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Article title: Insomnia: NWHIC
Who is likely to get insomnia?
What causes transient (temporary) or intermittent insomnia?
Can insomnia be aggravated by certain behaviors?
How do I know if I have insomnia?
What kind of treatment is there for insomnia?
Insomnia is the perception or complaint of inadequate or poor-quality sleep because of one or more of the following:
difficulty falling asleep
waking up frequently during the night with difficulty returning to sleep
waking up too early in the morning
Insomnia is not defined by the number of hours of sleep a person gets or how long it takes to fall asleep. Individuals vary normally in their need for, and their satisfaction with, sleep. Insomnia may cause problems during the day, such as tiredness, a lack of energy, difficulty concentrating, and irritability.
Insomnia can be classified as transient (short term), intermittent (on and off), and chronic (constant). Insomnia lasting from a single night to a few weeks is referred to as transient. If episodes of transient insomnia occur from time to time, the insomnia is said to be intermittent. Insomnia is considered to be chronic if it occurs on most nights and lasts a month or more.
Women, the elderly, and individuals with a history of depression are all more likely to experience insomnia. If other conditions (such as stress, anxiety, a medical problem, or the use of certain medications) occur along with the above conditions, insomnia is more likely.
There are many causes of insomnia. Transient and intermittent insomnia generally occur in people who are temporarily experiencing one or more of the following:
change in the surrounding environment
sleep/wake schedule problems such as those due to jet lag
medication side effects .
What causes chronic insomnia?
Chronic insomnia is more complex and often results from a combination of factors, including underlying physical or mental disorders. One of the most common causes of chronic insomnia is depression. Other underlying causes include arthritis, kidney disease, heart failure, asthma, sleep apnea, narcolepsy, restless legs syndrome, Parkinson's disease, and hyperthyroidism. However, chronic insomnia may also be due to behavioral factors, including the misuse of caffeine, alcohol, or other substances; disrupted sleep/wake cycles as may occur with shift work or other nighttime activity schedules; and chronic stress.
Some behaviors may prolong existing insomnia, and they can also be responsible for causing the sleeping problem in the first place:
expecting to have difficulty sleeping and worrying about it
ingesting excessive amounts of caffeine
drinking alcohol before bedtime
smoking cigarettes before bedtime
excessive napping in the afternoon or evening
irregular or continually disrupted sleep/wake schedules
Stopping these behaviors may eliminate the insomnia altogether.
Patients with insomnia are evaluated with the help of a medical history and a sleep history. The sleep history may be obtained from a sleep diary filled out by the patient or by an interview with the patient's bed partner concerning the quantity and quality of the patient's sleep. Specialized sleep studies may be recommended, but only if there is suspicion that the patient may have a primary sleep disorder such as sleep apnea or narcolepsy.
Transient and intermittent insomnia may not require treatment since episodes last only a few days at a time. For example, if insomnia is due to a temporary change in the sleep/wake schedule, as with jet lag, the person's biological clock will often get back to normal on its own. However, for some people who experience daytime sleepiness and impaired performance as a result of transient insomnia, the use of short-acting sleeping pills may improve sleep and next-day alertness. As with all drugs, there are potential side effects. The use of over-the-counter sleep medicines is not usually recommended for the treatment of insomnia.
Treatment for diagnosed chronic insomnia include identifying behaviors that may worsen insomnia and stopping (or reducing) them, possibly using sleeping pills (although the long-term use of sleeping pills for chronic insomnia is controversial), trying behavioral techniques to improve sleep, such as relaxation therapy, sleep restriction therapy, and reconditioning.
You can find out more about insomnia by contacting the following organizations:
National Center on Sleep Disorders Research (NCSDR)
Two Rockledge Centre
6701 Rockledge Drive, MSC 7920
Bethesda, MD 20892-7920
(301 ) 435-0199
(301) 480-3451 (FAX)
This information was abstracted from fact sheets developed by the National Heart, Lung, and Blood Institute.
All material contained in the FAQs is free of copyright restrictions, and may be copied, reproduced, or duplicated without permission of the Office on Women's Health in the Department of Health and Human Services; citation of the source is appreciated.
Publication date: 1998
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