Do you have a difficult time falling or staying asleep at night? Do you wake feeling more exhausted than when you went to bed? Do you feel tired most of the day or have difficulty concentrating? If you answered yes to any or all of these questions, then you may have insomnia. Insomnia is defined as poor sleep due to one or more of the following: trouble falling asleep, frequently waking up during the night, waking up too early or waking up feeling less than refreshed. In fact, the Latin definition of insomnia is “no sleep.”

Insomnia is not defined by the number of hours of sleep per night because people vary in the amount of sleep they require. The National Institutes of Health classifies insomnia into three categories: transient (short-term), intermittent (on and off), and chronic (constant). It is not unusual for most people to experience occasional bouts of short-term insomnia. However, when sleep difficulties occur several nights a week for a month or more, then a case of chronic insomnia is diagnosed.

Insomnia regularly affects more than 70 million Americans and as many as 58% of adults experience insomnia symptoms more than one night a week. Chronic insomnia affects 10-15% of the general population. It affects men and women of all ages, but appears to be more common in females, the elderly, and those with a history of depression. It is estimated that the total direct cost (treatment and health care services) and indirect cost (work loss and accidents) of insomnia is approximately 42 billion dollars a year.

There are many causes of insomnia. Short-term and intermittent insomnia can be caused by: stress, noise, anxiety, weather changes, jet lag, environmental changes, schedule changes, a medical problem or the use of certain medications. Long-term insomnia may result from underlying conditions such as depression, arthritis, kidney disease, heart failure, sleep apnea, Parkinson’s disease, and asthma. A number of behavioral factors can also cause or aggravate the condition. Examples include: night shift work, chronic stress, and misuse of caffeine, alcohol, tobacco or other substances.

The course of treatment will depend on the person and the exact cause of the insomnia. Treatment options include: medication, relaxation therapy, sleep restriction, and reconditioning (retraining of sleep patterns). Sleeping pills may be used for short-term insomnia, but due to potential side effects, they are generally not used to treat long-term insomnia. Supplementing with the hormone melatonin, which helps to regulate sleep cycles, has been found useful for some people. As always, talk to your doctor before taking any medication or supplements. If the insomnia is caused by another condition like depression, then treatment of the depression itself will be a necessary part of the treatment process. In addition to the above recommendations, here are a few general ideas for sleep improvement from the National Sleep Foundation:

• Go to bed at the same time every day of the week
• Do not spend too much time in bed or nap too close to bedtime
• Do not eat or drink (other than water) before bedtime
• Avoid alcohol, nicotine, and caffeine, particularly before bed
• Exercise regularly, but try to finish no less than three hours before bedtime

• Keep your sleeping area quiet, cool, dark, and comfortable
• Sleep on a quality, supportive bed and mattress.

Insomnia can negatively affect physical and mental health, but there are many treatment options available. If you or someone you know is experiencing trouble sleeping, talk to your doctor for more information. Sleep well!

By Brent Grider

References

1. National Institute of Health Website. “What is Insomnia” (03/09). Http://health.nih.gov/topics/SleepDisorders. (09/22/09)
2. National Sleep Foundation Website. “Insomnia & Sleep” http://www.sleepfoundation.org/article/sleep-related-problems/insomnia-and-sleep. (09/22/09)
3. Mayo Clinic Website. Staff article. “Insomnia” (01/08/09). http://www.mayoclinic.com/health/insomnia/DS00187. (09/22/09)