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Insomnia
Insomnia includes having trouble falling or staying asleep. Insomnia is very common and occurs in 30% to 50% of the general population. Approximately 10% of the population may suffer from chronic insomnia.
With insomnia, you usually awaken feeling un-refreshed, which takes its toll on one's ability to function during the day. Insomnia can sap not only one's energy level and mood, but also one's health, work performance and quality of life.
How much sleep is enough varies from person to person. Most adults need seven to eight hours a night.
SymptomsImpairment of daytime functioning is the defining and most common symptom of insomnia.
Other common symptoms include:- Daytime fatigue or sleepiness
- Difficulty falling asleep at night
- Irritability, depression or anxiety
- Awakening during the night
- Awakening too early
- Not feeling well rested after a night's sleep
- Difficulty paying attention or focusing on tasks
- Increased errors or accidents
- Tension headaches
- Gastrointestinal symptoms
- Ongoing worries about sleep
CausesInsomnia may have many causes and it most often stems from some other problem, such as a medical condition that causes pain or use of substances that interfere with sleep.
Common causes of insomnia include:- Stress. Worries about work, school, health or family can keep your mind busy at night, making it difficult to sleep. Stressful life events, such as a death in the family, divorce, or loss of a job, may lead to insomnia
- Anxiety. Everyday anxieties as well as more-serious anxiety disorders may disturb sleep
- Depression. You might either sleep too much or have trouble sleeping if you're depressed. This may be due to chemical imbalances in your brain or because worries that accompany depression may keep you from relaxing enough to fall asleep. Insomnia often accompanies other mental health disorders as well
- Medications. Prescription drugs that can interfere with sleep include antidepressants, heart and blood pressure medications, allergy medications, stimulants and corticosteroids. Many over-the-counter (OTC) medications, including some pain medication combinations, decongestants and weight-loss products, contain caffeine and other stimulants. Antihistamines may initially make you groggy, but they can worsen urinary problems, causing you to get up more during the night
- Caffeine, nicotine and alcohol. Coffee, tea, cola and other caffeine-containing drinks are well-known stimulants. Drinking coffee in the late afternoon can prevent you from falling asleep at night. Nicotine in tobacco products is also a stimulant that can cause insomnia. Alcohol is a sedative that may help you fall asleep, but it prevents deeper stages of sleep and often causes you to wake up during the night
- Medical conditions. If you have chronic pain, breathing difficulties or need to urinate frequently, you might develop insomnia. Conditions linked with insomnia include arthritis, cancer, congestive heart failure, diabetes, lung disease, gastroesophageal reflux disease (GORD), overactive thyroid, stroke, Parkinson's disease and Alzheimer's disease
- Change in your environment or work schedule. Travel, working late or early shifts can disrupt your body's circadian rhythms, making it difficult to sleep
- Poor sleep habits. Habits that help promote good sleep are called "sleep hygiene". Poor sleep hygiene includes an irregular sleep schedule, stimulating activities before bed, an uncomfortable sleep environment and use of your bed for activities other than sleep or sex
- 'Learned' insomnia. This may occur when you worry excessively about not being able to sleep well and trying too hard to fall asleep
- Eating too much late in the evening. Having a light snack before bedtime is okay, but eating too much may cause you to feel physically uncomfortable whilst lying down, making it difficult to get to sleep
- Insomnia and aging. Insomnia becomes more prevalent with age. As you get older, changes can occur that may affect your sleep
Lifestyle and Home RemediesNo matter what age, insomnia usually is treatable. The key often lies in changes to your routine during the day and when you go to bed. - Sleep as much as possible to feel rested, then get out of bed (do not over-sleep)
- Maintain a regular sleep schedule
- Do not force yourself to sleep
- Do not drink caffeinated beverages in the afternoon or evening
- Do not drink alcohol prior to going to bed
- Do not smoke, especially in the evening
- Adjust the bedroom environment to induce sleep
- Do not go to bed hungry
- Resolve stress and anxiety before going to bed
- Exercise regularly, but not 4-5 hours prior to bed time
TreatmentsChanging your sleep habits and addressing any underlying causes of insomnia can restore restful sleep for many people. Good sleep hygiene — simple steps such as keeping the same bedtime and rising time — promotes sound sleep and daytime alertness. If these measures don't work, your doctor may recommend medications to help with relaxation and sleep.
MedicationsTaking prescription sleeping pills may also help improve sleep.
Ask your healthcare professional for further advice.
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