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Symptoms and Signs of Insomnia

Doctor's Notes on Insomnia

Insomnia, or sleeplessness, is difficulty falling or staying asleep, or both, or the perception of poor quality sleep. Insomnia may result in inadequate quantity or quality of sleep. Insomnia may be classified based on the duration of the problem. In general, symptoms lasting less than one week are classified as transient insomnia, symptoms that last between one to three weeks are classified as short-term insomnia, and symptoms lasting longer than three weeks are classified as chronic insomnia.

Symptoms of insomnia include difficulty falling asleep, waking up frequently during the night, poor concentration and focus, difficulty with memory, impaired coordination, irritability, problems with social interaction, or motor vehicle accidents because of fatigued, sleep-deprived drivers. Insomnia may or may not cause daytime sleepiness. Many people with insomnia have difficulty falling asleep during daytime naps.

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 3/11/2019

Insomnia Symptoms

Doctors associate a variety of signs and symptoms with insomnia. Often, these symptoms complicate other medical or mental health conditions.

  • Some people with insomnia may complain of difficulty falling asleep or waking up frequently during the night. The problem may begin with stress. Then, as you begin to associate the bed with your inability to sleep, the problem may become chronic.
  • Most often daytime symptoms will bring people to seek medical attention. Daytime problems caused by insomnia include the following:
    • Poor concentration and focus
    • Difficulty with memory
    • Impaired motor coordination (being uncoordinated)
    • Irritability and impaired social interaction
    • Motor vehicle accidents because of fatigued, sleep-deprived drivers
  • People may worsen these daytime symptoms by their own attempts to treat the symptoms.
    • Alcohol and antihistamines may compound the problems with sleep deprivation.
    • Others have tried nonprescription sleep aids.

Many people with insomnia do not complain of daytime sleepiness, and in fact, they may have difficulty falling asleep during intentional daytime naps.

Insomnia Causes

The side effects of certain medications include insomnia, including:

  • Certain over-the-counter cold and asthma preparations.
  • Prescribed medications for upper respiratory congestion.
  • Medications prescribed to treat asthma
  • Steroid medications to treat inflammation
  • Some medications used to treat high blood pressure.
  • Some medications used to treat depression, anxiety, and schizophrenia.

Insomnia may be caused by a host of different reasons. These causes may be divided into situational factors, medical or psychiatric conditions, or primary sleep problems.

Many of the causes of transient and short-term insomnia are similar and they include:

  • Jet lag
  • Changes in shift work
  • Excessive or unpleasant noise
  • Uncomfortable room temperature (too hot or too cold)
  • Stressful situations in life (exam preparation, loss of a loved one, unemployment, divorce, or separation)
  • Presence of an acute medical or surgical illness or hospitalization
  • Withdrawal from drug, alcohol, sedative, or stimulant medications
  • Insomnia related to high altitude (mountains)

Uncontrolled physical symptoms (pain, fever, breathing problems, nasal congestion, cough, diarrhea, etc.) can also cause someone to have insomnia. Controlling these symptoms and their underlying causes may lead to resolution of insomnia.

Physical health causes vary from circadian rhythm disorders (disturbance of the biological clock) and sleep-wake imbalance, to a variety of medical conditions. The following are the most common medical conditions that trigger insomnia:

Physical health causes vary from circadian rhythm disorders (disturbance of the biological clock) and sleep-wake imbalance, to a variety of medical conditions. The following are the most common medical conditions that trigger insomnia:

The majority of causes of chronic or long-term insomnia are usually linked to an underlying psychiatric or physiologic (medical health) condition.

The majority of causes of chronic or long-term insomnia are usually linked to an underlying psychiatric or physiologic (medical health) condition.

The most common mental health problems that may lead to insomnia include:

Insomnia may be an indicator of depression. Many people will have insomnia during the acute phases of a mental illness. As mentioned earlier, depression and anxiety are strongly associated with insomnia and are the most common causes of sleeplessness.

The most common mental health problems that may lead to insomnia include:

Insomnia may be an indicator of depression. Many people will have insomnia during the acute phases of a mental illness. As mentioned earlier, depression and anxiety are strongly associated with insomnia and are the most common causes of sleeplessness.

  • Common stimulants associated with poor sleep include caffeine and nicotine. You should consider not only restricting caffeine and nicotine use in the hours immediately before bedtime but also limiting your total daily intake.
  • People often use alcohol to help induce sleep, as a nightcap. However, it is a poor choice. Alcohol is associated with sleep disruption and creates a sense of non-refreshed sleep in the morning.
  • A disruptive bed partner with loud snoring or periodic leg movements also may impair your ability to get a good night's sleep.
  • Common stimulants associated with poor sleep include caffeine and nicotine. You should consider not only restricting caffeine and nicotine use in the hours immediately before bedtime but also limiting your total daily intake.
  • People often use alcohol to help induce sleep, as a nightcap. However, it is a poor choice. Alcohol is associated with sleep disruption and creates a sense of non-refreshed sleep in the morning.
  • A disruptive bed partner with loud snoring or periodic leg movements also may impair your ability to get a good night's sleep.

20 Tips to Beat Insomnia and Sleep Better Slideshow

20 Tips to Beat Insomnia and Sleep Better Slideshow

Smart phones, e-readers, tablets, computer screens, TVs, and digital clocks emit blue light, a short frequency of light that may be harmful to the eyes and disrupt sleep. Minimize screen time for several hours before bedtime to get a good night's rest. Wearing orange tinted glasses that block out blue light may also be helpful. Apps are available for your computer, tablet, and smartphones that prevent the screens from emitting blue light. Besides blue light exposure, it makes sense to power down several hours before bedtime to maximize your chances of getting a good night's rest. Cover up any displays that may be visible from your bed, like a digital clock. Black out curtains can block out ambient light from outside.

REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.

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