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Video - Insomnia Guide

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Written by Dr. Welsh, Article reviewed and edited by Dr. Fine M.D..
Published on 03 November 2014

Insomnia Guide

What is Insomnia?

Insomnia is a condition in which a patient has serious issues falling asleep, or wakes up frequently throughout the night. Insomnia refers to a number of sleep issues, and can be diagnosed when the patient:

  • Has Trouble Getting to Sleep

  • Is Restlessness During Sleep

  • Sleeps for a Short Time and Wakes Up Unable to Fall Asleep Again

  • Wakes Up Before One is Rested

  • Is Fatigued Even After Rest

Kinds of Insomnia

There are two main categories of Insomnia, based upon the root source of the condition: Primary Insomnia and Secondary Insomnia

What is Primary Insomnia?

Primary Insomnia refers to sleep issues that are not caused by other health issues that the patient experiences.

What is Secondary Insomnia?

Secondary Insomnia refers to sleep issues that are related to other aspects of a patient's health state or lifestyle. There are a number of subcategories here:

  • Emotional issues such as depression and anxiety can lead to Insomnia

  • Health problems such as heartburn, cancer, or arthritis can lead to Insomnia

  • Lifestyle issues such as drinking or shift work can lead to Insomnia

Chronic and Acute Insomnia

Insomnia is also categorized by frequency and duration. Chronic Insomnia refers to Insomnia which has been an issue in the patient's life for an extended period of time, whereas Acute Insomnia refers to temporary, yet still significant sleep disruption. Some patients deal with Chronic Insomnia day after day, whereas others only experience the condition under certain circumstances.

From a medical perspective, Chronic Insomnia refers to sleep disruption which lasts for at least a month and manifests itself at least 3 times per week, whereas Acute Insomnia refers to Insomnia which only occurs a single time or over the course of less than a month.

What Causes Acute Insomnia?

Acute Insomnia is generally the result of factors and changes in one's life, including stress and environment. As such, usually Acute Insomnia can be treated through changing one's habits. The following are some factors which can lead to Acute Insomnia:

  • Disruption of Sleeping Habits resulting from Lifestyle Adjustments

  • Certain Medications, including those for Asthma, Hypertension, Depression, Allergies, and Cold

  • Environmental disruptions, including uncomfortable heat or cold, light, or noise

  • Uncomfortable sleeping arrangements

  • Emotional distress

  • Illness

  • Major stress, such as stress resulting from moving, divorce, mourning, or employment changes

What Causes Chronic Insomnia?

There are certain conditions in one's life which can lead to Chronic Insomnia, but in the case of Primary Insomnia, the root cause is physiological and direct. Secondary causes of Chronic Insomnia include:

  • Discomfort or pain which make it hard to fall asleep

  • Chronic stress which prevents the body and mind from successfully falling asleep

  • Anxiety and depression which make it difficult to prime the mind for restful sleep

What Are the Symptoms of Insomnia?

Sleep is incredibly important. Our bodies use the time that we are asleep to rebuild and rejuvenate our bodies. Our brains also use sleep to form long term memories and remember important information. Hormone Balance is also predicated on healthy sleep, as Testosterone and Human Growth Hormone, along with other hormones, are primarily produced while we are asleep. The following are some of the most common symptoms of Insomnia:

  • Forgetfulness

  • Trouble Concentrating

  • General Exhaustion

  • Daytime Sleepiness, or a Tendency to Fall Asleep During the Day

How is Insomnia Diagnosed?

Unlike many other conditions, it's pretty easy to recognize when one is suffering from Insomnia, although patients that wake up exhausted may be less likely to seek assistance as quickly as those that experience frequent sleepless nights. If you believe that you are experiencing Insomnia, make an appointment with a health professional.

During your appointment, you'll usually provide a medical history, and your doctor will perform a physical in order to evaluate your condition. You'll also, obviously, need to report the sleeping issues that you've been experiencing, including the severity and the duration of your issues.

Most doctors will request that you maintain a diary of your sleeping habits over the course of a couple of weeks, in which you write down when you remember falling asleep and waking up, as well as your energy levels during the day. If you have a partner, your doctor may want to discuss your sleeping habits with them in order to learn more about your sleeping habits, including any snoring or restlessness that you may not experience consciously.

If your doctor suspects sleep apnea, or another condition which inhibits sleep which can't be effectively diagnosed without actually monitoring your sleep, they may arrange for you to go to a sleep specialist.

How is Insomnia Treated?

How Insomnia is treated depends upon the severity and the duration of the Insomnia. For patients that experience short term, Acute Insomnia, no treatment may be needed at all, or the treatment may just be minor, perhaps even just a simple OTC Sleep Aid.

