Insomnia

Insomnia is a common sleep disorder in which you have trouble falling asleep, staying asleep, or both, so you get too little sleep or poor-quality sleep and may not feel refreshed on waking.

Types

• Acute (short-term) insomnia is common and usually lasts days or weeks. It is often brought on by stress at work, family pressures or a traumatic event.
• Chronic insomnia lasts a month or longer. Most cases are secondary — a symptom or side effect of something else, such as a medical condition, a medicine or another sleep disorder, or substances such as caffeine, tobacco and alcohol. Sometimes it is primary, not caused by anything else; its causes are not well understood, but long-term stress, emotional upset, travel and shift work can play a part. Primary insomnia usually lasts more than a month.

Who is at risk

Insomnia is common. It affects women more often than men and can occur at any age, though older adults are more likely to have it. Risk is also higher if you:

• are under a lot of stress;
• are depressed or distressed, for example after a divorce or the death of a spouse;
• have a lower income;
• work at night or have frequent major changes in your work hours;
• travel long distances across time zones;
• are inactive;
• are African American — research shows African Americans take longer to fall asleep, sleep less well and have more sleep-related breathing problems than White Americans.

Symptoms

• lying awake a long time before falling asleep;
• sleeping only in short stretches;
• being awake much of the night;
• feeling as if you have not slept at all;
• waking too early.

Insomnia can cause daytime sleepiness and low energy; make you anxious, depressed or irritable; and make it hard to focus, pay attention, learn and remember. It can also be dangerous — for example, drowsiness while driving can cause a crash.

Diagnosis

A provider takes your medical history and a detailed sleep history, examines you to rule out other medical causes, and may recommend a sleep study, which measures how well you sleep and how your body responds to sleep problems.

Treatment

• Lifestyle changes, including good sleep habits, often relieve short-term insomnia and can make it easier to fall and stay asleep.
• Cognitive behavioral therapy (CBT), a type of counseling, can ease the anxiety tied to chronic insomnia.
• Medicines can help relieve insomnia and restore a regular sleep schedule.
• If insomnia is a symptom of another problem, treating that problem, where possible, is important.

Sources

• MedlinePlus, National Library of Medicine: "Insomnia," drawing on the National Heart, Lung, and Blood Institute.