What is it?
Insomnia is a sleep disorder that is characterized by difficulty falling and/or
staying asleep. People with insomnia have one or more of the following symptoms:
- Difficulty falling asleep
- Waking up often during the night and having trouble going back to sleep
- Waking up too early in the morning
- Feeling tired upon waking
What causes Insomnia?
- Significant life stress (job loss or change, death of a loved one, divorce, moving).
- Emotional or physical discomfort.
- Environmental factors like noise, light, or extreme temperatures (hot or cold) that
interfere with sleep.
- Some medications (for example those used to treat colds, allergies, depression,
high blood pressure, and asthma) may interfere with sleep.
- interferences in normal sleep schedule (jet lag or switching from a day to night
shift, for example).
Treatments for Insomnia
Acute insomnia may not require treatment. Mild insomnia often can be prevented or
cured by practicing good sleep habits. If your insomnia makes it hard for you to
function during the day because you are sleepy and tired, your health care provider
may prescribe sleeping pills for a limited time. Rapid onset, short-acting drugs
can help you avoid effects such as drowsiness the following day. Avoid using over-the-counter
sleeping pills for insomnia since they may have undesired side effects and tend
to lose their effectiveness over time.
Treatment for chronic insomnia includes first treating any underlying conditions
or health problems that are causing the insomnia. If insomnia continues, your health
care provider may suggest behavioral therapy. Behavioral approaches help you to
change behaviors that may worsen insomnia and to learn new behaviors to promote
sleep. Techniques such as relaxation exercises, sleep restriction therapy, and reconditioning
may be useful.
Types of Insomnia
There are two types of insomnia: primary insomnia and secondary insomnia.
- Primary insomnia: Primary insomnia means that a person is having
sleep problems that are not directly associated with any other health condition
- Secondary insomnia: Secondary insomnia means that a person is having
sleep problems because of something else, such as a health condition (like asthma,
depression, arthritis, cancer, or heartburn); pain; medication they are taking;
or a substance they are using (like alcohol).
If you think you have insomnia, talk to your health care provider. An evaluation
may include a physical exam, a medical history, and a sleep history. You may be
asked to keep a sleep diary for a week or two, keeping track of your sleep patterns
and how you feel during the day. Your health care provider may want to interview
your bed partner about the quantity and quality of your sleep. In some cases, you
may be referred to a sleep center for special tests.
In addition, always follow the directions on your prescription label carefully and
ask your doctor or pharmacist to explain any part that you do not understand. Take
these drugs exactly as directed. Do not take more or less or take it more often
than prescribed by your doctor. Do not take these drugs more than once a day.
Good Sleep Habits for Beating Insomnia
Good sleep habits, also called sleep hygiene, can help you get a good night's sleep
and beat insomnia. Here are some tips:
- Try to go to sleep at the same time each night and get up at the same time each
morning. Try not to take naps during the day because naps may make you less sleepy
- Avoid caffeine, nicotine, and alcohol late in the day. Caffeine and nicotine are
stimulants and can keep you from falling asleep. Alcohol can cause waking in the
night and interferes with sleep quality.
- Get regular exercise. Try not to exercise close to bedtime because it may stimulate
you and make it hard to fall asleep. Experts suggest not exercising for at least
three to four hours before the time you go to sleep.
- Don't eat a heavy meal late in the day. A light snack before bedtime, however, may
help you sleep.
- Make your bedroom comfortable. Be sure that it is dark, quiet, and not too warm
or too cold. If light is a problem, try a sleeping mask. If noise is a problem,
try earplugs, a fan, or a "white noise" machine to cover up the sounds.
- Follow a routine to help you relax before sleep. Read a book, listen to music, or
take a bath.
- Avoid using your bed for anything other than sleep or sex.
- If you can't fall asleep and don't feel drowsy, get up and read or do something
that is not overly stimulating until you feel sleepy.
- If you find yourself lying awake worrying about things, try making a to-do list
before you go to bed. This may help you to not focus on those worries overnight.M
Medications for Insomnia
In some cases, doctors will prescribe drugs for the treatment of insomnia. All insomnia
medications should be taken shortly before bed. Do not attempt to drive or perform
other activities that require concentration after taking an insomnia medication
as the medication will make you sleepy. Medications should be used in combination
with good sleep practices.
Listed below are some drugs that can be used to treat insomnia.
- Ambien : The original version of Ambien works well at helping you
get to sleep, but some people tended to wake up in the middle of the night. Ambien
CR is an extended release version. It helps you get to sleep within 15 to 30 minutes,
and the new extended release portion helps you stay asleep. You should not take
Ambien or Ambien CR unless you are able to get a full night's sleep -- at least
7 to 8 hours.
The FDA has approved a prescription oral spray called Zolpimist, which contains
Ambien's active ingredient, for the short-term treatment of insomnia brought on
by difficulty falling asleep.
- Lunesta : Lunesta also helps you fall asleep quickly, and studies
show people sleep an average of seven to eight hours. Don't take Lunesta unless
you are able to get a full night's sleep as it could cause grogginess.
- Rozerem : This is a new sleep medication that works differently
than the others. It works by targeting the sleep-wake cycle, not by causing central
nervous system depression. It is prescribed for people who have difficulty falling
asleep. Rozerem can be prescribed for long-term use and the medication has shown
no evidence of abuse and dependence.
- Sonata : Of all the new sleeping pills, Sonata stays active in
the body for the shortest amount of time. That means you can try to fall asleep
on your own. Then, if you're still staring at the clock at 2 a.m., you can take
it without feeling drowsy in the morning. However, if you tend to wake during the
night, this might not be the best choice for you.
- Silenor : In 2010, this sleep medicine was approved for use in
people who have trouble staying asleep. Silenor may help with sleep maintenance
by blocking histamine receptors. Do not take this drug unless you are able to get
a full seven or eight hours of sleep. Dosage is based on your medical condition,
age, and response to therapy.
- Benzodiazepines: These older sleeping pills (Halcion, Restoril,
and others) are useful when you want an insomnia medication that stays in your system
longer. For instance, they have been effectively used to treat sleep problems such
as sleepwalking and night terrors. However, these drugs may cause you to feel sleepy
during the day and can also cause dependence, meaning you may always need the drug
- Antidepressants : Insomnia is a common symptom of depression. Thus,
some antidepressant drugs, such as trazodone (Desyrel), are particularly effective
in treating sleeplessness and anxiety that's caused by depression.
- Over-the-Counter Sleep Aids: Most of these sleeping pills are antihistamines. They
generally work well but can cause some drowsiness the next day. They're safe enough
to be sold without a prescription. However, if you're taking other drugs that also
contain antihistamines -- like cold or allergy medications -- you could inadvertently
take too much.
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