Insomnia is a disorder that can make it hard to fall asleep, hard to stay asleep, or both. With insomnia, you usually awaken feeling unrefreshed, which takes a toll on your ability to function during the day. Insomnia can sap not only your energy level and mood but also your health, work performance and quality of life.
How much sleep is enough varies from person to person. Most adults need seven to eight hours a night. Many adults experience insomnia at some point, but some people have long-term (chronic) insomnia.
You don't have to put up with sleepless nights. Simple changes in your daily habits can help.
Insomnia symptoms may include:
Someone with insomnia will often take 30 minutes or more to fall asleep and may get only six or fewer hours of sleep for three or more nights a week.
When to see a doctor
Common causes of insomnia include:
Insomnia and aging
Sleep problems may be a concern for children and teenagers as well. Some children and teenagers simply have trouble getting to sleep or resist a regular bedtime because their internal clocks are more delayed. They want to go to bed later and sleep later in the morning.
Nearly everyone has an occasional sleepless night. But your risk of insomnia is greater if:
Sleep is as important to your health as a healthy diet and regular exercise. Whatever your reason for sleep loss, insomnia can affect you both mentally and physically. People with insomnia report a lower quality of life compared with people who are sleeping well.
Complications of insomnia may include:
Preparing for your appointment
If you're having sleep problems, start by talking to your family doctor or a general practitioner. Because appointments can be brief, and there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. For insomnia, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment.
What to expect from your doctor
Tests and diagnosis
In addition to asking you a number of questions, your doctor may have you complete a questionnaire to determine your sleep-wake pattern and your level of daytime sleepiness. You may also be asked to keep a sleep diary for a couple of weeks, if you haven't already done so.
Your doctor will do a physical exam to look for signs of other problems that may be causing insomnia. Occasionally, a blood test may be done to check for thyroid problems or other conditions that can cause insomnia.
If the cause of your insomnia isn't clear, or you have signs of another sleep disorder, such as sleep apnea or restless legs syndrome, you may need to spend a night at a sleep center. Tests are done to monitor and record a variety of body activities while you sleep, including brain waves, breathing, heartbeat, eye movements and body movements.
Treatments and drugs
Changing your sleep habits and addressing any underlying causes of insomnia can restore restful sleep for many people. Good sleep hygiene — simple steps such as keeping the same bedtime and arising time — promotes sound sleep and daytime alertness. If these measures don't work, your doctor may recommend medications to help with relaxation and sleep.
Behavior therapies include:
Doctors generally don't recommend relying on prescription sleeping pills for more than a few weeks, but several newer medications are approved for indefinite use. However, some of these medications are habit-forming.
If you have depression as well as insomnia, your doctor may prescribe an antidepressant with a sedative effect, such as trazodone, doxepin or mirtazapine (Remeron).
Over-the-counter sleep aids
Lifestyle and home remedies
No matter what your age, insomnia usually is treatable. The key often lies in changes to your routine during the day and when you go to bed. Try these tips:
Many people never visit their doctor for insomnia, and instead try to cope with sleeplessness on their own. Several therapies that may be helpful include:
Be sure to talk with your doctor before taking any herbal supplements or over-the-counter products as some can interact with medications, and others, such as L-tryptophan, may be dangerous on their own.
Last Updated: 2011-01-07
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