Defined as having difficulty falling asleep or staying asleep, insomnia affects 58% of U.S. adults, according to the National Sleep Foundation. Women are more susceptible to insomnia than men, and occurrences seems to increase with age. Those in lower socioeconomic groups appear to have an especially high incidence of insomnia, as do alcoholics.
Types of Insomnia
Many people experience an occasional day or even several days of insomnia, where sleep just won’t come, no matter how tired they are. This is known as “transient insomnia” and typically lasts for less than one week. With “acute insomnia,” sleep difficulties last slightly longer, but less than a month. Sufferers of “chronic insomnia” are unable to sleep or to sleep enough most nights for more than a month, to the point where it is affecting their relationships, their job and their wellbeing.
Causes of Insomnia
Insomnia can be caused by certain medications, by a sleep disorder such as sleep apnea, by another condition such as menopause or asthma, or even by having too much caffeine. All of these causes are what is known as “secondary insomnia,” and most people with insomnia have this form of the condition.
When there is not a separate medical cause of sleep problems, a patient is said to have “primary insomnia,” which occurs in only about two in ten cases, according to the National Institutes of Health. Shift workers or anyone keeping a schedule that results in widely varying bed times are frequently plagued by primary insomnia and stress is believed to play a role in this type of insomnia.
Treatment of Insomnia
Lifestyle modifications are the first line of defense against insomnia and some doctors recommend a series of behavioral changes before prescribing medical treatment. Sufferers are advised to:
- Avoid eating right before bed
- Avoid caffeine and alcohol within eight hours of bedtime
- Take a bath or find some other way to relax before going to bed
- Don’t eat, read or watch TV in bed
- Make sure the bed is comfortable
- Keep the room darkened and quiet and the temperature cool
- If sleep won’t come, get up and read in another room, don’t stay in bed
- Try to stick to the same schedule every day for going to bed and getting up
For those with acute insomnia, lifestyle changes may be enough to help relieve the occasional sleep-related problems. That is likely not the case for chronic insomnia, however, which may require some other form of intervention, including pharmaceutical treatment.
Cognitive-Behavioral Therapy (CBT) is an approach to relieving insomnia that involves re-training the body and mind to sleep at the appropriate and desired time. Working with a therapist, the insomnia patient will incorporate new behaviors into their daily routines and will learn relaxation techniques that target the anxiety that many with insomnia have about falling asleep. CBT has been proven effective, often more so than pharmaceutical therapy, particularly for long-term relief of insomnia.
Prescription medications are often used to treat insomnia and there are a variety of types available. Benzodiazepines such as Halcion and Restoril and non-benzodiazepines such as Lunesta and Ambien are well-known examples of prescription sleep-aids. These drugs can be effective for some people, but they are also associated with some serious side-effects, including sleep walking and daytime fatigue. Users can also develop dependence on some of these medications with long-term use.
Non-prescription and natural sleep remedies are also widely available for insomnia treatment. Perhaps the most well-known non-prescription sleep aid is melatonin. Melatonin is a naturally-occurring hormone and its use as a sleep-aid has been demonstrated to be effective. Other products that are available over the counter are L-tryptophan supplements and valerian teas and extracts. Many sufferers find relief with these treatments, but the research on their effectiveness is limited. Over the counter antihistamines are also used frequently for inducing sleep.
Insomnia plagues many people and can take its toll on lives and relationships. But with proper attention, short bouts of insomnia can be kept from becoming long bouts and chronic insomnia can be finally resolved.
