Insomnia is a sleep disorder that is characterized by difficulty falling and/or staying asleep. It can occur at any age, but it is most likely to occur as we age. Symptoms may include difficulty falling asleep, daytime sleepiness, frequent awakenings during the night, difficulty falling back to sleep, early morning awakenings, feeling tired upon waking, irritability, fatigue, depression, anxiety, difficulty with concentration and memory, and persistent worrying about sleep.
Psychological conditions that can cause insomnia include depression, anxiety, panic disorder, chronic stress, bipolar disorder, and post-traumatic stress disorder. Medications that can cause insomnia include antidepressants, cold and flu medications that contain alcohol; pain relievers that contain caffeine (Midol, Excedrin), diuretics, corticosteroids, thyroid hormone, and high blood pressure medications. Medical conditions that can cause insomnia include sleep disorders, adrenal gland dysfunction, pain, asthma, food and environmental allergies, Parkinson’s disease, hyperthyroidism, acid reflux, and kidney disorders.
Primary insomnia occurs when it is not directly associated with any other health conditions or disorders. Secondary insomnia occurs when sleep problems are associated with health conditions like depression, anxiety, pain, and chronic or acute diseases like asthma, cancer, and arthritis. It can also be associated with medications or drugs like alcohol, nicotine, and caffeine.
Insomnia can be chronic (long-term) or acute (short-term). Acute insomnia can last from one night to a few weeks while chronic insomnia occurs at least three nights a week for a month or longer. Acute causes of insomnia may include acute stressors or illnesses, medications, and abrupt lifestyle, work, or environmental changes. The two most common causes of chronic insomnia are depression and anxiety. Other causes of chronic insomnia may include stress, chronic medical conditions, and sleep disorders like sleep apnea, narcolepsy, and restless legs syndrome.
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If you think you have insomnia, seek help from a licensed health care provider. An evaluation may include a medical history, sleep history and diary, a sleep study, brain EEG and another specialized testing to identify causes of secondary insomnia. Elevated bedtime hormone levels of the hormone cortisol are a common cause of insomnia. It is important to identify the underlying cause of your insomnia. Treating the symptoms of insomnia with prescriptions and over-the-counter medications will often lose their effectiveness and may cause dependency.
Tips for combating insomnia include:
- Go to bed at the same time each night.
- Avoid daytime naps.
- Limit or avoid caffeine, nicotine, and alcohol late in the night.
- Regular exercise during the day.
- Increase light exposure during the day.
- Avoid late-night heavy meals.
- Eat a small bedtime snack.
- Use blackout curtains or sleep masks to avoid awakening due to sunlight.
- Use earplugs or white noise machines to drown out disturbing sounds.
- Limit artificial light by avoiding electronics like iPads, cell phones, and televisions at bedtime, which might overstimulate you.
- Make your bed comfortable with a good mattress and pillow.
- Read a book, listen to music, or take a bath before bedtime to relax before you sleep.
- Avoid using your bed for anything other than sleep or sex.
- If you can’t sleep, get up and read, listen to soft music or do something that is not overly stimulating.
- To avoid worrying at night by making a to-do list before you go to bed.
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