Insomnia is a common sleep problem that can affect your quality of life. People with insomnia have trouble falling asleep or staying asleep. They may wake up during the night or wake up too early the next morning.
Your sleep problems may come and go, or they may be ongoing.
There are many things that can cause sleep problems. Insomnia may be caused by:
The symptoms of insomnia are different for each person. People with insomnia may:
Insomnia is not a disease, and no test can diagnose it. But when you can't sleep well, it often has to do with some other cause. Your doctor will probably assess your current health and ask about any health problems you have had and any medicines you are taking.
Sometimes a doctor will do a physical exam, blood tests, and, in some cases, sleep studies to help find out if you have a health problem that may be causing the insomnia.
Your doctor may also ask about your sleep history—how well you sleep, how long you sleep, your bedtime habits, and any unusual behaviors you may have. Your doctor may ask you to keep a sleep diary, which is a record of your sleep patterns, for a week or two. He or she may recommend a counselor if your symptoms point to a mental health problem, such as depression or anxiety.
Treatment for insomnia focuses on the reason why you don't sleep well. If you have a medical problem, such as chronic pain, or an emotional problem, such as stress, treating that problem may help you sleep better. You may be able to sleep better by making some small changes. It may help to:
Some people may need medicine for a while to help them fall asleep. Doctors often prescribe medicine for a short time if other treatment isn't working. But medicine doesn't work as well over time as lifestyle and behavior changes do. Sleep medicine can also become habit-forming. Medicine works best as a short-term treatment combined with lifestyle and behavior changes.
Your doctor may also recommend counseling, which can help you learn new habits that may help you sleep better.
Talk to your doctor about your sleep problems and any other health issues you may have. This is important, because lack of sleep can lead to depression, accidents, problems at work, marital and social problems, drinking more alcohol than usual, and poor health. Treatment may help you avoid these problems and feel better.
Learning about insomnia:
Living with insomnia:
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Each person experiences insomnia differently. People with insomnia may:
One Man's Story:
"When I wake up at 2 or 3 in the morning, my mind starts processing stuff—things that I need to get done, that I forgot to do. Trying to relieve that anxiety seems to me a very worthwhile sleep prescription."—Cort, 64
The quality of their day is what makes people who have insomnia different from people who typically sleep fewer hours or who have a different sleep disorder. With insomnia, you sleep so badly that you feel grouchy and perform poorly during the day. But it is possible to be a restless sleeper or to sleep less than 8 hours a night and yet get the amount of sleep you need. If you wake up refreshed with energy and are able to get things done during the day, then you are probably getting enough sleep.
Not getting enough sleep can affect your quality of life. It can lead to serious problems including injury, accidents, anxiety, and depression. Talk with your doctor if you think that you have insomnia.
Insomnia is not a disease, and no specific test can diagnose it. But it can make you feel bad, and it can affect your health. It can also be a sign of other problems. Your doctor may want to do blood tests to rule out certain medical conditions such as thyroid problems. "Normal sleep" differs for each person. Checking your health and sleep history is an important first step to finding a cause for poor-quality sleep. Talk with your doctor about your medical history and any medical problems you have or any medicines you are taking.
If your doctor thinks that you have a sleep disorder, he or she may refer you for a sleep study. When you have a sleep study, you stay overnight in a special sleep lab.
Your doctor may recommend a sleep study if your insomnia seems to be caused by breathing problems (such as sleep apnea) or periodic limb movement disorder, or if you have tried other treatments that haven't worked.
Tossing and turning during the night or having trouble falling asleep can make you sleepy and grouchy during the day. You may have tried some things to help your insomnia that haven't worked. The good news is that there are many treatments to help you sleep better. But first it helps to know the reason why you don't sleep well. If you have a medical problem, such as chronic pain, or an emotional problem, such as stress or depression, treating that problem may help you sleep better.
Treatment options include behavior and lifestyle changes, medicines, and complementary medicines.
Getting ready for bed means more than turning down the sheets. Sleep experts know that there are many things that affect how well you sleep. Behavior and lifestyle changes improve overall sleep quality and the time it takes to fall asleep—without the side effects of sleep medicines. Perhaps most important, these improvements last over time.
