Symptoms and treatment of Insomnia

Description

Insomnia is a common sleep disorder that can make it difficult to fall asleep or stay asleep. It can also cause you to wake up too early and not be able to go back to sleep. You may feel tired when you wake up. Insomnia can affect your energy level and affect your mood. It can also affect your health, work performance and quality of life.

How much sleep is enough varies from person to person. But most adults need between 7 to 9 hours per night.

At some point, many adults have insomnia in the short term. This can last for days or weeks. Short-term insomnia is usually due to stress or a painful event. But some people have long-term insomnia, also called chronic insomnia. This has a duration of three months or more. Insomnia may be the primary problem, or it may be related to other medical conditions or medications.

You do not have to deal with the sleepless nights. Simple changes in your daily habits can often help.

Symptoms

Insomnia symptoms may include:

Having trouble falling to sleep at night.
Waking up during the night.
Waking up too early.
Feeling tired or drowsy during the day.
Feeling moody, depressed, or anxious.
Having a hard time paying attention, focusing on tasks or remembering.
Making more errors or have more accidents.
Have continuing concerns about the dream.

When to see a doctor

If insomnia makes it difficult for you to do daily activities, consult your doctor or other primary care professional. Your doctor will find the cause of your sleep problem and help with the treatment. If you think you may have a sleep disorder, your doctor may suggest you go to a sleep center for special tests.

Causes

Insomnia may be the primary problem, or it may be related to other conditions.

Long-term insomnia is due to stress, life events or habits that disrupt sleep. While the treatment of the cause of your sleep problem, you can leave your insomnia, it can sometimes last for years.

The common causes of long-term insomnia include:

Stress. Concerns about work, school, health, money, or family can keep your mind active at night, making it hard to sleep. Stressful life events, such as the death or illness of a loved one, a divorce, or the loss of a job, can also lead to insomnia.
Travel or work schedule. Your body's "internal clock", known as circadian rhythms, guides and of such things as your sleep-wake cycle, metabolism and body temperature. The disruption of these rhythms can lead to insomnia. The causes include the feeling of jet lag of traveling through multiple time zones, work sooner or later the change, or to change work shifts often.
Poor sleep habits. Poor sleep habits include going to bed and waking up at a different time each day, taking naps, being too active before you go to bed and have a sleep area that is not comfortable. Other good sleep habits include working, eating or watching TV while in bed. The use of the computers or smart phones, video games, or watching TV before bed can disrupt your sleep cycle.
Eating too much late in the evening. Have a light snack before going to sleep is okay. But eating too much may cause you to feel uncomfortable while lying down. Many people also have heartburn. This is when the stomach acid backs up into the tube that carries food from the mouth to the stomach. This tube is called the esophagus. Heartburn can keep you awake.
Mental health disorders. Anxiety disorders, such as post-traumatic stress disorder, may disrupt your sleep. Waking up too early can be a sign of depression. Insomnia often occurs with other mental health conditions.
Drugs. Many prescription drugs can interfere with sleep, such as certain antidepressants and medications for asthma or blood pressure. Many medicines available without a prescription, such as some pain medications, allergy and cold medications, and weight-loss products that contain caffeine and other stimulants that can disrupt sleep.
Medical conditions. Examples of conditions associated with insomnia include chronic pain, cancer, diabetes, heart disease, asthma, and gastroesophageal reflux disease (GERD), overactive thyroid, Parkinson's disease and Alzheimer's disease.
Sleep-related disorders. Sleep apnea causes you to stop breathing at times during the night, interrupting sleep. Restless legs syndrome causes a strong uncomfortable urge to move their legs when trying to fall asleep. This can avoid staying asleep or getting back to sleep.
Caffeine, nicotine and alcohol. Coffee, tea, cola, and other beverages that contain caffeine are stimulants. Drink in the evening or at night, can keep you from falling asleep at night. The nicotine in tobacco products is another stimulant that can disrupt sleep. Alcohol can help you fall asleep, but it prevents deeper stages of sleep and often results in waking up in the middle of the night.

