2021-08-04 10:18 AM

If insomnia makes it difficult to function during the day, see your doctor and determine what may be the cause of the sleep problem, and if it can be treated.

Insomnia diagnosisbook


Insomnia includes difficulty falling asleep or staying asleep. It is one of the most common medical inquiries. People with insomnia often awakens a feeling of not remembering, which affects the ability to function during the day. Insomnia can affect not only low energy and mood but also work performance, health, and quality of life.

The sleep time is enough varies from person to person. Most adults need 7-8 hours a night. More than a third of adults have had insomnia at one time, while 10 to 15 percent reports long-term (chronic) insomnia.

No drug treatment is required for sleepless nights. Simple changes to your daily routine can resolve insomnia and restore much-needed rest.


Symptoms of Insomnia

Insomnia signs and symptoms may include:

Difficulty sleeping at night.

Waking up in the night.

Waking up too early.

Feeling unrested after sleeping a night.

Fatigue or daytime sleepiness.

Irritability, depression, or anxiety.

Difficulty paying attention or concentrating on tasks.

Increased errors, accidents.

Tension headache.

Digestive symptoms.

Worry about sleep.

If insomnia makes it difficult to function during the day, see your doctor and determine what may be the cause of the sleep problem if it can be treated. If your doctor thinks you may have a sleep disorder, go to the hospital for a special checkup.


Insomnia often stems from some other problem, such as a medical problem such as a cause of pain or the use of substances that interfere with sleep. Common causes of insomnia include:

Insomnia causes

Stress. Concerns about work, health, school, or family can keep the mind active at night, making it difficult to fall asleep. Stressful life events, such as death or illness, divorce, love, or job loss can lead to insomnia.
Worried. Daily anxiety as well as more serious anxiety disorders can disrupt sleep.
Depression. You may sleep too much or have trouble sleeping if you're depressed. This could be due to a chemical imbalance in the brain or because the anxiety that accompanies depression can keep you relaxed enough to fall asleep. Insomnia often accompanies mental health disorders.

Medicine. Prescription drugs that can affect sleep include some antidepressants, heart and blood pressure medications, allergy medications, stimulants (such as Ritalin), and corticosteroids. Over-the-counter (OTC) medications, including some pain relievers, decongestants, and weight loss medications contain the stimulant caffeine. H1 antihistamines can make you drowsy but can worsen urinary problems, waking you up more during the night.

Caffeine, nicotine, and alcohol. Coffee, tea, cola, and other caffeinated and stimulant beverages. Drinking coffee in the late afternoon can make it difficult to fall asleep at night. Nicotine in cigarettes is a stimulant that can cause insomnia. Alcohol is a sedative that can help you fall asleep, but it interferes with the deeper stages of sleep and often wakes you up in the middle of the night.

Medical problem. Chronic pain, shortness of breath, and frequent need to urinate can cause insomnia. Problems associated with insomnia include arthritis, cancer, congestive heart failure, diabetes, lung disease, gastroesophageal reflux disease (GERD), hyperthyroidism, stroke, Parkinson's disease, and Alzheimer's disease. . Treating medical problems can also help treat insomnia. For example, if you have arthritis, taking a pain reliever before bed can help you sleep better.

Change in environment or work schedule. Traveling or changing jobs can disrupt the body's circadian rhythms, making it difficult to fall asleep. The circadian rhythm acts as an internal clock, guiding things like sleep-wake cycles, metabolism, and body temperature.

Sleep habits. Poor sleep habits include an irregular sleep schedule, stimulating bedtime activities, a comfortable environment, and using the bed for activities other than sleep or sex.

Insomnia. This can happen when you worry too much about not being able to sleep well and have a hard time trying to fall asleep. Most people with this condition sleep better when they are away from their usual sleeping environment or when they are not trying to fall asleep, such as when they are watching TV or reading a book.

Eat too much late in the evening. A bedtime snack is OK, but eating too much can make you feel uncomfortable lying down, making it hard to get to sleep. Many people also experience heartburn, acid reflux, and gastroesophageal reflux after eating. This feeling uncomfortable can make you sober.

Insomnia and age

Insomnia becomes more common with age. For people with older age, changes can occur that can affect sleep.

