to quit. Be aware that cutting back on smoking without quitting may lead to nicotine withdrawal in the middle of the night that could wake you up.
  • Keep a healthy weight. Being overweight may worsen sleep apnea.
  • Be active during the day. Exercise regularly. Limit daytime naps to no more than 1 hour each day.
  • Massage or a warm bath before bed may relax you.
  • Before you go to bed, write down the things you are worrying about. Then write down what you can do tomorrow. Mark the other things as things to do later in the week. Read something light or entertaining just before you go to bed, to get your mind off the day’s troubles.
  • Stick to a routine of going to bed and getting up at the same time each day.
  • Use the bedroom only for sleep and sex, not for reading or watching TV.
Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth.
Last modified: 2014-05-29
Last reviewed: 2014-05-28
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2015 McKesson Corporation and/or one of its subsidiaries. All rights reserved.

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