What is Insomnia?
Insomnia is difficulty falling asleep and staying asleep. A sleep disorder. People with insomnia can feel dissatisfied with their sleep and this can lead to fatigue and other symptoms like
- mood disturbances,
- low energy,
- decreased performance in work.
According to the American Psychiatric Association (APA), about one-third of all adults report insomnia symptoms. But between 6 to 10 percent of all adults have symptoms severe enough for them to be diagnosed with insomnia disorder. The APA defines insomnia as a disorder in which people have trouble falling asleep or staying asleep. Doctors make a clinical diagnosis of insomnia if both of these criteria apply.Sleep difficulties occurring at least three nights a week for a minimum of three months.
Sleep difficulties creating major distress or functional difficulties in a person’s life.
Keep reading to learn all about the symptoms, causes, and types of insomnia.
Symptoms of Insomnia
People who experience insomnia usually report at least one of these symptoms:
- unrefreshing sleep and waking too early in the morning,
- trouble falling or staying asleep.
These symptoms of insomnia can lead to other symptoms, including:
- fatigue and
- mood changes.
You may also have difficulty concentrating on tasks during the day.
Types of insomnia are also characterized by their symptoms.
Onset insomnia is the medical term for insomnia in which you have difficulty falling asleep at the beginning of the night.Maintenance insomnia is the term for the inability to stay asleep. People with maintenance insomnia often wake up during the night and then find it difficult to go back to sleep.
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 (NHLBI), people with certain risk factors are more likely to have insomnia.
These risk factors include:
- high levels of stress,
- emotional disorders,
- such as depression or distress related to a life event,
- traveling to different time zones,
- sedentary lifestyle and Medications,
- lower income,
- changes in work hours, or
- working night shifts.
- Menopause can lead to insomnia as well.
Diagnosis for Insomnia
In order to arrive at a diagnosis, your doctor will ask questions about your:
- medical conditions,
- social environment,
- psychological or emotional condition,
- sleep history.
This information can help them determine the underlying causes of your sleep problems. You might be asked to:
- keep a sleep log record when you fall asleep,
- note the instances when you wake up repeatedly,report what time you wake up each day.
A sleep log will give your doctor a picture of your sleep patterns. The doctor may also order medical tests or blood work to rule out medical problems that can interfere with your sleep.
Sometimes a sleep study is recommended.
For this, you’ll stay overnight at a sleep center. Electrodes will be placed on your body. They’ll be used to record brainwaves and sleep cycles.The results of your sleep study will provide your doctor with potentially important neuroelectrical and physiological information.
There are many different ways to characterize insomnia, and some of these types of insomnia will even overlap.
Causes of Insomnia
Insomnia may be either
- primary or
Primary insomnia is insomnia that’s not caused by another condition. It’s often triggered by
- life changes, such as a varying work schedule.
Secondary insomnia is the result of an underlying health condition or lifestyle habit, such as a
- mental health condition or excessive daytime napping. Doctors often call this type of insomnia comorbid insomnia.The causes of your insomnia will depend on the type of sleeplessness you experience.Short-term insomnia may be caused by stress, an upsetting or traumatic event, or changes to your sleep habits. Chronic insomnia lasts for at least three months and is usually secondary to another problem or a combination of problems, including:
- stress, and
- depression are some of the most common causes of chronic insomnia.
Other common emotional and psychological causes include
- bipolar disorder, and
- trauma medical conditions which make it harder to sleep, such as
- arthritis or back pain,
- psychological issues,
- substance use.
Treatments for Insomnia
Treating insomnia:- There are both pharmaceutical and non-pharmaceutical treatments for insomnia.
Your doctor can talk to you about what treatments might be appropriate. You may need to try a number of different treatments before finding the one that’s most effective for you.The American College of Physicians (ACP) recommends cognitive behavioral therapy (CBT) as a first-line treatment for chronic insomnia in adults.
Sleep hygiene training may also be recommended. Sometimes, behaviors that interfere with sleep cause insomnia. Sleep hygiene training can help you change some of these disruptive behaviors.
Suggested changes may include:
- avoiding exercise near bedtime,
- minimizing time spent on your bed when you’re not specifically intending to sleep,
- such as watching TV or surfing the web on your phone and avoiding caffeinated beverages near bedtime.
If there’s an underlying psychological or medical disorder contributing to your insomnia, getting appropriate treatment for it can alleviate sleep difficulties.
Insomnia medications: An example of an over-the-counter (OTC) medication that can be used for sleep is an antihistamine, such as diphenhydramine (Benadryl). Medications like this can have side effects, especially long term, so it’s important to talk to a doctor before starting yourself on an OTC medicine for insomnia.
Prescription medications that may be used to treat insomnia include:
- eszopiclone (Lunesta),
- zolpidem (Ambien).
Talk with your doctor before using any medications or supplements to treat your insomnia.
There might be dangerous side effects or drug interactions. Not every “sleep aid” is appropriate for everyone.
Home remedies for insomnia
Many cases of insomnia can be effectively managed by making lifestyle changes or trying home remedies.
- Warm milk,
- herbal tea, and
- valerian are just a few of the natural sleep aids you can try.
