Insomnia

Insomnia

Most people have had a night during which they couldn't get to sleep, no matter how desperately they tried.

When you can't sleep, the ticking of the clock only reminds you of your exhaustion and the interminable hours until morning. And perhaps you finally drop off around dawn, only to be jarred awake by the alarm an hour later.

Insomnia, the term for having trouble sleeping at night, is one of the most common sleep complaints. About one in three adults has bouts of insomnia that last a few days at a time. This is acute insomnia. But 10% to 15% of adults suffer ongoing difficulty sleeping that occurs more than 3 nights a week for over a month, known as chronic insomnia.

Facts about insomnia

Insomnia affects people in different ways. If you suffer from it, you may not be able to go to sleep or you may not be able to stay asleep. You might constantly wake up earlier than you would like, perhaps in the wee hours of the morning, and find yourself unable to go back to sleep. 

Women are more likely to have insomnia than men. It is also more common among shift workers, who don't have consistent sleep schedules; people with low incomes; people who have a history of depression; and those who don't get much physical activity.

Insomnia can have serious consequences. Poor sleep quality is linked to:

  • Increased risk for heart disease

  • Increased risk for stroke

  • Increased risk for diabetes

  • Excessive weight gain or obesity

  • Depression

  • Increased risk for injury to yourself or others, such as a car accident caused by driving while drowsy

Symptoms of insomnia

These are common symptoms of insomnia:

  • Frustration and preoccupation with your lack of sleep

  • Physical aches and pains, such as headaches and stomachaches

  • Impaired performance at work

  • Daytime drowsiness or low energy

  • Difficulty paying attention

  • Anxiety

  • Tension and irritability

  • Depression and mood swings

Causes

Insomnia has many possible causes. The reasons you're lying awake when you don't want to be are individual. They can include any or all of these:

  • Medications that interfere with sleep

  • Dietary choices, such as caffeine late in the day, that interfere with sleep

  • Stressful thoughts

  • Depression

  • Recent upheavals in your life, such as a divorce or death of a loved one

  • Hormone changes, such as those accompanying menopause

  • Bedtime habits that don't lead to restful sleep

  • Sleep disorders

  • Chronic pain

  • Medical conditions such as acid reflux, thyroid problems, stroke, or asthma

  • Substances like alcohol and nicotine

  • Travel, especially between time zones

Diagnosis and treatment

You may need to see a sleep medicine specialist to find out what's causing your insomnia. It will be helpful to bring a record of your sleep patterns.

The process of making a diagnosis may include:

  • Your personal medical history. Your doctor will consider any medical conditions, any medications you're taking, and stressful life changes that could be causing insomnia.

  • Your sleep history. Be prepared to describe your insomnia with details such as how long it's been going on, what you think could be contributing to it, and what your sleep is like, such as whether you can barely get to sleep at all or if you wake up too early.

  • Physical exam. The doctor will look for any physical reasons that could be causing sleep problems.

  • Sleep study. You may need to sleep overnight in a special lab setting where your doctors monitor your sleep.

You have many options for treatment:

  • Medications to help you get to sleep and stay asleep

  • Change in existing medication if that's what's causing the problem

  • Counseling to help relieve stress and other issues bothering you

  • Change in lifestyle choices that may interfere with sleep

  • Better-sleep bedtime habits, called "sleep hygiene"

The exact course will depend on what your doctor identifies as the possible causes of your insomnia. 

 
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