For patients with light Insomnia, the best form of treatment is often lifestyle adjustment—making the effort to engage in healthy and conscientious sleeping habits.

For patients that are experiencing Chronic Insomnia which is impacting their ability to perform in their Day-to-Day life, your physician may provide you with one of many prescription medications designed to help you fall asleep easier. Generally, these treatments are only prescribed short term, as the goal is to restore a normalized sleeping pattern and then train the patient to sleep better on his or her own.

For Chronic Insomnia, the ideal prescription medication for most patient activates rapidly and helps the patient fall asleep quickly before wearing off, allowing the patient to sleep restfully throughout the rest of the night. For these patients, OTC Sleep Aids aren't enough under most circumstances, and long term use of these sleep aids can lead to side-effects which can even exacerbate Insomnia in the long term.

Of course, one of the most important aspects of Chronic Insomnia diagnosis and treatment is to discover whether the patient is suffering from Primary or Secondary Insomnia. The physical and medical history will provide evidence as to any underlying conditions which may be preventing healthy sleep. By treating these conditions, and helping the patient fall asleep more easily in the meantime, it is often possible to help the patient overcome Insomnia completely.

Cognitive Behavioral Therapy is also highly effective for the treatment of Insomnia, because there are certain patterns and behaviors which can exacerbate Insomnia, or may even be the root cause of Chronic Insomnia. Some forms of therapy which have shown significant effectiveness are reconditioning, sleep restriction, and relaxation techniques.

How Can I Overcome Insomnia with Good Habits?

If you are having issues with Acute Insomnia and would like to try to fix the problem on your own before seeing a specialist, there are some smart steps you can take to improve your sleep hygiene and improve your sleeping habits. Try incorporating these tips into your life and see what happens:

  • Don't smoke or use caffeine in the early afternoon or evening—These vices have the capacity to cause or exacerbate anxiety. Both nicotine and caffeine are stimulants, and if you use them late, it can make it really hard to go to sleep if you have a sleep sensitivity. Caffeine has a half life of around 5 or 6 hours, so you should have your last cup of coffee at least six hours before bed, if not nine hours.

  • Don't drink in the evening—Alcohol can help you go to sleep, but the intoxicating effects will wear off while you are asleep, and this can cause you to wake up early and hungover.

  • Establish a stable sleeping pattern—For people with Insomnia, making the effort to create a normalized sleeping pattern can be highly beneficial. Your body prefers to run on an established 24 hour pattern, and deviating from that pattern can have consequences in the form of poor sleep and insomnia.

  • Avoid naps—Although some people function well with an afternoon nap, for people with Insomnia, a nap can lead to nighttime restlessness that prevents them from getting healthy sleep.

  • Exercise Regularly—Exercise stimulates your body and helps you establish set physiological patterns. If you don't get enough exercise, this can cause you to experience symptoms of Chronic Fatigue, which can leave you constantly tired but unable to sleep well. Of course, it's important to exercise at the right time. Exercise is a highly stimulative activity, so its best for the morning or early afternoon, when you would normally find yourself dragging. Daytime exercise can help you sleep better, but if you exercise in the 3-4 hours before bed, this can get you too stimulated to sleep.

  • Don't eat too much just before bedtime—Many people make the mistake of loading up on a big meal late in the evening before bed. Although it is true that a light, protein-based snack can provide healthy benefits while you sleep, a big meal weighs you down and puts a strain on your digestive system, which slows down when you fall asleep.

  • Create a comfortable and inviting sleep space—Often, people have trouble sleeping because they don't have their bedroom designed with a healthy night's sleep in mind. Excess light and sound can make it really hard to sleep. Also, be sure to turn your thermostat to a temperature that really puts you in a comfortable mood.

  • Establish patterns before bed to help you relax—Try to follow the same pattern every night, and your body will adopt the pattern and promote restfulness. Take a hot shower before taking a half hour to wind down with a book, for example.

  • Don't use your bed as an entertainment space—Too often, people have trouble getting to sleep, because they watch television or play games on their laptop or cell phone in bed. Anything that stimulates you in bed (besides sex) is counterproductive.

  • Don't Stay in Bed When You Can't Sleep—If you find yourself dwelling on the fact that you can't sleep, get out of bed and do something else. It can actually make it even harder to fall asleep if you don't get out of bed. Spend thirty minutes or so doing something like reading or organizing that doesn't get you too active.

  • Keep a To-Do List—For people that have trouble sleeping because of anxiety and worry, it can be helpful to write down a list of things you need to do in the near future. Create a time line or a grocery list. Write a list of your worries. Once you get your worries down on paper, push them out of your mind until the next morning.

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