Change sleep. Often becomes less restful sleep with age. More time spent in stages 1 and 2, non-rapid eye movement (NREM), and less sleep in stages 3 and 4. Stage 1 is transitional sleep, stage 2 is new sleep, and stage 3 is deep sleep, the quietest kind. Because of being asleep, there is also a greater chance of waking. With age, the internal clock frequently changes, which means feeling tired earlier in the evening and waking up early in the morning. But older adults still need the same amount of sleep as younger people.

Change of activity. Maybe less physically or socially active. Activity helps promote a good night's sleep. You may also be more likely to take a daily nap, which can also affect sleep at night.

Health change. Chronic pain from illnesses such as arthritis or back pain as well as depression, anxiety, and stress can affect sleep. Older men often develop an enlarged prostate (benign prostatic hyperplasia), which can cause the need to urinate frequently, disrupting sleep. In women, hot flashes that accompany menopause can be problematic.

Other sleep-related disorders, such as sleep apnea and restless legs syndrome, also become more common with age. Sleep apnea causes breathing to stop periodically throughout the night and then awaken. The cause of the syndrome is the uncomfortable feeling of restlessness in the legs and the almost irresistible urge to move them, which can make it difficult to fall asleep.

Use drugs. Older adults use more medications than younger people, increasing the risk of drug-induced insomnia.

Trouble sleeping can be a concern for children and adolescents. Some children and adolescents simply have trouble getting to bed or resist regular bedtimes because their biological clocks are slower. They want to go to bed late and sleep later in the morning.

Risk factors

Nearly everyone has had a sleepless night. But the risk of insomnia is increasing in cases:

Women. Women twice more than men can experience insomnia. Hormonal changes during the menstrual cycle and during menopause play a role. Many women have problems sleeping during perimenopause, the time leading up to menopause. During menopause, night sweats and hot flashes often disturb sleep. In postmenopausal women, a lack of estrogen is thought to contribute to difficulty sleeping.

Insomnia risk factors

Over the age of 60. Due to changes in sleep, insomnia increases with age. By some estimates, insomnia affects nearly half of all older adults.

Have a mental health disorder. Many disorders including depression, anxiety, bipolar disorder, and post-traumatic stress disorder disrupt sleep. Early awakening is a symptom of classic depression.

Under a lot of stress. Stressful events that can cause temporary or long-term insomnia, such as the death of a loved one or divorce, can lead to chronic insomnia. Being poor or unemployed also increases the risk.

Night work or shift. Working at night or frequently changing shifts increases the risk of insomnia.

Long-distance traveling. Crossing multiple time zones can cause insomnia.


Sleep is just as important to health as a healthy diet and regular exercise. Whatever the reason for insomnia, insomnia can affect both mentally and physically. People with insomnia see a lower quality of life than those who are sleeping well.

Insomnia complications

Complications of insomnia can include:

Decreasing performance at work or at school.

Slowed reaction times while driving and risk of accidents.

Mental problems, such as depression or anxiety disorders.

Overweight or obese.

Weak immune system function.

Increased risk and severity of chronic diseases, such as high blood pressure, heart disease, and diabetes.

Tests and diagnostics

In addition to asking for a few questions, your doctor may complete a questionnaire to determine your sleep-wake pattern and degree of daytime sleepiness. You may also be asked to keep a sleep diary for a few weeks.

Your doctor will do a physical exam to look for signs of other problems that may be causing your insomnia. Occasionally, blood tests may be done to check for thyroid problems or other problems that may be causing insomnia.

If there are other signs of a sleep disorder, such as sleep apnea or restless legs syndrome, a night at a center may be necessary. Tests are done to monitor and record a variety of bodily activities during sleep, including brain waves, breathing, heart rate, eye movements, and body movements.

Treatments and drugs

Changing sleep habits and addressing any causes of insomnia can restore a good night's sleep for many people. Good sleep - steps as simple as relaxing before bed and increasing time promote sleep, sound, and wakefulness during the day. If these measures don't work, your doctor may recommend medication to help you relax and sleep.

Behavioral therapy

Teaches new sleep behavior treatments and ways to make sleep environments more conducive to sleep. Research shows that behavioral therapy is equally or more effective than sleeping pills. Behavioral therapy is often recommended as the first line of treatment for people with insomnia.

Behavioral therapy includes:

Education about good sleep habits. Sleep and wake habits promote good sleep.

