Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 12/3/2021
Doctor's Notes on Primary Insomnia
Primary insomnia is sleeplessness, insufficient sleep, or the perception of poor-quality sleep not caused by medical or psychiatric diseases, conditions, genetics, illnesses, or environmental causes (such as drug abuse, medication, or shift-work). Insomnia can be classified as primary, which is caused by either psychological factors, sleep state misperception, or is idiopathic (no known cause). When insomnia is caused by another disease, condition, or illness it is considered secondary insomnia.
Symptoms of primary insomnia may range from mild to severe and include
- difficulty falling asleep,
- frequent awakenings in the night, and
- an inability to sleep well anywhere else but in one’s own bedroom.
Symptoms that may accompany insomnia include
- difficulties with attention or concentration,
- hyperactivity,
- hypersensitivity or insensitivity to medications,
- tension,
- dissatisfaction, and
- repression (denial or minimization) of emotional problems.
What Is the Treatment for Primary Insomnia?
Evaluating sleep habits is important in the management of insomnia. Treatment of underlying sleep disorders and in some instances, changing sleep habits may correct the problem without the need for medications. Good sleep habits (also referred to as good sleep hygiene) should include:
- Regular sleep times
- A comfortable bed and quiet room at a comfortable temperature
- A darkened room
- Regular exercise, but not close to bedtime or late in the evening
- A bedroom that is not used for work, watching television, or other activities not related to sleep other than sex
- Avoidance of stimulants (for example, caffeine or tobacco), alcohol, and large meals close to bedtime (avoid 2 to 4 hours before bedtime if possible)
- Many people watch television before falling asleep. TV can be a very stimulating medium and needs to be closely evaluated if it adds to a person's insomnia.
- Relaxation techniques such as breathing exercises or yoga
- No naps during the day
- Try drinking warm milk before bed
- It is high in the amino acid tryptophan, which helps induce sleep
Medications are widely used to treat insomnia. Common medications used for insomnia may include:
- Melatonin
- Valerian
- Kava kava
- L-trypophan
- Diphenhydramine
- Doxylamine
- Zolipidem
- Zaleplon
- Eszopiclone
- Ramelteon
- Temazepam
- Doxepin
- Trazadone
Insomnia : What Is Insomnia? Quiz
QuestionWhat is insomnia?
See AnswerMust Read Articles:
-
Disruptive Sleep Disorders (Parasomnias)
Parasomnias are sleep problems that significantly disrupt the lives of those who suffer them. Parasomnias include speech and movements during sleep, sleep walking, night terrors, sleep paralysis , and abnomalities in the natural stages of sleep, among other problems. These problems are diagnosed through polysomnography (sleep testing), and can be treated with a combination of medications, sleep hygiene depending on the particular disorder. -
Fatigue
Fatigue is a common health complaint by individuals. Fatigue is also referred to as feeling weary, tired, exhausted, lethargic, and a lack of energy. There are several causes of fatigue from sleep disturbances to some diseases or conditions. Treatment of fatigue is generally directed toward the condition or disease causing fatigue. -
How Do You Fix Insomnia?
There are a variety of treatment options and lifestyle changes that can help insomnia. Insomnia treatments include a consistent sleep routine, make your bedroom a calm sanctuary, keep the room cool, using blackout curtains or sleep masks, wearing earplugs or using white noise, and others. -
Insomnia
Insomnia affects most people at some point in their lifetime. Insomnia is actually a symptom of a condition, disease, or situation. Non-medical treatment of insomnia includes: sleep hygiene, relaxation therapy, stimulus control, and sleep restriction. There are many medications that can be prescribed to a person with insomnia. -
Insomnia Medications
Insomnia is a common problem for many people. Insomnia can be primary or secondary. Secondary causes of insomnia include medications, diseases, environmental factors, and pregnancy. Non-drug, home remedies, and OTC and prescription drugs that treat insomnia include: Sleeping pills Melatonin Sleep hygiene education Biofeedback Relaxation therapy Common side effects of sleeping pills include: Impaired coordination, balance, or mental alertness Depression Suicidal thoughts -
Narcolepsy
Narcolepsy is a sleep disorder that causes the sufferer to fall asleep or experience extreme exhaustion during the day or at inappropriate times. The treatment involves a variety of different classes of medication, depending on the patient. -
Sleep Apnea (Obstructive and Central)
There are two types of sleep apnea: obstructive sleep apnea (the most common type) and central sleep apnea. Sleep apnea can be caused by many factors such as strokes, heart failure, medications, or physical structures in the throat and mouth. Treatment range from medical devices to surgery. -
Sleep Basics (How To Get a Good Night's Sleep)
Sleep is defined as a state of unconsciousness from which a person can be aroused. In this state, the brain is relatively more responsive to internal stimuli than external stimuli. Sleep deprivation has many deleterious effects on the body. Sleep apnea and sleep paralysis are two common kinds of sleep disorders. Several activities can help one to fall asleep fast. -
Sleeplessness and Circadian Rhythm Disorder
A person's circadian rhythm is an internal biological clock that regulates a variety of biological processes according to an approximate 24-hour period. A disorder of the circadian rhythm may cause sleeplessness on at transient or chronic basis. The disorder can be caused by air travel across time zones, shift work, irregular sleep-wake cycle, delayed sleep phase syndrome, and advanced sleep-phase syndrome. -
Sleepwalk (Somnambulism)
Sleepwalking is a sleep disorder or "parasomnia." It is characterized by complex action and walking during sleep. This is common in children in early and middle adolescence. The sleepwalker doesn't remember what happens during these episodes. -
What Are the 3 Types of Insomnia?
Insomnia is a sleep disorder that causes difficulty in falling asleep, staying asleep, or getting quality sleep. The three types of insomnia include transient insomnia (less than one week), acute insomnia (short term), and chronic insomnia (long term). -
What Is the Main Cause of Insomnia?
Lifestyle and environmental issues like stress, drug and alcohol use and shift work may cause insomnia. Medications, mental, hormonal or neurological disorders may also be a cause of sleeplessness.
REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.