Insomnia

Insomnia is a condition in which the sufferer has trouble falling asleep, staying asleep, or both. An individual can have acute insomnia (lasting less than a month), which can be caused by life stressors or traumatic events. When insomnia lasts for more than a month, the condition becomes chronic. Chronic insomnia can be either secondary or primary. Secondary insomnia is induced by other medical or mental disorders or substances, while primary insomnia is its own disorder and not caused by other conditions.

Chronic Insomnia

The majority of chronic insomnia cases are secondary. It can be induced by a wide range of conditions, including but not limited to the following:

  • Disorders that cause pain
  • Disorders that lead to difficulty in breathing
  • Mental disorders such as depression and anxiety
  • Sleep disorders
  • Overactive thyroid
  • Gastrointestinal disorders

Insomnia can be a side effect from prescribed medications, such as certain asthma, allergy, and cold medicines. Some commonly used substances, such as caffeine, tobacco, and alcohol, can also cause insomnia.

Primary Insomnia

Primary insomnia is a distinct disorder in itself. It is not caused by other physical or mental disorders or substances. Chronic stress or emotional distress are common precursors to primary insomnia. Insomnia may not fully disappear even if these precursors are resolved. This may be due to the formation of habits in dealing with poor sleep, such as taking naps and worrying. The disorder is poorly understood.

Prevalence

Women are more likely than men to suffer from insomnia. Older adults are more likely to have insomnia than younger people. African-Americans have higher risks for insomnia than Caucasians. Environmental factors such as stress, lower incomes, and long-distance travel can also increase the risk for insomnia.

Treatments

If insomnia is secondary, treating the primary condition can improve the symptoms. However, if the primary condition is more difficult or takes longer to treat, there are also ways to target insomnia itself.

The first step in treating insomnia is to establish good sleep hygiene, which includes various lifestyle changes. The following are some tips to improve your sleep hygiene:

  • Avoid taking naps during the day.
  • Avoid substances that may disrupt sleep, such as caffeine.
  • Go to sleep and wake up at the same times everyday, even on weekends and holidays.
  • Develop a ritual before sleep, such as taking a warm bath or light reading.
  • Avoid “screens” before bed, such as TV, computer, or cell phone. The light emitted by these electronics can trick your brain into thinking it is daytime.
  • If you are not asleep after 20 minutes, get out of bed and engage in relaxing activities. Avoid stimulating activities.
  • Exercise regularly. But don't do strenuous exercise within 4 hours before bedtime.
  • Maintain a healthy diet. Going to sleep with an empty stomach may be distracting for some people. If it is the case, try eating a small snack.

Cognitive behavior therapy (CBT) is also effective in treating insomnia. CBT therapists target the thoughts and behaviors that cause or reinforce insomnia. Interventions include relaxation techniques, biofeedback, and changing worrying thoughts about not being able to fall sleep. CBT therapists are trained mental health professionals, so they can also treat the primary psychological issues (e.g. depression, anxiety, stress) that caused or were maintained by the insomnia. They may also help clients with certain factors of their primary medical conditions that are not addressed by the medical doctors, such as medication adherence and dealing with chronic pain. Consult a mental health professional about CBT.

There are also many prescribed or over-the-counter medications that can help people sleep. Prescribed medications include medicines that are made specifically for insomnia or ones that induce drowsiness (e.g. anti-anxiety medications). Melatonin is a popular over-the-counter supplement to treat insomnia and jet lag. Melatonin is a natural hormone that regulates the sleep-wake cycle. Taking it as dietary supplement can help with realigning the sleep-wake cycle and reducing the amount of time taken to fall asleep. Consult a medical doctor about these medications.