What is insomnia?

Insomnia is a sleep disorder where individuals have difficulty:

  • Falling asleep
  • Staying asleep
  • Waking up too early

Insomnia is classified as:

  • acute, short term, lasting only for a few days, usually trigger by a specific incident
  • chronic, is if it persists over several months (at least longer than 3 months).  Many times people who have acute insomnia will try to compensate and develop maladaptive behaviors that propagate the symptoms of acute insomnia and turning it into a chronic problem.

Symptoms of insomnia include forgetfulness, difficulty with concentration, irritability, depression, anxiety, and non-restful sleep.

Insomnia can be caused by stress, circadian rhythm disruption (due to travel and/or work), poor sleep habits, heavy meals before bed. It can also be affected by mental health disorders, medications, caffeine, nicotine, alcohol intake, certain medical conditions, and other underlying sleep disorders. Additionally, as you age, insomnia might be more common due to changes your sleep patterns, activity patterns, overall health, and need for medications.

Who is most at risk for insomnia?

  • Women: hormonal shifting, menopause, night sweats, and pregnancy
  • Adults over 60: natural shifts in sleep patterns
  • Excessive stress
  • Irregular schedule

Ways to prevent insomnia

  • Consistent bed and wake times
  • Physical activity during day
  • Checking your medication
  • Avoid / limiting naps
  • Avoid / limiting caffeine, alcohol and nicotine
  • Avoid large meals and beverages for several hours before bed
  • Reserve the bed for sleep and sex only
  • Create a wind-down routine

Common treatments for acute and chronic insomnia

Behavioral

These behavioral interventions focus on the maladaptive behaviors that have unknowingly developed over a course of time.  These behaviors are typically not conducive to healthy sleep.  The group of intervention to address this is packaged into CBT-I (cognitive behavioral therapy for insomnia).  Components of it include:

  • Stimulus control
  • Relaxation techniques
  • Sleep restriction
  • Light therapy in mornings

Pharmacological

Pharmacologic medication can be used as first line in acute insomnia but should not be used as first line for chronic insomnia.  Common medications include:

  • Eszopiclone (Lunesta)
  • Zolpidem (Ambien)
  • Zaleplon (Sonata)
  • Ramelteon (Rozeram)