Insomnia Causes, Symptoms, Diagnosis, Treatmant And Prevention

Insomnia Causes, Symptoms, Diagnosis, Treatmant And Prevention

What Is Insomnia?

Insomnia is the perception or complaint of inadequate or poor-quality sleep because of one or more of the following: 

Insomnia Causes, Symptoms, Diagnosis, Treatmant And Prevention

  • difficulty falling asleep
  • waking up frequently during the night with difficulty returning to sleep
  • waking up too early in the morning
  • unrefreshing sleep
Insomnia is not defined by the number of hours of sleep a person gets or how long it takes to fall asleep. Individuals vary normally in their need for, and their satisfaction with, sleep. Insomnia may cause problems during the day, such as tiredness, a lack of energy, difficulty concentrating, and irritability. 

Insomnia can be classified as transient (short term), intermittent (on and off), and chronic (constant). Insomnia lasting from a single night to a few weeks is referred to as transient. If episodes of transient insomnia occur from time to time, the insomnia is said to be intermittent. Insomnia is considered to be chronic if it occurs on most nights and lasts a month or more.

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Insomnia Causes

Certain conditions seem to make individuals more likely to experience insomnia. Examples of these conditions include:
  • advanced age (insomnia occurs more frequently in those over age 60)
  • female gender
  • a history of depression
If other conditions (such as stress, anxiety, a medical problem, or the use of certain medications) occur along with the above conditions, insomnia is more likely. 

There are several insomnia causes. Transient and intermittent insomnia generally occur in people who are temporarily experiencing one or more of the following:

Insomnia Causes, Symptoms, Diagnosis, Treatmant And Prevention

  • stress
  • environmental noise
  • extreme temperatures
  • change in the surrounding environment
  • sleep/wake schedule problems such as those due to jet lag
  • medication side effects
Chronic insomnia is more complex and often results from a combination of factors, including underlying physical or mental disorders. One of the most common causes of chronic insomnia is depression. Other underlying causes include arthritis, kidney disease, heart failure, asthma, sleep apnea, narcolepsy, restless legs syndrome, Parkinson's disease, and hyperthyroidism. However, chronic insomnia may also be due to behavioral factors, including the misuse of caffeine, alcohol, or other substances; disrupted sleep/wake cycles as may occur with shift work or other nighttime activity schedules; and chronic stress. 

In addition, the following behaviors have been shown to perpetuate insomnia in some people:
  • expecting to have difficulty sleeping and worrying about it
  • ingesting excessive amounts of caffeine
  • drinking alcohol before bedtime
  • smoking cigarettes before bedtime
  • excessive napping in the afternoon or evening
  • irregular or continually disrupted sleep/wake schedules
These behaviors may prolong existing insomnia, and they can also be responsible for causing the sleeping problem in the first place. Stopping these behaviors may eliminate the insomnia altogether. 

Symptoms of insomnia

The symptoms of insomnia depend on the type of sleeping problem that you have. A lack of sleep can affect your mood and cause tiredness and fatigue during the day.

  • lying awake for a long time at night before falling asleep
  • waking up several times in the middle of the night
  • waking up early in the morning and not being able to get back to sleep
  • feeling tired and not refreshed by sleep
  • not being able to function properly during the day and finding it difficult to concentrate
  • being irritable
Insomnia Causes, Symptoms, Diagnosis, Treatmant And Prevention

How much sleep do I need?

As every individual is different, it's difficult to define what ‘normal sleep’ is. Factors that influence the amount of sleep you need include your age, lifestyle, diet and environment.

For example, newborn babies can sleep for 16 hours a day, while school-age children need to have an average of 10 hours sleep.

Most healthy adults sleep for an average of seven to nine hours a night. As you get older, it's normal to find sleep more difficult to maintain, although you still need the same amount of sleep.

Who Gets Insomnia?

Insomnia is found in males and females of all age groups, although it seems to be more common in females (especially after menopause) and in the elderly. The ability to sleep, rather than the need for sleep, appears to decrease with advancing age. 

How Is Insomnia Diagnosed?

Patients with insomnia are evaluated with the help of a medical history and a sleep history. The sleep history may be obtained from a sleep diary filled out by the patient or by an interview with the patient's bed partner concerning the quantity and quality of the patient's sleep. Specialized sleep studies may be recommended, but only if there is suspicion that the patient may have a primary sleep disorder such as sleep apnea or narcolepsy. 

Insomnia Treatment

Transient and intermittent insomnia may not require treatment since episodes last only a few days at a time. For example, if insomnia is due to a temporary change in the sleep/wake schedule, as with jet lag, the person's biological clock will often get back to normal on its own. However, for some people who experience daytime sleepiness and impaired performance as a result of transient insomnia, the use of short-acting sleeping pills may improve sleep and next-day alertness. As with all drugs, there are potential side effects. The use of over-the-counter sleep medicines is not usually recommended for the treatment of insomnia. 

Insomnia Causes, Symptoms, Diagnosis, Treatmant And Prevention

Treatment for chronic insomnia consists of: 

  • First, diagnosing and treating underlying medical or psychological problems.
  • Identifying behaviors that may worsen insomnia and stopping (or reducing) them.
  • Possibly using sleeping pills, although the long-term use of sleeping pills for chronic insomnia is controversial. A patient taking any sleeping pill should be under the supervision of a physician to closely evaluate effectiveness and minimize side effects. In general, these drugs are prescribed at the lowest dose and for the shortest duration needed to relieve the sleep-related symptoms. For some of these medicines, the dose must be gradually lowered as the medicine is discontinued because, if stopped abruptly, it can cause insomnia to occur again for a night or two.
  • Trying behavioral techniques to improve sleep, such as relaxation therapy, sleep restriction therapy, and reconditioning.

