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Insomnia is trouble falling asleep or staying asleep through the night.
Episodes may come and go (episodic), last up to 3 weeks (short-term), or be long-lasting (chronic).
Sleep disorder - insomnia; Learned insomnia; Chronic insomnia; Primary insomnia
Causes, incidence, and risk factors
Sleep habits we learned as children may affect our sleep behaviors as adults. When we repeat these behaviors over many years, they become habits.
Poor sleep or lifestyle habits that may cause insomnia or make it worse:
The use of some medications and drugs may also affect sleep:
Physical, social, and mental health issues can affect sleep patterns, including:
With age, sleep patterns tend to change. Many people find that aging causes them to have a harder time falling asleep, and that they wake up more often.
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The most common complaints or symptoms in people with insomnia are:
People who have insomnia sometimes keep thinking about getting enough sleep. The more they try to sleep, the more frustrated and upset they get, and the harder sleep becomes.
A lack of restful sleep can affect your ability to do your daily activities because you are tired or have trouble concentrating.
Signs and tests
Your health care provider will do a physical exam and ask you questions about your current medications, drug use, and medical history. Usually, these are the only methods needed to diagnose insomnia.
It is important to remember that not getting 8 hours of sleep every night does not mean you are putting your health at risk. Different people have different sleep needs. Some people do fine on 6 hours of sleep a night. Others only do well if they get 10 to 11 hours of sleep.
Treatment often begins by reviewing any drugs or medical conditions that may be causing your insomnia or making it worse.
Thinking about any lifestyle and sleep habits that may be affecting your sleep is an important next step. This is called sleep hygiene. Making some changes in your sleep habits may improve or solve your insomnia.
Using medicine to treat insomnia can sometimes be useful, but there can be risks.
It may help to see a psychiatrist or other mental health provider to test for a mood or anxiety disorder that can cause insomnia.
Most people are able to sleep by practicing good sleep hygiene. See a doctor if you have insomnia that does not improve.
Daytime sleepiness is the most common complication of insomnia. There is also evidence that a lack of sleep can lower your immune system's ability to fight infections.
A lack of sleep is also a common cause of auto accidents. If you are driving and feel sleepy, take a break.
Calling your health care provider
Call your doctor if insomnia has become a problem.
Wickwire EM, Collop NA. Insomnia and sleep-related breathing disorders. Chest. 2010;137:1449-1463.
Morgenthaler T, Kramer M, Alessi C, Friedman L, Boehlecke B, Brown T, et al. Practice parameters for the psychological and behavioral treatment of insomnia: an update. An American Academy of Sleep Medicine report. Sleep. 2006;29:1415-1419.
Vitiello MV, Rybarczyk B, Von Korff M, Stepanski EJ. Cognitive behavioral therapy for insomnia improves sleep and decreases pain in older adults with co-morbid insomnia and osteoarthritis. J Clin Sleep Med. 2009;5:355-362.
Reviewed by:David B. Merrill, MD, Assistant Clinical Professor of Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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