Insomnia

Signs and Symptoms

Insomnia is a common problem that approximately half of American adults report experiencing at some time. The condition is classified into three groups depending on the length that it lasts:

• Transient insomnia is defined as lasting for a few nights
• Intermittent is periodic episodes of insomnia
• Chronic insomnia occurs on most nights and lasting a month or more

Although insomnia is not considered a serious medical problem, lack of sleep can seriously impact your quality of life. It can cause a person to feel tired, depressed and irritable, as well as impair their concentration. Although it differs for each person, most adults need approximately seven to nine hours of sleep to feel completely rested. Both men and women experience insomnia, although females and elderly are typically affected the most. And, despite common belief, the need for sleep does not decrease with age.

Some of the most common causes of insomnia include:

• Stress
• Anxiety
• Depression

Other factors that also can cause insomnia include:

• Drinking too much caffeine throughout the day
• Drinking alcohol before bedtime
• Excessive napping during the day
• Changes in your surroundings and sleep schedule
• Noise
• Jet lag
• Certain medications
• Pain from medical problems, such as arthritis

Symptoms of insomnia include:

• Trouble falling asleep
• Experiencing restless sleep, in which you wake frequently throughout the night and then have trouble falling back asleep
• Waking too early in the morning
• Feeling tired and un-refreshed upon waking in the morning

Diagnosis

If you think that you are experiencing insomnia, your doctor will start by asking you about your medical history as well as your sleep history. Your doctor will ask you and your bed partner, if he or she is present, certain questions to determine your sleep habits. This may include questions about the following:

• When you go to bed and wake up
• The amount of caffeine and/or alcohol you drink
• How long you've had insomnia
• Whether you are experiencing any stress or anxiety that may be affecting your sleep
• If you snore
• Any medical problems that may be interrupting your sleep

If the cause of your insomnia is unclear to your doctor, he or she may ask you to keep a sleep diary, in which you will record:

• The time you go to bed
• How long it takes you to fall asleep
• How often you wake during the night
• What time you wake up
• How you feel upon waking

Treatment

The first step in treatment for insomnia involves diagnosing and treating any underlying medical or psychological problems that may be contributing to your insomnia. The key to treating insomnia is to determine what is causing it and then eliminating those factors from your life. Often once the causes, such as jet lag or stress, are dealt with, insomnia goes away on its own. However, there are some cases when other treatment is required. In addition to identifying the causes of insomnia and then trying to eliminate or reduce them, treatment may include the following.

Sleeping Pills

Typically, sleeping pills are prescribed at a low dose and for a short duration of time. They are not recommended for long-term use and should be taken under the close supervision of your doctor.

Behavioral Techniques

Behavior techniques may help to improve your sleep and include relaxation therapy, sleep restriction therapy and reconditioning.

• Relaxation therapy can be used to reduce or eliminate nighttime stress, body tension and anxiety, and prevent a person's mind from racing, so that they are able to fall asleep.

• You may find that if you are unable to fall asleep or wake up in the night, you spend a lot of time in bed trying unsuccessfully to sleep. If so, you may benefit from a sleep restriction program that initially allows only a few hours of sleep during the night. Gradually this time is increased until a normal sleep period is achieved.

• Reconditioning aims to condition a person's body to associate the bed and bedtime with sleep. For most people, this means using the bed only for sleep and sex. People are advised to go to sleep only when very sleepy, wake and go to bed at the same time every day, and if they are unable to fall asleep, get out of bed and leave their bedroom and not return until they feel sleepy again. Napping is not recommended during this process.