Meditation is a natural, easy, drug-free method for treating insomnia. According to the National Sleep Foundation, meditation can help improve the quality of your sleep, as well as make it easier to fall asleep and stay asleep.The Mayo Clinic says that meditation can also help with symptoms of conditions that may contribute to insomnia. These include:
- digestive problems,
- pain and stress,
The hormone melatonin is naturally produced by the body during the sleep cycle. People often take melatonin supplements in hopes of improving their sleep.Studies are inconclusive regarding whether melatonin can actually help treat insomnia in adults. There’s some evidence that supplements may slightly decrease the time it takes you to fall asleep but more research is needed.
Melatonin is generally thought to be safe for a short period of time, but its long-term safety has yet to be confirmed.It’s always best to work with your doctor when deciding to take melatonin.
Essential oils are strong aromatic liquids made from a variety of plants, flowers, and trees. People treat a variety of conditions by inhaling oils or massaging them into the skin. This practice is called aromatherapy.Essential oils that are thought to help you sleep include:
- Roman chamomile,
- neroli, or
- bitter orange.
A review of 12 studies in 2015 found aromatherapy to be beneficial in promoting sleep.
Another study found lavender to be especially useful in promoting and sustaining sleep. The study reported that a mixture of essential oils reduced sleep disturbance and increased well-being in older adults.Essential oils don’t generally cause side effects when used as directed. Most essential oils have been classified GRAS (generally recognized as safe) by the U.S. Food and Drug Administration (FDA).
However, aromatherapy isn’t regulated by law in the United States, and no license is required for practice. Therefore, it’s important to select practitioners and products carefully.
Insomnia and pregnancy
Insomnia is common during pregnancy, especially in the
- first and
- third trimesters.
- Fluctuating hormones,
- nausea, and
- an increased need to urinate are some of the bodily changes that may keep you awake in early pregnancy.
- You may also face emotional stressors, such as anxiety about the increasing responsibilities you’ll face as a mother.
- Pain — such as cramps and back discomfort — may also keep you awake.
Your body is undergoing many changes, like an
- active metabolism and increase in progesterone,
- to accommodate the new life growing in you.
- It’s normal for your sleep patterns to change, too.
Lifestyle changes that may help include:
- keeping active during your pregnancy,
- maintaining a healthy diet,
- staying well-hydrated
- maintaining a consistent sleep schedule,
- practicing relaxation techniques during the day or taking a warm bath before bedtime, if you have anxiety.
Contact your doctor about any new exercise routines, medications, or supplements you might be interested in. You’ll want to ensure that they’re safe for someone who’s pregnant.The good news is that pregnancy-related insomnia usually passes, and it doesn’t affect your baby’s development.
Duration of insomnia
Short-term forms of insomnia include
- situational insomnia and
- episodic insomnia.
Situational insomnia is also known as acute insomnia and lasts for days, or even weeks.
Episodic insomnia lasts for one to three months.Chronic forms of insomnia include persistent insomnia and recurrent insomnia.
Persistent insomnia lasts for at least three months.Recurrent insomnia is characterized by at least two episodes of insomnia over the course of a year. These episodes will last for one to three months at a time.
Insomnia in children
Children can have insomnia, too — often for the same reasons as adults. These reasons might include:
- excessive caffeine intake,
- psychiatric disorders.
If your child has trouble falling asleep or staying asleep, or if they wake up too early, insomnia may be the reason.
According to the Cleveland Clinic, symptoms of insomnia in children may include:
- daytime sleepiness or restlessness,
- irritability and mood swings,
- repeated disciplinary issues,
- memory problems and attention deficits.
Treatment for children is often the same as treatments for adults.
Children will benefit from a consistent sleep schedule and good sleep hygiene. Reducing stress and avoiding screen time near bedtime will help as well.
Insomnia and depression | Depression
According to the National Sleep Foundation, not only does insomnia make you more likely to develop depression, but depression can also make you more likely to develop insomnia.
A meta-analysis of 34 studies concluded that poor sleep — especially during times of stress — significantly increased the risk of depression.Another study found that as insomnia persisted and symptoms worsened, subjects developed an even greater risk of developing depression.For other people, symptoms of depression may precede insomnia.
The good news is that the same treatments often help both depression and insomnia, no matter which condition comes first.The most common treatments are medications, therapy, and lifestyle changes. These lifestyle changes can include better sleep habits, exercising in the daytime, and eating a balanced diet.
Insomnia and anxiety
Anxiety can cause insomnia, and insomnia can cause anxiety. This can result in a self-perpetuating cycle that may lead to chronic insomnia.According to Australia’s Sleep Health Foundation, anxiety and worrying are leading causes of insomnia.
Short-term anxiety develops when you worry frequently about the same specific issue, such as work or your personal relationships. Short-term anxiety usually goes away once the issue is resolved. Your sleep should return to normal as well.
People can also be diagnosed with an anxiety disorder, such as generalized anxiety disorder (GAD) or panic disorder. These disorders can result in varying degrees of insomnia.The causes of anxiety disorders aren’t completely understood. Treatment is usually long term and includes a combination of therapy and medications.
The same lifestyle and behavioral practices recommended for other forms of insomnia help diminish anxiety-related insomnia, such as restricting stressful topics of conversation to the daytime. Learn more about the connection between mental health issues and insomnia.