Insomnia
Understanding Insomnia
Insomnia is trouble falling asleep, staying asleep or waking up too early, even when you have enough time to sleep, along with daytime effects such as fatigue, poor concentration or irritability. Insomnia is considered chronic when it happens at least three nights a week for three months or longer. It affects up to 30% of adults at some point.
Common contributors include:
- Stress, anxiety, depression or major life changes
- Pain, reflux, frequent urination and other medical conditions
- Caffeine, alcohol, nicotine and some medications
- Irregular sleep schedules, shift work or too much time in bed
- Other sleep disorders such as sleep apnea, restless legs syndrome or circadian rhythm problems
Diagnosis & Treatment
How we evaluate insomnia
We take a detailed sleep and medical history, review your medications and habits, and often ask you to keep a sleep diary for one to two weeks. A sleep study is not needed for most people with insomnia, but we order one when we suspect another sleep disorder, such as sleep apnea or periodic limb movements, is playing a role.
Treatment options
- Cognitive behavioral therapy for insomnia (CBT-I), the recommended first-line treatment. It retrains sleep habits through stimulus control, sleep scheduling, relaxation techniques and changing unhelpful thoughts about sleep
- Treating conditions that disrupt sleep, such as sleep apnea, pain, reflux or restless legs
- Sleep hygiene and schedule adjustments
- Medication in selected cases, chosen carefully and reviewed regularly
See also: Shift Work Disorder · Restless Legs Syndrome