Insomnia

What is insomnia?

If you experience difficulty falling asleep, staying asleep, or enjoying a restful night's sleep, you may be suffering from insomnia. Insomnia is defined as the perception or complaint of inadequate or poor-quality sleep because of one or more of the following:

• Difficulty falling asleep

• Waking up frequently during the night with difficulty returning to sleep

• Waking up too early in the morning

• Nonrefreshing sleep

Insomnia is a common symptom in the U.S. The Institute of Medicine estimates that between 50 and 70 million Americans have chronic sleep problems.

Insomnia is classified as:

• Transient (short term). Lasting from a single night to a few weeks

• Intermittent (on and off). Episodes occur from time to time

• Chronic (constant). Occurs on most nights and lasts a month or more

What causes insomnia?

Insomnia may be caused by many factors, including the following:

• Stress

• Depression

• Anxiety

• Physical illness

• Caffeine intake

• Irregular schedules

• Circadian rhythm disorders

• Drugs (including alcohol and nicotine)

• Occasional or chronic pain

What are the symptoms of insomnia?

• Daytime sleepiness

• Low energy or fatigue

• Anxiety or frustration about sleep

• Attention, concentration or memory problems

• Waking up tired or in pain

How can sleep problems be solved?

• Get up about the same time every day.

• Go to bed only when you are sleepy and get out of bed when you are awake.

• Establish presleep rituals, such as a warm bath, a light bedtime snack, brushing teeth, putting on bedtime clothing, or 10 minutes of reading.

• Exercise regularly. If you exercise vigorously, do this at least three to six hours before bedtime. Mild exercise, such as simple stretching or walking, should not be done closer to bedtime than four hours.

• Maintain a regular schedule. Regular times for meals, taking medications, doing chores, and other activities help keep your "inner clock" running smoothly.

• Avoid anything containing caffeine within six hours of bedtime.

• Avoid alcohol within several hours of bedtime or when you are sleepy.

• Avoid smoking close to bedtime because nicotine is a stimulant.

• Avoid falling asleep in front of the television.

• If you take naps, try to do so at the same time every day. For most people, a short midafternoon nap is most helpful. Limit naps to about 20 minutes. 

• Avoid sleeping pills or use them conservatively. Most doctors avoid prescribing sleeping pills for a period of longer than three weeks. Never drink alcohol while taking sleeping pills.

• Reduce evening light exposure by turning off bright lights. This may help cue the body and mind for sleep.

• Expose yourself to light (through windows or a timed lamp) 30 minutes before waking to prepare for getting out of bed.

• Make your bedroom cool, dark, and quiet. If possible, remove nonsleep related items, such as televisions or computers, so that the room is associated only with sleep.

People who suffer from insomnia that lasts for more than a few days should consult a doctor so that the underlying cause can be identified, if possible, then treated. If you have loud, irregular snoring, jerking legs, or pauses in breathing in addition to other symptoms of insomnia, seek the advice of a health care provider. These symptoms may be related to sleep apnea, a potentially life-threatening condition. There are a variety of effective treatment options available.