Relaxation Therapy

There are specific and effective techniques that can reduce or eliminate anxiety and body tension. As a result, the person's mind is able to stop "racing," the muscles can relax, and restful sleep can occur. It usually takes much practice to learn these techniques and to achieve effective relaxation. 

Sleep Restriction

Some people suffering from insomnia spend too much time in bed unsuccessfully trying to sleep. They may benefit from a sleep restriction program that at first allows only a few hours of sleep during the night. Gradually the time is increased until a more normal night's sleep is achieved. 


Another treatment that may help some people with insomnia is to recondition them to associate the bed and bedtime with sleep. For most people, this means not using their beds for any activities other than sleep and sex. As part of the reconditioning process, the person is usually advised to go to bed only when sleepy. If unable to fall asleep, the person is told to get up, stay up until sleepy, and then return to bed. Throughout this process, the person should avoid naps and wake up and go to bed at the same time each day. Eventually the person's body will be conditioned to associate the bed and bedtime with sleep. 

How to Prevent Insomnia

Insomnia can occur in response to a behavioral, physical, or mental health issue. Physical, psychological, environmental, and modifiable lifestyle factors can all play a role in preventing the condition, or alleviating the symptoms if it occurs.

Treat Underlying Disease

Chronic disease and pain can cause insomnia for a variety of reasons. Diseases or conditions that may disrupt sleep include:

Discuss with your doctor whether these conditions or any other physical problems can be treated. Proper and timely treatment can reduce symptoms and often lead to an improved night's sleep.

Avoid Certain Medications

Certain medicines can cause sleeping difficulties as a side effect. Having to take one or more of these drugs can lead to insomnia. Some medicines that may affect sleep include:

  • Decongestants and other Cough and Common Cold remedies
  • Diet pills
  • Steroids
  • Some High Blood Pressure medicines (beta blockers)
  • Theophylline (Asthma-Adult medicine)
  • Phenytoin (anti-seizure medicine)
  • Levodopa (medicine to treat Parkinson's Disease)
  • Stimulants to treat Attention Deficit Hyperactivity Disorder and Attention Deficit Disorder, excessive daytime sleepiness, or Overweight
  • Selective serotonin reuptake inhibitors (antidepressants)
Avoid taking over-the-counter cold medicines if you have difficulty sleeping. If you are taking a prescription medicine that disturbs sleep as a side effect, talk to your doctor. You may be able to take an alternative drug that does not disturb your sleep.

Note: Do not stop taking any prescription medicine without the approval of your doctor.

Reduce Stress

Stress is considered by most sleep experts to be the number one cause of short-term sleeping difficulties. Common triggers include school- or job-related pressures, a family or marriage problem, and a serious illness or death in the family. Exercise regularly to help relieve stress. But, do so at least three hours before bedtime. A workout after that time may actually keep you awake because your body has not had a chance to cool down and relax. Other techniques that may reduce stress are meditation and deep breathing.

Adjust Daily Activities

Habits and activities that you do during the day or night can interfere with getting a good night's sleep. Adjust your time schedule in order to avoid:

  • Exercising close to bedtime
  • Eating a large meal prior to bedtime
  • Following an irregular morning and nighttime schedule
  • Working or doing other mentally intense activities right before or after getting into bed
  • Napping during the day, which can interfere with your ability to sleep at night-If you nap, do so for no more than one hour during the day.

Avoid Nicotine, Caffeine, and Alcohol

Insomnia Causes, Symptoms, Diagnosis, Treatmant And Prevention
Insomnia Complications

Tobacco Use Disorder and caffeine stimulate the nervous system. Although this may give you a sense of energy during the day, these substances may interfere with your ability to go to sleep at night. Alcohol depresses the nervous system. Although alcohol makes you feel drowsy at bedtime, it interferes with normal sleep patterns during the night and causes restlessness. Avoid using tobacco products and drinking beverages that contain caffeine or alcohol in the afternoon or evening. They can create a vicious cycle of poor sleep at night and an increased use of stimulants during the day to counteract the drowsiness from poor sleep.

Follow Bedtime Rituals If Working Night Shifts

Night shift work forces you to try to sleep when activities around you and your own "biological rhythms" signal you to be awake. One study shows that night shift workers are 2-5 times more likely than are employees with regular, daytime hours to fall asleep on the job because of poor sleep quality. If you work the night shift, speak with your employer about how to minimize the dangers of fatigue. Discuss your need for creating a sleep environment in the daytime with your family or those with whom you live. Try to keep a consistent schedule for sleep throughout the week, even on your days off. Make your daytime home environment conducive to sleep by keeping light out of the room you sleep in and minimizing external noise.

Create Good Sleep Habits and Environment

A distracting sleep environment, such as a room that is too hot or cold, too noisy, or too brightly lit can be a barrier to sound sleep. Interruptions from pets, children, or other family members can also disrupt sleep. Other influences may be the comfort and size of your bed and the habits of your sleep partner. Try to create an environment that is restful by painting your room a light blue or green, using shades to block light, and playing soothing music or “white noise” (such as a fan). Seek medical help for a sleeping partner who snores loudly, or consider separate sleeping arrangements.

Establish a regular, relaxing bedtime routine that will allow you to unwind and send a "signal" to your brain that it is time to sleep. Avoiding exposure to bright light before bedtime and taking a warm bath may help. Do not use your bed for anything other than sleep or sex. Your bed should be associated with sleep. Avoid “clock watching” after going to bed. Also, avoid drinking fluids just before bed.

Prepare for Jet Travel

Jet lag is the inability to sleep as a result of crossing many time zones in a short period of time. This can disturb your biological rhythms and deprive you of good sleep. To help minimize its effect, get a good night's sleep before traveling, drink plenty of water, and avoid alcohol during the trip.

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