Insomnia and aging

Insomnia becomes more common with age. As you get older, you can:

Change your sleep patterns. Sleep often becomes less of a break with the old, so that the noise or other changes in their environment, are more likely to wake up. With age, your internal clock is often moves forward in time, so that you get tired earlier in the evening and wake up early in the morning. But older people may still need the same amount of sleep as younger people.
Change your level of activity. You may be less active physically or socially. The lack of activity can interrupt a good night's sleep. Also, the less active you are, the more likely it is that you can take a daily nap. Naps can disrupt sleep at night.
Have changes in your health. Ongoing pain from conditions such as arthritis or back problems, as well as depression or anxiety, can disrupt sleep. Issues that make it more likely that you will have to urinate during the night, such as prostate or bladder problems, can disrupt sleep. Sleep apnea and restless legs syndrome become more common with age.
Taking more medicines. Older people typically use more prescription drugs than younger people. This raises the possibility of insomnia related to drugs.

Insomnia in children and adolescents

Sleep problems can be a concern for children and teenagers as well. But some children and teenagers simply have trouble falling asleep or to resist a regular bedtime because their internal clocks are more delayed. Want to go to bed later and sleep later in the morning.

Risk factors

Almost everyone has a night of occasional sleeplessness. But you are more likely to have insomnia if:

You are a woman. The changes in hormones during the menstrual cycle and the menopause may play a role. During menopause, night sweats and hot flashes often disrupt sleep. Insomnia is also common during pregnancy.
You have more than 60 years. Due to the changes in sleep patterns and health, it is more likely to have insomnia as you get older.
You have a mental health or physical health status. Many of the problems that affect their mental or physical health can disrupt sleep.
You are under a lot of stress. Being stressed out can cause short-term insomnia. Severe or long-term, stress can lead to long-term insomnia.
You do not have a regular schedule. For example, the change of shifts at work or traveling, it can disrupt your sleep-wake cycle.

Complications

Sleep is so important for your health, as a healthy diet and regular physical activity. What keeps you from sleeping, insomnia can affect you mentally and physically. People with insomnia report a lower quality of life compared to people who sleep well.

Complications of insomnia can include:

Reduced performance at work or in school.
Slower reaction time while driving and an increased risk of accidents.
Mental health conditions, such as depression, anxiety, or substance abuse.
Increased risk or worsening of long-term diseases or conditions, such as high blood pressure and heart disease.

Prevention

Good sleep habits as these may help to prevent insomnia:

Keep the time you go to bed and when you wake up the same every day, including weekends.
Stay active. Regular physical activity can lead to a good night's sleep.
Limit naps or no naps at all.
Limit the use of caffeine, alcohol and nicotine.
Do not eat large amounts of food or drinking too much liquid before bedtime.
Make your bedroom comfortable for sleep, and only use it for the sex or sleep.
Create a relaxing bedtime ritual, such as taking a warm bath, reading or listening to soft music.

Diagnosis

Depending on your situation, the diagnosis of insomnia and the search for its cause may include:

Physical exam. If the cause of insomnia is not known, your healthcare provider may do a physical exam to look for signs of health problems that can be associated with insomnia. Sometimes, a blood test may be done to check for thyroid problems or other conditions that may be related to the lack of sleep.
Sleep habits review. In addition to asking questions about your sleep, your doctor or other health care professional can make you to fill out a questionnaire to show their sleep-wake pattern and the level of daytime sleepiness. You may also be asked to keep a sleep diary for a couple of weeks.
Sleep study. If the cause of your insomnia is not clear, or you have symptoms of another sleep disorder, such as sleep apnea or restless legs syndrome, you may need to spend a night in a sleep center. Tests are done to track and record the various activities while you sleep. This includes the brain waves, breathing, heart beat, movements of the eyes and the movements of the body.

Treatment

The change of sleep habits and taking care of any problems associated with insomnia, such as stress, medical conditions or medications, can result in a good night's sleep for many people. If these steps do not work, your doctor may recommend cognitive behavioral therapy (CBT), medications, or both to enhance relaxation and sleep.

CBT for insomnia

The cognitive-behavioral therapy for insomnia can help to control or stop the negative thoughts and actions that keep you awake. Generally, it is recommended as the first treatment for people with insomnia. Normally, the CBT is as effective or more effective than medication for sleep.

The cognitive part of CBT teaches you how to learn and change beliefs that affect your sleep. It can help control or stop the negative thoughts and worries that keep you awake. You can also consist in putting an end to the cycle of worrying so much about getting to sleep, you can't fall asleep.

The behavioral part of CBT helps you learn good sleep habits and behaviors that prevent you from sleeping well.

