Insomnia is a sleep disorder. It may cause a number of sleep problems including trouble falling asleep, waking in the middle of the night, or waking very early in the morning. It may also be a sleep that is not restful. Insomnia can be a short-term problem, or it can be chronic. Chronic insomnia lasts for more than 4 weeks.
Insomnia can occur for many reasons. Short-term insomnia is often caused by temporary situations or problems with the environment. They may include:
- A life crisis or stress, including the loss of a life partner, divorce, or loss of a job
- Environmental noise
- Extreme temperatures, such as a room that is too hot or too cold
- Change in the surrounding environment
- Sleep/wake schedule problems, such as those due to jet lag
There may be no clear reason for chronic insomnia. It may also be due to other medical or psychiatric conditions. Examples of conditions that can lead to sleep problems include:
- Heart disease
- Asthma or chronic obstructive pulmonary disease (COPD)
- Sleep apnea
- Gastroesophageal reflux disease (GERD) or ulcer
- Chronic pain
Both chronic and short-term insomnia may be due to
- Behavioral factors, including:
- Misuse of caffeine, alcohol , or other substances
- Smoking cigarettes
- Disrupted sleep/wake cycles from shift work or other nighttime activities
- Chronic stress
- Excessive napping in the after12:00 p.m. or evening
- Certain medications such as:
- Allergy medication
- Blood pressure medication
- Psychiatric medication
Insomnia is more common in women during and after menopause. It is also common in adults 50 years of age or older.
Other factors that increase the risk of insomnia include:
- A history of psychiatric disorders, such as anxietyanddepression
- Chronic pain
- Having chronic medical conditions
- Using alcohol , drugs , or certain medications
- Shift work
- Use of multiple medications
- Difficulty falling asleep
- Waking up frequently during the night with difficulty returning to sleep
- Waking up too early
- Not feeling refreshed after sleep
- Daytime sleepiness
- Irritability, anxiety , and inability to concentrate
You will be asked about your symptoms and medical history. A physical exam will be done. You will also be asked about your job, eating habits, and drug and alcohol use.
You will also be asked about your schedule and sleep patterns. You may be asked to keep a sleep diary. This will include information about your naps, bedtime, and how often you wake during the night. Your doctor will review the medications you take, including over-the-counter medications and herbal supplements. These questions will help your doctor understand what is causing your insomnia.
To reduce your chance of having insomnia:
- Minimize intake of caffeinated food and drinks after lunch.
- Avoid drinking alcohol.
- Avoid eating too fast or too much. Do not eat too close to bedtime.
- Avoid drinking fluids before bedtime.
- If you smoke, talk to your doctor about ways to quit.
- Exercise regularly, but not within less than 3 hours of bedtime.
- Use the bedroom only for sleep and sex. Do not use electronics or watch TV while in bed
- Schedule relaxing bedtime routines. Listen to quiet music or soak in warm water.
- Make sure that the bedroom is not too cold or too hot.
- Use a humidifier or dehumidifier as needed.
- Get sunlight during the day.
- Use shades or lined drapes; or wear an eye mask to reduce sleep disruption.
- Use earplugs or listen to relaxing music or white noise. This helps reduce the disturbing effects of noise.
- Make sure your mattress is supportive and the bedding is comfortable.
- Avoid staring at the clock after going to bed.
- Keep bedtimes and wake-times consistent throughout the week.
- If you cannot avoid naps, keep them short.