Insomnia is a sleep disorder. Individuals who suffer from insomnia find it difficult to fall asleep, stay asleep, or both. They don’t feel refreshed when they wake up from sleeping, which can lead to fatigue and other symptoms. It can be short-term (acute) or long-term (chronic). 

Risk Factors for Insomnia

Insomnia can occur at any age, and is more likely to affect women than men. According to the National Heart, Lung, and Blood Institute, people with certain risk factors are more likely to have insomnia. These risk factors include:

  • high levels of stress
  • emotional disorders like depression or distress related to a traumatic life event
  • lower income
  • traveling to different time zones
  • certain medical conditions
  • sedentary lifestyle
  • changes in work hours or night shifts

Causes of Insomnia

Acute insomnia is typically caused by stress or an upsetting event. It can last for days, or even weeks. Chronic insomnia is insomnia that occurs three times a week for three months or more. This type of insomnia is often secondary to another problem, like a medical condition, psychological issue, or a combination of these such as substance abuse. Primary insomnia is usually caused by life changes.

Symptoms of Insomnia

The National Sleep Foundation identifies several symptoms of insomnia. People who suffer from the disorder report at least one of these symptoms:

  • waking too early in the morning
  • un-refreshing sleep
  • trouble concentrating
  • fatigue
  • trouble falling or staying asleep
  • mood changes, like irritability
  • trouble in school or with relationships

Diagnosing Insomnia

Insomnia differs from many other disorders because it doesn’t have a specific diagnostic test. Your doctor will ask you questions about your medical, social, psychological/emotional condition and sleep history. This will provide information that can help find underlying causes of sleep problems. You might be asked to:

  • keep a sleep log
  • recording when you fall asleep
  • note whether you woke up repeatedly
  • report what time you wake up each day

This gives your doctor a picture of your sleep patterns. The doctor might also order medical tests or blood work to rule out medical problems that might be interfering with sleep.

Sometimes a sleep study is recommended. For this, you will stay overnight at a sleep center. Electrodes will be placed on your body and hooked up to an electroencephalography (EEG) machine, which will record brainwaves and sleep cycles. The neuroelectrical and physiological information from this type of study provides the doctor with potentially important diagnostic information about your sleep issues.

Treatment of Insomnia

There are both pharmaceutical and non-pharmaceutical treatments for insomnia. Your doctor can talk with you about what treatments might be appropriate for you and you can try more than one to see which is more effective.

Sleep hygiene training may be recommended. Sometimes behaviors that interfere with sleep are causing insomnia and sleep hygiene training can help you change some of these disruptive behaviors. This means avoiding caffeinated beverages or exercise near bedtime and minimizing time spend on the bed when not specifically intending to sleep (i.e. not watching TV in bed).

If there is an underlying psychological or medical disorder contributing to insomnia, addressing this issue with appropriate treatment can alleviate sleep difficulties.

Sometimes medications are used to treat insomnia. Common types of drugs include hypnotics and benzodiazepines. These have a high potential for abuse and it’s easy to build up a tolerance. They should only be used short-term. Sometimes certain antidepressants such as trazadone are sometimes used quite effectively to treat sleep problems. Such medications have the added benefit of potentially improving coincident mood problems. Over-the-counter medications like antihistamines can help with sleep problems, but can have unpleasant side effects like daytime sleepiness and dry mouth.

Before using any drug, medicine, or supplement to treat your insomnia, talk with your doctor. There might be dangerous side effects or drug interactions. Not every “sleep aid” drug is appropriate for everyone, and many cases of insomnia can be much more effectively managed by lifestyle changes or emotional remedies

Insomnia isn’t just a nuisance or a small inconvenience. It’s a real sleep disorder, and can be treated. If you think you have insomnia, talk to your doctor. By exploring possible causes, you can get the appropriate and safe treatment you need.