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Insomnia

What Is Insomnia?

Insomnia is a sleep condition that involves difficulty falling asleep and staying asleep. Almost everyone goes through bouts of sleeplessness from time to time. But if someone struggles to fall asleep or wakes up at night or early in the morning and finds it difficult to fall back asleep, and this happens at least three times a week for a few months, that person is likely suffering from chronic insomnia.

Short-acting sleeping pills may improve sleep and next-day alertness, but the best way to handle a bout of insomnia is to do nothing; the body's sleep mechanism tends to right itself if given the chance. The most effective treatments for chronic insomnia are behavioral techniques that eliminate sleep anxiety and allow the body's own sleep cycle to kick in.

Insomnia may cause daytime fatigue and reduced energy levels. People with insomnia may also experience weakened coping skills, difficulty paying attention and concentrating, memory problems, and trouble performing even routine tasks. But most of all, insomnia affects mood. The chronic sleep disruption of insomnia appears to be a major trigger for depression and irritability.

For more information on symptoms, causes, and treatment see our Diagnosis Dictionary.

What Causes Insomnia?

Stress is the primary cause of insomnia, but there are also physical conditions and other factors that can bring it on. A doctor should rule these out first. They include sleep apnea, overactive thyroid, certain medications, and gastrointestinal problems, such as gastroesophageal reflux.

Lack of sufficient physical activity during the day can interfere with the body's drive for sleep. Substance abuse can also be a major sleep disruptor.

Insomnia is often related to how people handle a bad night or a few bad nights of sleep. One may try to compensate for a brief sleepless period by sleeping later, napping in the afternoon, having a few drinks before bed, or going to bed early. But those actions may only impair the body's natural sleep drive or cause more early wakefulness.

Some people are at risk of insomnia due to environmental factors such as shift work and jet lag. People who do not get enough exposure to sunlight during the day can also have trouble sleeping. And such factors as drinking too much caffeine or overheating a bedroom can also interfere with sleep.

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How to Deal With Insomnia

A short-term bout of insomnia is best handled by doing nothing. It's important not to compensate by staying in bed longer or napping during the day.

Chronic insomnia responds well to behavioral treatments aimed at eliminating anxiety and stopping the behaviors that wind up worsening and perpetuating the condition. Cognitive behavioral therapy targets the thoughts and actions that disrupt sleep. It may include relaxation training or establishing a sleep schedule that restricts the time one spends in bed awake.

Effective treatments for insomnia encourage good "sleep hygiene," which can involve going to sleep and waking at the same time every day, getting daily exercise, limiting caffeine consumption and restricting it to morning hours, limiting alcohol (a sleep disrupter), and keeping the bedroom dark and cool.

Sleep Problems in Children and Teens

Young children need 10 to 11 hours of sleep, experts say. Sleep difficulties in children often occur when early bedtimes are not strictly enforced. And children with ADHD frequently suffer from sleep problems.

Teenagers are a sleep-deprived group: Experts estimate that a quarter of adolescents suffer from insomnia. And a recent study found that teens who go to bed after midnight are 20 percent more likely to develop depressive symptoms than are those who go to bed before 11 p.m.

Sleep Problems in Women

Women are especially sensitive to irregular sleeping habits because of the hormonal changes they experience during pregnancy and perimenopause. Studies indicate that about one in four women is currently experiencing insomnia symptoms.

Insomnia can cause women to have more accidents, with falls being especially common, especially for the elderly. Women with insomnia are at increased risk for certain health problems, including diabetes and high blood pressure. Women are also more likely to suffer from depression, which is linked to sleeplessness.

Insomnia and Depression

Depression is a major cause of insomnia, and yet it can also result from insomnia. For some people, depressive symptoms will appear before the onset of sleeping problems, while others will notice insomnia symptoms first. Due to the similarity of symptoms, insomnia can be misdiagnosed as depression, and vice versa.

The mood-sleep connection often plays out in a frustrating cycle for sufferers of either condition: Anxiety and rumination keep them up at night, and the lack of restorative sleep triggers a worse state of mind the next day.

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