Insomnia

Insomnia is a sleep disorder that is characterized by difficulty falling asleep and/or staying asleep. Sleep-onset insomnia means you have trouble with the former, while sleep maintenance insomnia refers to the latter. 

Some people experience insomnia short-term (for days or weeks), while others experience chronic insomnia (lasting for a month or more). There are a variety of lifestyle remedies and prescription medications available to help manage insomnia and its effects on daily life.

People Affected

According to the Sleep Foundation, 10% to as high as 30% of U.S. adults experience chronic insomnia. It tends to affect people more as they age. Pregnant women also report higher levels of insomnia.

Risk Factors

Some risk factors and causes of insomnia include: 

  • Hormone shifts: During menstruation, menopause, and pregnancy, hormone shifts might cause insomnia. 

  • Age: Especially over the age of 60, insomnia risk increases. This is because sleep becomes less restful as you age. You are also more likely to have chronic pain and take more medications, which can both disrupt sleep. 

  • Sleep conditions: Sleep apnea and restless leg syndrome disrupt sleep. 

  • Other medical conditions: Chronic pain, mental health disorders, and conditions that cause you to wake up in the night to go pee (such as bladder issues) can all contribute to insomnia. Cancer, diabetes, heart disease, asthma, GERD, overactive thyroid, Parkinson’s, and Alzheimer’s have also been linked with insomnia. 

  • Medications: Certain antidepressants, medications for asthma, and blood pressure medications are all prescription drugs that can affect sleep. Additionally, some over-the-counter drugs that contain stimulants like caffeine (including pain relievers, allergy meds, cold meds, and weight-loss products) might play a role too. 

  • Stress: Both everyday stress and traumatic events can affect mental health and lead to insomnia. 

  • Irregular schedule: Changing shifts at work or travel can impact your body’s natural ability to regulate sleep. 

  • Caffeine, nicotine, and alcohol: All three of these are stimulants that can make it difficult for you to both fall asleep and reach a deep level of sleep.

Signs & Symptoms

Overall symptoms of insomnia can include: 

  • Difficulty falling asleep

  • Frequent waking up during the night (i.e. difficulty staying asleep)

  • Waking up too early

  • Not feeling well-rested

  • Daytime sleepiness

  • Irritability, depression, or anxiety

  • Difficulty paying attention

  • Memory problems

  • Increased errors or accidents

  • Ongoing worries about sleep

Medical Experts

Primary Care Physician: Your general doctor might be able to diagnose and treat insomnia.


Neurologist: Neurologists are doctors that specialize in brain disorders, including insomnia.

Diagnosis

Your doctor may perform a physical exam and/or a blood test to rule out other causes of poor sleep such as thyroid problems. You may also complete a questionnaire about your sleep patterns, which may include keeping a sleep journal for a couple of weeks. If a diagnosis is still unclear, you may need to undergo a sleep study at a sleep center, at which your sleep is monitored and recorded overnight.

Prescription Treatment

There are a variety of prescription sleep medications that can help with insomnia. Generally, they are recommended for short term use only, as some can be habit-forming and come with side effects. 

However, some have been used for long-term use, including eszopiclone (Lunesta), ramelteon (Rozerem), zaleplon (Sonata), and zolpidem (Ambien).

Insomnia Rx Options

Lifestyle Remedies

Poor sleep habits can be a big contributor to insomnia, which means making small changes with your sleep hygiene can make a big impact: 

  • Go to bed at the same time

  • Wake up at the same time

  • Avoid screens an hour before bed

  • Avoid naps late in the day

  • Avoid eating late in the evening

  • Keep your room cool. 

In general, try to reserve your bedroom just for sex and sleeping. That means avoiding watching tv, relaxing, and working from bed, as these can all confuse your brain when it’s time to fall asleep. If you do wake up in the night and can’t fall back asleep, get out of bed and remain somewhere else until you get sleepy again. This trains your brain to only associate your bed with sleep. 


You can read our full guide to better sleep here.

Top Insomnia Medications

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