The strategies include:

Stimulus Control therapy. This method helps to train the mind and the body for better sleep and not struggle against sleep. For example, can be trained to establish a regular schedule for going to bed and waking up, do not nap, and use the bed only for sleep and sex. You can also be trained to walk out of the room if you can go to sleep within 20 minutes, and only came back when you're sleepy.
The methods of relaxation. The progressive muscle relaxation, biofeedback, and breathing exercises are all ways to reduce anxiety at bedtime. The practice of these methods can help you control your breathing, heart rate, and muscle tension, so that you can relax.
Sleep restriction. With this method, you can reduce the time you spend in bed and stop to take a nap during the day, so that you get less sleep. This makes you more tired the next night. Once your sleep improves, gradually increase the time in bed.
Remaining passively awake. It is also called intention paradoxical, this strategy for the learned insomnia aims to reduce your worry and anxiety about being able to get to sleep. You get in bed and try to stay awake instead of waiting to fall asleep. This approach reduces your extreme attention in the sleep and the anxiety about not sleeping, which is more easier to fall asleep.
The light therapy. If you sleep too early and then wake up too early, you can use light to push back your internal clock. You may go out when the light from outside at night, or you can use a light box. Talk to your doctor for advice.

Your doctor may recommend other strategies related to their style of living and sleeping area to help create habits that lead to the quality of sleep during the day and the state of alert.

Prescription medications

Prescription sleeping pills may help with falling asleep, staying asleep, or both. Usually, doctors do not recommend relying on prescription sleeping pills for more than a couple of weeks. And medicines should not be the only treatment. But there are several medications that are approved for long-term use.

It is not known how long the drugs can be wisely used. Rather, the drugs are prescribed on a case-by-case basis, with you and your doctor weigh up the benefits and risks. In general, it is best to use the lowest effective dose and do not use medication for too long.

Options for the treatment of people who are having sleep problems are:

Eszopiclone (Lunesta).
Ramelteon (Rozerem).
Temazepam (Restoril).
Triazolam (Halcion).
Zaleplon (Sonata).
Zolpidem tartrate (Ambien, Ambien CR, Edluar).

Options for the treatment of those who are having trouble falling asleep, waking too early or struggling to get back to sleep are:

Hydrochloride, doxepin (Silenor).
Eszopiclone (Lunesta).
Suvorexant (Belsomra).
Temazepam (Restoril).
Zolpidem tartrate (Ambien, Ambien CR, Edluar).

Prescription sleeping pills can have side effects, such as causing day disorientation, and the creation of a greater risk of falls. You can also create a habit. If your doctor prescribes a medication to help you sleep, ask for more information, including possible side effects and how long it can take.

Insomnia is available without a prescription

Sleep medicines available over the counter contain antihistamines that can make you sleepy. These medications are not for regular use. Talk with your doctor before taking these medications, such as antihistamines can cause side effects. Side effects might include daytime drowsiness, dizziness, confusion, problems with thinking and difficulty with urination. The side effects can be worse in older adults.

Lifestyle and home remedies

No matter your age, insomnia can usually be treated. The key is often found in the changes to your routine during the day and when you go to bed.

These tips may help:

Follow a sleep schedule. Keep your bedtime and waking up at the same time every day, including weekends.
Stay active. Regular physical activity can lead to a good night's sleep. Hours of exercise at least a couple of hours before going to bed. Not to take part in activities that use a lot of energy too close to bedtime.
Review your medicines. If you take any medicines regularly, talk with your doctor to see if they can play a role in insomnia. Also, check the labels of the products available over the counter to see if they contain caffeine or other stimulants, such as pseudoephedrine.
Limit or stop napping. Naps can make it harder to fall asleep at night. If you can't get by without one, try to limit a nap of no more than 30 minutes. In addition, don't nap after 3 pm, if your sleep time is in the evening.
Limit the use of caffeine, alcohol and nicotine. Caffeine, alcohol and nicotine, can make it more difficult to sleep. This effect may last for several hours.
Do not put up with the pain. If a painful condition that bothers you, talk with your doctor about which pain relievers can control the pain while you sleep.
Do not eat large amounts of food or drinking too much liquid before bedtime. A snack is good and can help you avoid heartburn. Drink less fluid before bed, so that you don't have to urinate frequently.

