• Topic Overview
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• Symptoms
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• Treatment Overview
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Topic Overview

What is insomnia?

Insomnia is a common sleep problem that can affect your quality of life. People with insomnia have trouble falling asleep or staying asleep. They may wake up during the night or wake up too early the next morning.

Your sleep problems may come and go, or they may be ongoing.

• A short-term sleep problem is often linked to short-term stress. This short-term insomnia can last for days to weeks. It often gets better in less than a month.
• A chronic sleep problem is ongoing. This is called chronic insomnia. It is often a symptom of another health problem, such as depression or chronic pain. Chronic insomnia is less common than short-term sleep problems.

What causes insomnia?

There are many things that can cause sleep problems. Insomnia may be caused by:

• Stress. Stress can be caused by fear about a single event, such as giving a speech. Or you may have ongoing stress, such as worry about work or school.
• Depression, anxiety, and other mental or emotional conditions.
• Poor sleep habits, such as watching TV in bed or not having a regular bedtime schedule. If you have trouble sleeping, you may worry about being able to fall asleep. This can make the problem worse.
• Changes in your sleep habits or surroundings. This includes changes that happen where you sleep, such as noise, light, or sleeping in a different bed. It also includes changes in your sleep pattern, such as having jet lag or working a late shift.
• Other health problems, such as pain, breathing problems, and restless legs syndrome.
• Stimulants, such as tobacco and caffeine, as well as certain medicines, alcohol, and drugs.
• Lack of regular exercise.

What are the symptoms?

The symptoms of insomnia are different for each person. People with insomnia may:

• Have trouble falling asleep. This can mean lying in bed for up to an hour or more, tossing and turning, waiting to fall asleep.
• Wake up during the night and have trouble going back to sleep.
• Wake up too early in the morning.
• Feel tired when they wake up, like they didn't get enough sleep.
• Feel grouchy, sleepy, or anxious, and be unable to get things done during the daytime.

How is insomnia diagnosed?

Insomnia is not a disease, and no test can diagnose it. But when you can't sleep well, it often has to do with some other cause. Your doctor will probably assess your current health and ask about any health problems you have had and any medicines you are taking.

Sometimes a doctor will do a physical exam, blood tests, and, in some cases, sleep studies to help find out if you have a health problem that may be causing the insomnia.

Your doctor may also ask about your sleep history—how well you sleep, how long you sleep, your bedtime habits, and any unusual behaviors you may have. Your doctor may ask you to keep a sleep diary, which is a record of your sleep patterns, for a week or two. He or she may recommend a counselor if your symptoms point to a mental health problem, such as depression or anxiety.

How is it treated?

Treatment for insomnia focuses on the reason why you don't sleep well. If you have a medical problem, such as chronic pain, or an emotional problem, such as stress, treating that problem may help you sleep better. You may be able to sleep better by making some small changes. It may help to:

• Go to bed at the same time each night.
• Get up at the same time each day.
• Avoid caffeine and alcohol for several hours before bedtime.
• Get regular exercise (but make sure you finish the exercise at least 3 to 4 hours before you go to bed).
• Avoid daytime naps.

Some people may need medicine for a while to help them fall asleep. Doctors often prescribe medicine for a short time if other treatment isn't working. But medicine doesn't work as well over time as lifestyle and behavior changes do. Sleep medicine can also become habit-forming. Medicine works best as a short-term treatment combined with lifestyle and behavior changes.

Your doctor may also recommend counseling, which can help you learn new habits that may help you sleep better.

Talk to your doctor about your sleep problems and any other health issues you may have. This is important, because lack of sleep can lead to depression, accidents, problems at work, marital and social problems, drinking more alcohol than usual, and poor health. Treatment may help you avoid these problems and feel better.

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