Dec 30, 2021

What is Insomnia and How Can You Treat It?

Do you find yourself waking up numerous times throughout the night? Or maybe you just lay in bed for hours, staring at the ceiling, unable to fall asleep. 

If this rings true for you, then the chances are you are suffering from a sleep disorder. And you aren't alone. Each year over 70 million Americans are affected by sleep disorders.

The American Sleep Association reports that insomnia is the most common sleep disorder, with 30% of adults reporting short-term issues and 10% chronic insomnia. 

Insomnia can impact your mental, emotional, and physical wellbeing, as well as affect your ability to function. 

What is insomnia?

Insomnia is a condition that can make it difficult to fall asleep, hard to stay asleep, or cause you to wake up earlier than desired and have difficulty getting back to sleep.

Symptoms and side effects insomnia

Signs of insomnia can vary from person to person due to the severity and cause of the disorder and other underlying health conditions.  

Typical symptoms of insomnia include:

  • Trouble falling asleep at night

  • Waking up during the night

  • Waking up too early

  • Problems falling back asleep 

  • Mood swings

  • Tired/not feeling well-rested after waking up

  • Daytime sleepiness/fatigue 

  • Low-energy during the day

  • Irritability, depression, or anxiety

  • Difficulty paying attention and focusing on tasks 

  • Memory issues 

Some side effects or risks of insomnia include:

  • Poor performance at work or school

  • Increased risk of accidents- one study found that 35% of truck drivers with insomnia reported a motor vehicle accident in the previous three years

  • High risk of developing chronic medical conditions, such as heart disease, stroke, and obesity

Causes of insomnia

Insomnia can be the main problem or associated with other health ailments. While stress and life events are often the primary cause of sleep disruption, several other factors can lead to insomnia. 

The development of insomnia can be the result of environmental, physiological, and psychological factors, including:

  • Unhealthy lifestyle

  • Poor sleep habits

  • Mental health problems such as anxiety disorders, depression, and PTSD

  • Chronic diseases like cancer, diabetes, and cardiovascular disease

  • Chronic pain due to arthritis, fibromyalgia, injuries, etc

  • Gastrointestinal disorders, such as heartburn and gastrointestinal reflux disease (GERD)

  • Hormone imbalances from menstruation, menopause, pregnancy, and thyroid disease

  • Medications like Alpha-blockers, Beta-blockers, Stimulants, decongestants (oral and nasal), SSRI antidepressants, ACE inhibitors, ARBs, cholinesterase inhibitors, H1 antagonists, Glucosamine/chondroitin, and Statins

  • Neurological disorders, such as Alzheimer's Disease, Parkinson's Disease, Epilepsy, and Stroke

  • Other undiagnosed or untreated sleep disorders, such as Sleep Apnea, Periodic Leg Movement Disorder (PLMD), and Restless Legs Syndrome

  • Brain injuries, like TBI, concession, and head trauma

Insomnia can trigger or worsen health conditions. 

Types of insomnia

There are two primary types of insomnia:

Short-term (acute) insomnia- Sleep disruption that lasts for a brief amount of time, usually a few days to a few weeks at a time. Many people experience acute insomnia at some point in their life due to:

  • Life stressors- losing a loved one, a worrisome medical diagnosis, a pandemic, withdrawal from a drug, or a significant life change, such as a job or relationship

  • Pregnancy or menopause (in women)

Long-term (chronic) insomnia- Insomnia becomes chronic if you have problems falling asleep and/or staying asleep at least three nights per week for three months or longer. Usually, those with long-term insomnia have a history of sleep issues, and they can come and go. Like acute insomnia, chronic can be caused by stress, but also can be linked to:

  • Poor sleep habits

  • Irregular sleep schedules

  • Mental health disorders

  • Bed partner

  • Underlying physical or neurological issues

  • Certain medications

  • Other sleep disorders

While we may often hear insomnia categorized in one of two ways, acute or chronic, there are other terms healthcare professionals and researchers may use. 

  • Sleep onset insomnia- the inability to fall asleep when laying down for the night

  • Sleep maintenance insomnia- the inability to stay asleep causing fragmented sleep

  • Early morning awakening insomnia- the inability to get the desired amount of sleep due to waking up early

  • Mixed insomnia- a combination of the above three 

  • Comorbid insomnia- the result of another health condition 

Treatment options for insomnia 

Treatment will depend on what is causing your insomnia and other health conditions you may have. Sometimes, you can treat it with over-the-counter sleep aids, finding successful ways to manage stress or both.  

However, if functioning during the day is challenging for you or your insomnia lasts more than a couple of weeks, you should see your doctor. Getting a proper diagnosis will help you get the right treatment options. 

How is insomnia diagnosed?

If you aren't sure what's causing your sleep problems, your physician will most likely do a physical exam to look for signs of conditions that might be the culprit. They may order blood work to rule out thyroid or other issues. 

The doctor may also give you a sleep questionnaire and have you keep a sleep diary. These will provide them with more insight into your sleep disturbances. 

If there are signs of other sleep disorders, you will probably need a sleep study to monitor your activities while you sleep, such as brain waves, breathing, heartbeat, eye movements, and body movements.

Treating insomnia

Creating healthy sleep habits and addressing the root cause of your insomnia (medication, stress, medical condition) can both be a tremendous help when it comes to restful sleep. However, there are times when additional treatment is necessary. 

  • Cognitive-behavioral therapy for insomnia (CBT-I)- focuses on helping you manage or eliminate negative thoughts and actions that keep you awake. It can include stimulus control therapy, relaxation techniques, sleep restriction, remaining passively awake, and light therapy. 

  • Prescription medications- These sleeping pills, like Eszopiclone (Lunesta), Ramelteon (Rozerem), Zaleplon (Sonata), and Zolpidem (Ambien), help you go to sleep, stay asleep, or both. Always consult with your doctor and pharmacist about potential side effects and risks of forming a dependence on these drugs. 

  • Over-the-counter sleep aids- These non-prescription sleep aids are available at a majority of pharmacies, groceries stores, and big-box stores. They contain antihistamines, which can help make you tired and more easily fall asleep, but are not recommended for regular use. Talk to your doctor or pharmacist before you take these about all potential side effects

  • Clinical trials- Ongoing research studies are available to test new treatment options and interventions to prevent, treat, and manage insomnia. Ask your healthcare provider if they can recommend any research options like The Mayo Clinic's clinical trials. 

  • Lifestyle changes and home remedies- As we mentioned above, sometimes insomnia is treatable by changing your bedtime and daily routine. Some recommendations include consistent bed and wake-up times, increasing physical activity, avoiding or limiting naps, avoiding large meals before bed, controlling pain, making your bedroom comfortable, relaxing before it's time to go to sleep, and only using your bed to sleep (that means no working in bed!). 

There are herbal and dietary supplements, like Melatonin and Valerian, that claim to help promote healthy sleep. While many are safe to take for a short amount of time, there isn't much evidence or research that shows them as effective treatments for insomnia. Some products can be harmful, and some can have adverse effects if taken with certain medications. 

Final thoughts

While insomnia is prevalent and most likely to affect all of us at some point in our life, you don't have to live with chronic sleepless nights. There are many treatment options available to help you sleep peacefully. 

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