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Insomnia - overview


Definition:

Insomnia is trouble falling asleep, staying asleep through the night, or waking up too early in the morning.

Episodes of insomnia may come and go or be long-lasting.

The quality of your sleep is as important as how much sleep you get.

Alternative Names:

Sleep disorder - insomnia; Sleep issues; Difficulty falling asleep

Symptoms:

The most common complaints or symptoms in people with insomnia are:

  • Trouble falling asleep on most nights
  • Feeling tired during the day or falling asleep during the day
  • Not feeling refreshed when you wake up
  • Waking up several times during sleep

People who have insomnia are sometimes consumed by the thought of getting enough sleep. But the more they try to sleep, the more frustrated and upset they get, and the harder sleep becomes.

Lack of restful sleep can:

  • Make you tired and unfocused, so it is hard to do daily activities.
  • Put you at risk for auto accidents. If you are driving and feel sleepy, pull over and take a break.
Exams and tests:

Your doctor will do a physical exam and ask you questions about your current medications, drug use, and medical history. Usually, these are the only methods needed to diagnose insomnia.

Treatment:

Not getting 8 hours of sleep every night does not mean your health is at risk. Different people have different sleep needs. Some people do fine on 6 hours of sleep a night. Others only do well if they get 10 to 11 hours of sleep a night.

Treatment often begins by reviewing any drugs or medical conditions that may be causing or worsen insomnia, such as:

  • Enlarged prostate gland, causing men to wake up at night
  • Pain or discomfort from arthritis or nerve disorders

You should also think about lifestyle and sleep habits that may affect your sleep. This is called sleep hygiene. Making some changes in your sleep habits may improve or solve your insomnia.

Using medicine to treat insomnia can sometimes be useful. But there can be risks. It may help to see a psychiatrist or another mental health provider to test for mood or anxiety disorders that can cause insomnia.

  • They may use talk therapy, such as cognitive-behavioral therapy, to help you gain control over anxiety or depression.
  • A psychiatrist may also prescribe antidepressants or another medicine to help you sleep and to address any mood or anxiety disorders you might have.
Outlook (prognosis):

Most people are able to sleep by practicing good sleep hygiene.

When to contact a medical professional:

Call your doctor if insomnia has become a problem.

References:

Morgenthaler T, Kramer M, Alessi C, Friedman L, Boehlecke B, Brown T, et al. Practice parameters for the psychological and behavioral treatment of insomnia: an update. An American Academy of Sleep Medicine report. Sleep. 2006;29:1415-1419.

Morin CM, Benca R. Chronic Insomnia. The Lancet. 2012 March24; vol. 379 (9821):1129-1141.

Vitiello MV, Rybarczyk B, Von Korff M, Stepanski EJ. Cognitive behavioral therapy for insomnia improves sleep and decreases pain in older adults with co-morbid insomnia and osteoarthritis. J Clin Sleep Med. 2009 Aug 15;5:355-362.

Wickwire EM, Collop NA. Insomnia and sleep-related breathing disorders. Chest. 2010;137:1449-1463.


Review Date: 5/11/2014
Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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