At bedtime:

Make your bedroom comfortable for sleep. Only use your bedroom for sex or sleep. Keep it dark, quiet and at a comfortable temperature. Hide all the clocks in your bedroom, including your watch and mobile phone. That way, you do not worry about what time it is.
Find ways to relax. Try put your worries and planning side when you get in bed. A hot bath or a massage before going to bed can help you prepare for sleep. Create a relaxing bedtime ritual, such as taking a hot bath, reading, listening to soft music, doing breathing exercises or yoga, or praying.
Don't try too hard to sleep. The harder you try to sleep, the more awake you'll become. Read in another room until you feel sleepy. Then go to bed to sleep. Do not go to bed too early, before you feel sleepy.
Get out of bed when you're not sleeping. Sleep as much as you need to feel rested. Then get out of the bed. Do not stay in bed if you're not sleeping.

Alternative medicine

Many people will never visit your doctor or other health care provider for insomnia. They try to cope with insomnia on your own.

Some people try to therapies such as:

Melatonin. This supplement, which is available without a prescription, is marketed to help fight insomnia. It is generally considered safe to use melatonin for a couple of weeks. But there is no convincing evidence to prove that it is effective to treat insomnia and the long-term safety is not known. The guidelines of The American Academy of Sleep Medicine to advise the medical and mental health professionals do not prescribe.
Valerian. This dietary supplement is sold as a sleep aid because it has a mild sedative effect. Has not been well studied. Discuss the use of valerian with your doctor before you try it. Some people who have used high doses or used in the long term may have had damage in the liver. But it is not clear if the valerian caused the damage.
Acupuncture. This therapy is commonly used to treat insomnia. But this therapy is generally not recommended due to the lack of evidence that it is beneficial.
Yoga or tai chi. Some studies suggest that the regular practice of yoga or tai chi can improve the quality of sleep. But this therapy is generally not recommended due to the lack of evidence that it is beneficial.
Meditation. Several small studies suggest that meditation along with conventional treatment can help to improve sleep and reduce stress.

Caution about the use of herbs and diet of insomnia

The Food and Drug Administration, not the order that manufacturers of dietary supplements and sleep aids to show that work and are safe. Talk with your doctor before taking any of the products available without a prescription. Some products can be harmful, and some can cause damage if you are taking certain medications.

Preparing for your appointment

If you are having trouble sleeping, is likely to begin by talking with your primary care professional. Ask if there is something that you need to do before your appointment, such as keeping a sleep diary. Take your bed partner along, if possible. Your partner can give you information about how much and how you're going to sleep.

What you can do

Prepare for your appointment by making a list of:

Its symptoms, including those that may not relate to the reason for the appointment.
Personal information, including new or ongoing health problems, the major stresses or recent life changes.
All the medicines you take, including prescription medication available without a prescription, vitamins, and herbs, or other supplements, as well as the dose. Let your doctor know about anything you've taken to help you sleep.
Questions to ask your doctor to make the most of your appointment time.

Basic questions to ask include:

What is likely causing my insomnia?
What is the best treatment?
How can I create an ideal sleep environment?
How can I manage insomnia with my other health conditions?
Should I go to a sleep clinic or sleep specialist? Will my insurance cover it?
Are there brochures or other printed material I can have?
What sites do you recommend?

Do not hesitate to ask questions during your appointment.

What to expect from your doctor

Your doctor may ask you several questions.

Common questions about insomnia are:

How often do you have trouble sleeping?
When did the insomnia to start?
How much time is needed to fall asleep?
Do you snore or wake up choking for breath?
How often you wake up during the night, and how much time you need to fall back to sleep?
What is your response when you can't sleep?
What have you tried to improve your sleep?

Common questions about the day routine include:

Do you feel refreshed when you wake up, or you're tired during the day?
Do you sleep or have trouble staying awake while sitting in silence or driving?
Do you nap during the day?
What is not often eat and drink in the night?

Common questions about bedtime, which include:

What is your bedtime routine?
Do you take medications, such as sleeping pills before going to bed?
What time do you go to bed and wake up? Is this different on the weekends?
How many hours a night do you sleep?

Common questions about other problems that can affect sleep include:

Have any stressful events that happened recently?
Do you use tobacco or drink alcohol?
Do you have any family members with sleep problems?
What medications do you take regularly?
Do you experience an uncomfortable urge to move the legs when trying to fall asleep?