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Insomnia 101: What It Is and What You Can Do

July 10, 2020

It’s frustrating to be tired — or even exhausted — and yet unable to sleep. While a night or two of poor rest probably won’t hurt you, insomnia can lead to irritability, problems concentrating, fatigue and forgetfulness. And the effects add up: the longer insomnia lasts, the worse the symptoms become.

According to the American Academy of Sleep Medicine, insomnia is a “persistent difficulty with sleep initiation, duration, consolidation or quality,” which causes daytime impairment and occurs despite the desire and opportunity to sleep. It’s one of the most common sleep disorders, affecting as many as 15 percent of adults; but it can be treated.

Types of Insomnia

There are two categories of insomnia characterized by general cause:

  • Primary insomnia is a sleep difficulty not caused by or associated with any other condition.
  • Secondary insomnia results from a medical condition, psychiatric problem, or medicine that interferes with sleep.

Insomnia can also be described by the type of sleep difficulty you’re having:

  • Sleep-onset insomnia is a type of sleep that refers to difficulty falling asleep.
  • Sleep-maintenance insomnia is another type of sleep that refers to difficulty staying asleep.

Insomnia can describe any type of sleep that is not restful or refreshing, even if it doesn’t fall into one of these categories. (Sleep apnea is another possible explanation for poor-quality sleep.)

Causes of Insomnia

Many medical and psychiatric conditions are linked to secondary insomnia, including COPD, GERD, restless leg syndrome, congestive heart failure, anxiety, and depression. Insomnia can also be a side effect of medicines, including antidepressants, ACE inhibitors and beta-blockers, as well as drugs for blood pressure, allergies, and emphysema.

If insomnia can’t be traced to a medication or medical condition, one of these factors may be involved:

  • Age and gender: Different types of insomnia are more common in older adults, possibly due to natural changes in sleep patterns. It’s also a more common sleep disorder in women, because fluctuating hormones can cause stress that keeps us awake or wakes us up too early.
  • Sleep environment: People with insomnia may need to consider their sleep environment. A bedroom that’s too warm, too bright, or too noisy can delay or interrupt sleep.
  • Problems with circadian rhythm: This common sleep disorder may be due to problems in our circadian rhythm. Many factors can throw off our natural sleep-wake cycle, including inadequate daytime light, change in work shifts, naps, or other irregularities in our schedules.

Treatments for Insomnia

If you’re suffering from secondary insomnia, try to address the underlying cause. You may want to see a doctor about changing your medication, for example, or consider therapy to address anxiety.

Cognitive-behavioral therapy has been shown to be effective against primary insomnia by targeting unwanted thoughts that can cause poor types of sleep. (You will need a referral to a behavioral sleep medicine therapist).

If you’d like to try to improve your primary insomnia yourself, it’s helpful to work on your sleep hygiene and to strengthen your circadian rhythm. Here are a few strategies that may work as treatments for insomnia:

  • Keep a sleep journal. Record your sleep patterns for a few weeks, noting how long it takes to fall asleep, how often you wake up, your stress level, how you feel in the morning, and any other factors that seem to have an effect on your type of sleep.
  • Go to bed and get up at the same time every day. It’s tempting to sleep in when you have the opportunity, but a regular routine that strengthens your overall sleep cycle will be a more beneficial insomnia treatment than a few extra hours of shut-eye.
  • Get your morning light. Within an hour of waking up, expose yourself to some bright light, preferably outdoors. This reinforces to your brain that it’s daytime and is a great way to get your sleep-wake cycle in check.
  • Watch out for caffeine, sugar and alcohol. Caffeine can stay in your system longer than you may think. Be sure to avoid it at least eight hours before bedtime to help reduce symptoms of your type of insomnia. Sweets and alcohol also affect your blood sugar, causing a “roller coaster” of stress hormones that can wake you in the middle of the night.
  • Avoid blue light at night. Put away your smartphone and computer, and turn off the television, at least an hour before bed. The light from these devices can trick your brain into thinking it’s daytime. Instead, unwind before bed, maybe by reading something calming or taking a hot bath. This can also be a helpful treatment for insomnia.

Do I Have Insomnia?

Ask yourself these questions:

  • Do unwanted thoughts keep me from relaxing in bed?
  • Does it take more than half an hour to fall asleep, or do I wake up earlier than intended?
  • Do I wake up groggy despite having allowed time for a full night’s sleep?
  • Do I feel moody, tired or brain-fogged during the day?

If insomnia is interfering with your well-being, it’s a good idea to talk to your doctor. They may be able to provide further testing to help you figure out what’s going on and get some relief. You can also learn more about this common sleep disorder at the American Sleep Association.

The information in this post is not intended to be a substitute for professional medical advice, diagnosis or treatment. Please seek the advice of a qualified healthcare provider with any questions you may have about a medical condition.

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