To improve your sleep, here are some things you can try:
Try these relaxation exercises:
In some cases, taking sleeping pills for a short time helps you get some rest, while behavior and lifestyle changes can help you over the long term. Doctors recommend taking sleep medicines only now and then or only for a short time. They are not the first choice for treating chronic insomnia.
This advice about medicines applies to everyone, but especially to older adults. Anyone can become dependent on sleep medicines, and these medicines can affect how well older people think during and after long-term use.1
Many sleep medicines cause side effects, such as low blood pressure, anxiety, and nausea. These medicines also may become less effective when your body gets used to them and may cause withdrawal symptoms when you stop using them.
Sleep medicines include:
To help you decide if you should use sleeping pills to treat insomnia, see:
One Man's Story:
While Cort does have a prescription for sleeping pills, he uses the medicine only when he needs to be well rested the next day, such as when he has to give a presentation at work. Cort heeds his doctor’s warning about becoming dependent on sleeping pills.
"I have a prescription for 5 mg tablets, and I never take a full one. I break them in half, and I never take them more than once in 2 weeks." —Cort, 64
Other treatments for insomnia may include complementary and alternative medicines. Two of the most popular alternative medicines are:
Some people use alcohol to help them sleep, but that's not a good idea. At first, drinking alcohol may make you sleepy and help you fall asleep. But when you drink alcohol, you are more likely to wake up later in the night and have a hard time falling back asleep. This can leave you feeling tired the next day.
After you and your doctor have treated any health problems related to your insomnia, there are many steps you can take to improve your sleep. Here are few examples:
For more tips on how to improve your sleep, see:
Older adults, especially those living in nursing homes or who are cared for by others, often have ongoing sleep problems. It's natural for your sleep patterns to change as you get older, but it doesn't mean that you need less sleep or that the sleep you do get is enough.
There are things you can do to cope with changing sleep patterns as you get older, such as having familiar evening and nighttime routines.
Be sure to talk to your doctor if your sleep problem gets worse, if it lasts for more than 2 weeks, or if your symptoms become more severe or happen more often.
|CDC Sleep and Sleep Disorders page|
This website by the CDC provides accurate, easy-to-read information about sleep and sleep disorders.
|American Academy of Sleep Medicine (AASM)|
This website was created by the American Academy of Sleep Medicine (AASM) to provide dependable information related to sleep, sleep disorders, treatments, and services.
|National Center for Complementary and Alternative Medicine (NCCAM), National Institutes of Health|
|9000 Rockville Pike|
|Bethesda, MD 20892|
The National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health (NIH) explores complementary and alternative healing practices in the context of rigorous science, trains complementary and alternative medicine researchers, and gives out authoritative information.
|National Heart, Lung, and Blood Institute (NHLBI)|
|P.O. Box 30105|
|Bethesda, MD 20824-0105|
The U.S. National Heart, Lung, and Blood Institute (NHLBI) information center offers information and publications about preventing and treating:
|National Sleep Foundation|
|1010 North Glebe Road|
|Arlington, VA 22201|
The National Sleep Foundation, an independent nonprofit organization, can provide you with brochures on sleep disorders and a list of accredited sleep disorder clinics.
- Martin JL, et al. (2007). Sleep disorders. In RJ Ham et al., eds., Primary Care Geriatrics: A Case-Based Approach, 5th ed., pp. 391–400. St. Louis: Mosby Elsevier.
- Valerian (2010). In A DerMarderosian et al., eds., Review of Natural Products. St. Louis: Wolters Kluwer Health.
Other Works Consulted
- Morin CM, et al. (2009). Cognitive behavioral therapy, singly and combined with medication, for persistent insomnia: A randomized controlled trial. JAMA, 301(19): 2005–2015.
- Ropper AH, Samuels MA (2009). Sleep and its abnormalities. In Adams and Victor's Principles of Neurology, 9th ed., pp. 374–396. New York: McGraw-Hill.
- Schutte-Rodin S, et al. (2008). Clinical guideline for the evaluation and management of chronic insomnia in adults. Journal of Clinical Sleep Medicine, 4(5): 487–503.
|Primary Medical Reviewer||Anne C. Poinier, MD - Internal Medicine|
|Specialist Medical Reviewer||Lisa S. Weinstock, MD - Psychiatry|
|Last Revised||April 2, 2012|
Last Revised: April 2, 2012
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