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Understanding Insomnia

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Updated June 02, 2007

Insomnia is a broad term used to describe difficulty falling asleep or staying asleep. The term also includes the situation of a person not feeling refreshed after 7 to 9 hours of being in bed. Temporary insomnia is normal and can be brought on by stress and anxiety. Chronic insomnia is defined as experiencing insomnia symptoms at least 3 times a week for at least one month. Between 30 and 40 percent of adults report some insomnia each year, with 10 to 15 percent saying they have chronic insomnia.

Effects of Insomnia

Chronic insomnia causes a person to feel tired during the day and can lead to moodiness, fatigue, difficulty concentrating and other effects related to lack of sleep. Insomnia can significantly lower a person’s quality of life.

Insomnia Causes

Most cases of insomnia are considered “secondary,” which means they are caused by something else. These causes include:
  • Medication Side Effects: These are especially common with decongestants, some pain relievers and steroids.
  • Diseases and Health Conditions: Alzheimer’s disease, arthritis, asthma, heart disease and many other health problems can cause trouble with sleep.
  • Poor Sleep Behaviors: These include drinking alcohol before bed, exercising before bed, drinking caffeine in the evening, poor exposure to sunlight and other behaviors that interfere with the body successfully achieving enough restful sleep.
  • Sleep Disorders: Restless legs syndrome or sleep apnea are just two common sleep disorders.

A few people have chronic primary insomnia, which is difficulty sleeping not caused by any other factor. These people may have an oversupply of certain hormones, faster heart rates or other physiological differences that make sleep difficult.

The Insomnia Cycle

One of the biggest dangers in insomnia is known as the “insomnia cycle.” This occurs when a person has difficulty falling asleep one night and then becomes anxious about falling asleep the next night, which makes it more difficult to fall asleep. The more they cannot sleep, the more anxious about sleep they become – which keeps them from sleeping. To break the ”insomnia cycle,” practice healthy sleep habits, such as only going to bed when you are tired, not lying in bed awake for more than 20 minutes and avoiding afternoon and evening caffeine.

Insomnia Treatment

Many of the most effective insomnia treatments involve changing your sleep behaviors and habits, while some require medications and supplements:
  • Improving Your Sleep Habits: By changing your habits around sleep you can greatly shorten the time it takes to fall asleep. More exercise, more sunlight exposure and less caffeine are just three examples of habits to change to improve sleep.
  • Relaxation Therapy: Some people with chronic insomnia may be directed to practice relaxation therapy, which can involve tensing and relaxing different muscle groups or focusing on deep breathing. Relaxation therapy can help people to fall asleep faster.
  • Sleep Restriction: Another effective insomnia treatment involves sleep restriction. This involves limiting sleep to 4 or 5 hours a night and then gradually adding time onto sleep. This can help retrain the body to fall asleep and stay asleep. People practicing sleep restriction should avoid driving and other dangerous activities until they are getting at least 7 hours of sleep each night.
  • Sleep Medications: There are many (widely advertised) sleep medications, which are available by prescription. Some of these medications may help you to fall asleep, but you may wake up unrefreshed. Some also lose their effectiveness over time. Sleep medications should be used under the careful direction of a doctor and as part of a comprehensive sleep plan that also addresses sleep behaviors.
  • Supplements: Many supplements claim to help with insomnia. The two most popular are melatonin and valerian.
    • Melatonin: This hormone is naturally produced by your body and stimulated by exposure to sunlight. Studies have not shown that melatonin is effective in treating insomnia. However, many people claim that taking melatonin helps them to fall asleep. Before taking melatonin, remember that the goal is for your body to produce enough melatonin on its own. Supplements may actually decrease your own production and should only be used in the short-term and under a doctor’s supervision.
    • Valerian: This is an herb that is reportedly effective in helping people fall asleep. Studies on valerian have been inconclusive. Valerian comes in many different forms (tea, pills extracts) and is unregulated. Dose and quality can vary widely from one product to another.

More on Sleep Disorders and Sleep Problems

Sources:

National Institutes of Health; National Heart, Lung and Blood Institute. Your Guide to Healthy Sleep. NIH Publication No. 06-5271.

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