General Information
DEFINITION--Sleep disturbance that includes difficulty in falling asleep,
remaining asleep, intermittent wakefulness, early morning awakening or a combination of
these. Insomnia affects all age groups but is more common in the elderly. Insomnia may be
transient due to a life crisis or lifestyle change; or chronic, due to medical or
psychological problems or drug intake.
BODY PARTS INVOLVED--Nervous.
SEX OR AGE MOST AFFECTED--Both sexes; all ages.
SIGNS & SYMPTOMS
- Restlessness when trying to fall asleep.
- Brief sleep followed by wakefulness.
- Normal sleep until very early in the morning (3 a.m. or 4 a.m.), then wakefulness (often
with frightening thoughts).
- Periods of sleeplessness, alternating with periods of excessive sleep or sleepiness at
inconvenient times.
CAUSES
- Depression. This is usually characterized by early-morning wakefulness.
- Overactivity of the thyroid gland.
- Anxiety caused by stress.
- Sexual problems, such as impotence or lack of a sex partner.
- Daytime napping.
- Noisy environment (including a snoring partner).
- Allergies and early-morning wheezing.
- Heart or lung conditions that cause shortness of breath when lying down.
- Painful disorders, such a fibromyositis or arthritis.
- Urinary or gastrointestinal problems that require urination or bowel movements during
the night.
- Consumption of stimulants, such as caffeine.
- Use of some medications, including dextroamphetamines, cortisone drugs or decongestants.
- Erratic work hours.
- New environment or location; jet lag after travel; lack of physical exercise.
- Alcoholism; drug abuse, including overuse of sleep-inducing drugs; withdrawal from
addictive substances.
RISK INCREASES WITH--Stress, obesity, smoking.
HOW TO PREVENT
What To Expect
DIAGNOSTIC MEASURES--
- Medical history and exam by a doctor.
- Laboratory thyroid studies, EEG (See Glossary).
- Tests in a sleep-study laboratory (sometimes).
APPROPRIATE HEALTH CARE
- Self-care after diagnosis.
- Doctor's treatment; psychotherapy or counseling, if the cause is psychological.
POSSIBLE COMPLICATIONS
- Transient insomnia becomes chronic.
- Increased daytime sleepiness that can affect all aspects of your life.
PROBABLE OUTCOME--Most persons can establish good sleep patterns if the
underlying cause of insomnia is treated or eliminated.
How To Treat
GENERAL MEASURES--
- Seek ways to minimize stress. Learn and practice relaxation techniques.
- Don't use stimulants close to bedtime.
- Treat any underlying or medical cause.
- Relax in a warm bath before bedtime.
- Don't turn your bedroom into an office or a den. Create a comfortable sleep setting.
- Turn off your mind. Focus on peaceful and relaxing thoughts. Play soft music or
relaxation tapes. Set a rigid sleep schedule.
- Use mechanical aids such as ear plugs, eye shades or electric blanket.
MEDICATION--Your doctor may prescribe sleep-inducing drugs for a short time if:
- Temporary insomnia is interfering with your daily activities.
- You have a medical disorder that regularly disturbs sleep.
- You need to establish regular sleep patterns. Long-term use of sleep inducers may be
counter-productive or addictive.
ACTIVITY-- Exercise regularly to create healthy fatigue, but not within 2 hours
of going to bed.
DIET--
- No special diet, but don't eat within 3 hours of bedtime if indigestion has previously
disturbed your sleep. Drinking warm milk before bedtime helps some. Limit caffeine
consumption.
Call Your Doctor If
- You have insomnia and self-help methods are ineffective.
- New, unexplained symptoms develop.
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