INSOMNIA

People with insomnia have trouble with falling and staying asleep. Long-term this can cause health problems like diabetes, hypertension and weight gain. 

SYMPTOMS

Chronic insomnia may cause:

  • Difficulty falling and staying asleep

  • Waking up in the middle of the night

  • Feeling tired/fatigued during the daytime

  • Irritability or depressed mood

  • Problems with concentration or memory

 

Insomnia be short-term and acute or long-term and chronic:

  • Short term insomnia tends to last for a few days or weeks and is often triggered by stress.

  • Chronic insomnia is when the sleep difficulties occur at least three times a week for three months or longer.

 

CAUSES

Many things can contribute to the development of insomnia including environmental, physiological and psychological factors, including:

  • Stress

  • Unhealthy lifestyle

  • Mental health problems

  • Chronic diseases

  • Hormone fluctuations

  • Medications and other substances

  • Other sleep disorders

 

 

RISK FACTORS

Insomnia becomes more common over the age of 60.  It effects women more often than men, which could be related to hormonal shifts related to menopause.  Chronic disease processes also contribute to the likelihood of someone developing insomnia.  

 

DIAGNOSIS

Diagnosis begins with a proper history and physical exam.  It is important to determine if you are on any medications that may cause insomnia.  Other tests that may aide diagnosis are:

  • Blood tests:  Your doctor may want you do a blood test to rule out certain medical conditions such as thyroid problems or low iron levels that can negatively impact sleep.

  • Keep a sleep diary:  You may be asked to write down your sleep patterns for one to two weeks (bedtime, wake time, naps, caffeine use, etc.) This information can help your provider identify patterns or behaviors that interfere with rest.

  • Complete a sleep study:  Sleep studies (polysomnograms) are not necessary for diagnosing insomnia. If your doctor has concerns that your insomnia may be caused by sleep apnea or another sleep disorder, you may be referred. You may go to a sleep disorders center or do the study at home.

  • Actigraphy:  While you might have the best intentions to provide an accurate history, sometimes you overlook certain aspects of your own life.  Actigraphy involves wearing a watch that tracks a multitude of data.  This data may provide insight into aspects of your behavior that you overlook that may be contributing to your insomnia.  We provide this service in our office.

 

COMPLICATIONS

Chronic insomnia can contribute to:

  • Diabetes

  • Driving accidents, injuries and falls

  • High blood pressure (hypertension), heart disease and stroke

  • Mood disorders

  • Weight gain and obesity

 

 

TREATMENT

Short-term insomnia often gets better on its own. For chronic insomnia, your healthcare provider may recommend:

  • Cognitive Behavioral Therapy for Insomnia:  CBT-I helps you identify and replace thoughts and behaviors that cause or worsen sleep problems with habits that promote sound sleep. 

  • Medications:  Behavior and lifestyle changes can best help you improve your sleep over the long term.  Sleeping pills should only be used when overseen by your physician and on a short-term basis.  

 

PREVENTION

Lifestyle changes and changing your pre-sleep routine can help.  Some examples include:

  • Avoid large meals, caffeine, and alcohol before bed

  • Be physically active during the day

  • Cut back on caffeine

  • Go to bed and get up at the same time each day

  • Put away smartphones, TVs, laptops or other screens at least 30 minutes before bedtime

  • Quit smoking

  • Keep your bedroom cool and dark

  • Use calming music to help you get to sleep

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