Introduction

The word "insomnia" means "unable to sleep". Difficulty falling or staying asleep is a common problem. Sleeplessness has a negative impact on health, concentration, productivity and mood. Sleep is an essential part of life, like food and water.

Your body refreshes itself through sleep, so it can work well during the day. If you have trouble falling or staying asleep, or you wake up feeling un-refreshed, you may be suffering from Insomnia.
Almost anyone can be affected by insomnia. Poor sleep is more common in elderly people. As we grow older, the number of hours we sleep lessens. With age sleep becomes less sound and one is easily woken. Divorced and widowed people are more likely to get insomnia than married people.

If lack of proper sleep is affecting your performance during the day (making you sleepy while driving the car or if you feel the need to take naps during the day) you should consult your doctor.

Chronic Insomnia

You may be suffering from chronic insomnia if you haven't been able to sleep well for a month or so and this has been having a negative impact on you every day life. Chronic insomnia is more difficult to treat, and may not go away on its own. Consult a doctor if you think you are suffering from chronic insomnia.

Transient Insomnia

Insomnia lasting for less than a month is called transient insomnia. People who have suffered from this type of insomnia usually know the cause e.g. worry caused by a work or health concern.

Diagnosis

Before you can treat insomnia, you need to identify its cause. Your GP may ask about your mood and list the causes of insomnia.
Causes of Insomnia

• Stress and anxiety
• Depression
• Disease
• Pain
• Medications such as steroids
• Caffeine
• Nicotine
• Alcohol
• Sleep disorders or poor sleep habits
• Environment and lifestyle habits
• Sleep disorders (such as restless legs syndrome in which one experiences a creepy crawling sensation in the legs relieved by movement)
• Women may experience insomnia before the onset of menstruation, during pregnancy and menopause

Problems Caused by Insomnia

Chronic insomnia can affect your personal as well as professional life. Tiredness and fatigue caused by the lack of sleep may affect your performance at work and make you irritable and edgy. People with insomnia might be at a greater risk of accidents due to the inability to concentrate or the possibility of falling asleep while driving. People with insomnia are very likely to suffer from depression.

Treating Insomnia With Medications

• Taking medicine is one of the most common ways of treating insomnia. Medicine, however, should be taken only when:
• The cause of insomnia has been identified and is best treated by medicine in conjunction with behavioral therapy.
• Behavioral methods have proven ineffective to treat insomnia.
• Sleep difficulties cause problems in accomplishing daily activities
• A person is suffering insomnia-related distress and beginning behavioral therapy.
• Insomnia is expected or occurs in association with a known medical or biological condition (e.g. Premenstrual Syndrome) or an event such as giving a speech or traveling across time zones.

Treatment with medications should be short-term (four weeks is recommended) though long-term use of sleep aids is not very uncommon.

Tips for a good night's sleep

• Limit or Avoid Caffeine: Caffeine is found in tea, chocolate, coffee, and cola drinks. It is a stimulant and has an awakening effect. Caffeine has a different effect on different people. Limit your consumption of caffeine during the day and avoid having it at least six hours before bedtime. If you are having trouble sleeping, you may be able to identify if caffeine is the cause by not having it after lunch for a week or so.

• Skip Alcohol: Most people think of alcohol as a sedative. Alcohol may speed going off to sleep but it will increase restlessness during the night and you make awake in the later hours of the night. Skip wine with dinner and see if you sleep better.

• Healthy diet: What you eat can affect your sleep. For instance there are certain foods that give people heartburn like very spicy dishes. Heartburn is intensified when you lay down, causes discomfort and is the cause of awakening during the night. Do not eat too much at night as this can make you uncomfortable and sleeping more difficult. However, do not sleep hungry as this might also cause uneasy sleep. Do not drink too many fluids before bedtime to reduce the number of trips to the bathroom.

• Stop smoking: Nicotine is a stimulant. Nicotine is linked to insomnia and nightmares. You may experience sleep problems initially when you give up smoking, but these are usually temporary and you will sleep better in the long run.

• Stay Active: Exercise helps you sleep better and sounder. It also helps reduce the time it takes for you to fall asleep. A brisk walk in the afternoon will promote a good night's sleep. Regular cardiovascular exercise has many benefits other than overcoming insomnia. Try to combine some aerobic activity (walking, running, bicycling, swimming etc) with strength training. Exercise helps promote sleep also because it encourages a feeling of well-being and keeps depression at bay. Do not exercise 1 - 2 hours before bedtime as this will have an alerting effect.

• Have a regular bedtime and waking time, even on weekends and days you don't go to work.

• Try a relaxing routine. Choose a bedtime ritual that you might enjoy. You may fine taking a hot bath before sleeping restful or you may find soothing music relaxing. Wear comfortable clothes. Meditation or prayer before sleeping might help some people. If you are kept awake by your worries, keep a notebook with you and jot down all that is on your mind, then decide to look at them during the day. Fall off to sleep relaxed. In the daytime, those worries might seem small.

• Record your progress when you begin using these tips.

• Use your bed only for sleeping rather than for eating, reading, worrying or watching television. Go to your bed only when you are tired and if you do not fall asleep within 15 minutes get out of bed and go back to bed when you feel sleepy.

• Avoid daytime naps.

• If you suffer from insomnia, try not taking a nap. Napping might make sleeping at night more difficult. However, napping can help promote short-term alertness, for example, to prepare for a long car trip or travel, studying for an exam etc.

• Some medications can lead to insomnia as well. These include medications for cold and allergy (some antihistamines and decongestants), high blood pressure (antihypertensives), heart disease (betablockers), thyroid disease and birth control (hormones), asthma and pain medications (containing caffeine).

• A room temperature that is slightly cool contributes to good sleep. That is because it matches the body's internal temperature when it drops during the night to its lowest level (about four hours after falling asleep).

• An environment that is too dry or too humid might also create trouble sleeping. Try a dehumidifier if your room is too humid and a humidifier if it is too dry.

• Sunlight is a very powerful regulator of our biological clock. This biological clock influences when we feel sleepy and when we are alert. Too little exposure to sunlight during the day may be the cause of difficulty falling asleep at night. One to two hours of evening bright light exposure might help you to sleep longer in the morning. Keep your bedroom dark by using thick lined curtains or shades so that the morning light does not interfere with your sleep.

• Your sleep might be disturbed by sounds of a partner's snoring, sirens, trains, airplanes, barking dogs etc. Noise is particularly bothersome for people whose sleep is frail. If noise is causing sleep discomforts, use ear plugs, keep a fan on, have double windows, use heavy drapes or keep relaxing music on.

• Make your bed comfortable. Mattress quality affects how we sleep. An uncomfortable mattress will make sleep difficult. Aching back when you wake up in the morning is a sure sign of an uncomfortable mattress.

• Getting anxious about the time you have for sleep may also cause insomnia. Set up an alarm clock, then relax and go off to sleep.

Written by Medpages Editorial Team
Last Editorial Review: 15/1/2010