Insomnia

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).
Illness.
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 or problem.
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).

Diagnosing Insomnia

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 at night.
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 to sleep.
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.