Relaxation technique. Muscle relaxation, biofeedback, and breathing exercises are ways to reduce anxiety at bedtime. These strategies help control breathing, heart rate, muscle tension, and mood.

Cognitive therapy. This involves replacing worries about not sleeping with positive thoughts. Cognitive therapy can be taught through a counselor or in groups.

Stimulating control. This means limiting the time you wake up in bed and stay in bed to sleep and have sex only.

Limit sleep. This treatment reduces sleep time, causes partial sleep deprivation, makes additional fatigue and sleep the following night. Once sleep has improved, sleep time is gradually increased.

Light therapy. If you fall asleep too early and then wake up too early, light can be used to push back your biological clock. During the evening light outside, go outside for 30 minutes or get the light through a medical lightbox.


Prescription drugs, such as zolpidem (Ambien), eszopiclone (Lunesta), zaleplon (Sonata), or ramelteon (Rozerem), can also help get you to sleep. However, in rare cases, these drugs can cause serious allergic reactions. Side effects of prescription sleeping pills are often more pronounced in older adults and can include excessive sleepiness, paranoid thoughts, agitation, and balance problems.

Doctors generally advise against relying on prescription sleeping pills for more than a few weeks, but some new medications are approved for indefinite use.

If you have depression as well as insomnia, your doctor may prescribe a sedative antidepressant, such as trazodone (Desyrel), doxepin (Sinequan, Adapin), or mirtazapine (Remeron).

Antihistamines in sleep aids can cause drowsiness. However, antihistamines can impair sleep quality, and they can cause side effects such as daytime sleepiness, dry mouth, and blurred vision.

Lifestyle and remedies

Age is not an issue, insomnia is usually treatable. What is important often lies in the changes in routine during the day and at bedtime. Try these tips:

Sleep schedule. Keep bedtime and wake times consistent from day to day, including on weekends.

Get out of bed when you're not sleeping. Sleep as much as you need to feel rested, and then get out of bed. If you can't fall asleep, get out of bed after 15 minutes and do something relaxing, like reading a book.

Avoid trying to sleep. Trying to sleep will be more difficult, becoming more awake. Read or watch television until you become very sleepy, then go to bed.

Use the bed and bedroom only for sleeping or sex. Do not read, watch TV, work or eat in bed.

Find ways to relax. Taking a warm bath before bed can help prepare you for sleep. Having a massage partner can also help with relaxation. Create relaxation before bed, such as reading, music, breathing exercises, yoga, or prayer.

Avoid or limit naps. Napping can make it hard to fall asleep at night. If that's not possible, try to limit naps to no more than 30 minutes and don't nap after 15:00.

Make the bedroom comfortable for sleep. Close the bedroom door or create subtle background noise, to help drown out other noises. Keep a comfortable bedroom temperature, which is usually cooler and darker. Do not keep computers or TVs in the bedroom.

Exercise and activity. Get at least 20 to 30 minutes of vigorous exercise daily at least 5-6 hours before bed.

Avoid or limit your intake of coffee, alcohol, and tobacco. Using caffeine and nicotine after lunch can make it difficult to fall asleep at night. Alcohol can make you feel drowsy at first, which can cause sleep but frequent awakenings.

Avoid large meals and drinks before bed. A light snack is fine, but eating too much in the evening can interfere with sleep. Drink less before bed so you won't have to pee as often.

Check the treatment. If taking the medication regularly, check to see if it may be contributing to insomnia. Also, check prescription product labels to see if they contain caffeine or other stimulants, such as pseudoephedrine.

Pain control. If the pain is bothersome, be sure the pain relievers are effective enough to control pain while you sleep.

Hide the bedroom clock. Set an alarm to know when, but then hide all the clocks in the bedroom. Less know what time at night is better.

Alternative medicine

Melatonin is a prescription supplement, which is one way to help overcome insomnia. The body produces melatonin naturally, releasing it into the bloodstream, increasing the amount starting in the evening and decreasing towards the morning. For most people, taking melatonin supplements is not effective in treating insomnia. The safety of using melatonin for more than three months is not known.

Valerian is a dietary supplement sold as a sleep aid. Research shows that valerian is no better than a sugar pill (placebo).

Be sure to talk to your doctor before taking any herbal supplements.

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