Insomnia

Insomnia

Central Nervous System,Emergency Medicine,Mental Health,Sleep Medicine

Written by the doctors and editors at UpToDate
What is insomnia? — Insomnia is a problem with sleep. People with insomnia have trouble falling or staying asleep, or they do not feel rested when they wake up. Insomnia is not about the number of hours of sleep a person gets. Everyone needs a different amount of sleep.
What are the symptoms of insomnia? — People with insomnia often:
Have trouble falling or staying asleep
Feel tired during the day
Forget things or have trouble thinking clearly
Get cranky, anxious, irritable, or depressed
Have less energy or interest in doing things
Make mistakes or get into accidents more often than normal
Worry about their lack of sleep
These symptoms can be so bad that they affect a person's relationships or work life. Plus, they can happen even in people who seem to be sleeping enough hours.
Are there tests I should have? — Probably not. Most people with insomnia need no tests. Your doctor or nurse will probably be able to tell what is wrong just by talking to you. He or she might also ask you to keep a daily log for 1 to 2 weeks, where you keep track of how you sleep each night.
In some cases, people do need special sleep tests, such as "polysomnography" or "actigraphy."
Polysomnography – Polysomnography is a test that usually lasts all night and that is done in a sleep lab. During the test, monitors are attached to your body to record movement, brain activity, breathing, and other body functions.
Actigraphy – Actigraphy records activity and movement with a monitor or motion detector that is usually worn on the wrist. The test is done at home, over several days and nights. It will record how much you actually sleep and when.
What can I do to improve my insomnia? — You can follow good "sleep hygiene." That means that you:
Sleep only long enough to feel rested and then get out of bed
Go to bed and get up at the same time every day
Do not try to force yourself to sleep. If you can't sleep, get out of bed and try again later.
Have coffee, tea, and other foods that have caffeine only in the morning
Avoid alcohol in the late afternoon, evening, and bedtime
Avoid smoking, especially in the evening
Keep your bedroom dark, cool, quiet, and free of reminders of work or other things that cause you stress
Solve problems you have before you go to bed
Exercise several days a week, but not right before bed
Avoid looking at phones or reading devices ("e-books") that give off light before bed. This can make it harder to fall asleep.
Other things that can improve sleep include:
Relaxation therapy, in which you focus on relaxing all the muscles in your body 1 by 1
Working with a counselor or psychologist to deal with the problems that might be causing poor sleep
Should I see a doctor or nurse? — Yes. If you have insomnia, and it is troubling you, see your doctor or nurse. He or she might have suggestions on how to fix the problem.
Are there medicines to help me sleep? — Yes, there are medicines to help with sleep. But you should try them only after you try the techniques described above. You also should not use sleep medicines every night for long periods of time. Otherwise, you can become dependent on them for sleep.
Insomnia is sometimes caused by mental health problems, such as depression or anxiety. If that's the case for you, you might benefit from an antidepressant rather than a sleep aid. Antidepressants often improve sleep and can help with other worries, too.
Can I use alcohol to help me sleep? — No, do not use alcohol as a sleep aid. Even though alcohol makes you sleepy at first, it disrupts sleep later in the night.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 16177 Version 11.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.

Acute Insomnia,Adjustment Insomnia,Chronic Insomnia,Insufficient Sleep Syndrome,Long-Term Insomnia,Paradoxical Insomnia,Primary Insomnia,Psychophysiological Insomnia,Secondary Insomnia,Short Duration Sleep,Short-Term Insomnia,Sleep Depravation,Sleep Difficulty,Sleep Disorder,Sleeplessness,Transient Insomnia

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© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.