Symptom Information: Insomnia

Symptom:

Insomnia:  Other names: sleeplessness, hyposomnia, insomniac, wakefulness, sleep difficulty, dyssomnia, difficulty in sleeping, sleep deprivation, sleep disturbance.

General Description:

Insomnia is a disorder in which you experience difficulty in falling and/or staying asleep.   Due to this lack of sleep you often awaken feeling un-refreshed which affects your ability to function during the day.  Insomnia affects your energy level, mood, general health, work performance and quality of life.  The amount of sufficient time asleep varies from person to person however, most adults need seven to eight hours of sleep a night. Insomnia is characterized as follows: 

• Transient insomnia— can last from one night to a few weeks
• Intermittent insomnia—occurs from time to time
• Chronic insomnia— occurs most nights and lasts a month or more

Causes:

Some causes of insomnia are:

• Stress - Concerns about work, school, health or family.  Stressful life events.
• Anxiety - Everyday anxieties and anxiety disorders.  
• Depression
• Medications - Some prescription drugs can interfere with sleep:
  • Antidepressants
  • Heart and blood pressure medications
  • Allergy medications
  • Stimulants (such as Ritalin)
  • Corticosteroids.  
  • Caffeine, nicotine and alcohol
• Medical conditions - Chronic pain, breathing difficulties or frequent urination can cause insomnia. 
• Environment - Change in your environment or work schedule 
• Poor sleep habits
• 'Learned' insomnia - This can occur when you worry excessively about not being able to sleep well and try too hard to fall asleep.
• Food - Overeating late in the evening
• Aging -  Change in sleep patterns, change in activity, change in health
• Sleep apnea
• Restless legs syndrome  

Risk factors:

• Gender - If you are a woman, shifts in hormones during the menstrual cycle and in menopause can effect sleep and may play a role.  
• Age - If you are 60 years of age or more. This is due to the changes in sleep patterns as you age, insomnia increases with age.
• Mental Disorder - Depression, anxiety, bipolar disorder, post-traumatic stress disorder can disrupt sleep.  When depressed early-morning awakening is a common.
• Stress. Temporary insomnia can occur during stressful events.  Death of a loved one, a divorce or other major or long-lasting stress  can cause chronic insomnia.
• Work Habits  - Alternating shift work where you work at night at times.
• Travel -  Long distances and jet lag can cause insomnia.

How you can help your doctor:

See your doctor if insomnia makes it hard for you to function during the day.  This list will help you determine what might be the cause of your sleep problem as well as explore treatments.  To prepare for your appointment  think about the following: 

• Keep a sleep diary - Identify:
• How often do you have trouble sleeping, and when did the insomnia begin?
• How long does it take you to fall asleep?
• How often do you awaken at night and how long does it take you to fall back to sleep?
• What time do you go to bed at night and wake up in the morning?  
• How many hours a night do you sleep?
• Do you snore or wake up choking for breath?
• Do you feel refreshed when you wake up?
• Are you tired during the day?
• Do you doze off or have trouble staying awake while sitting quietly or driving?
• Do you nap during the day?
• Identify or map out your bedtime routine.
• Where do you sleep?  
• Is it noisy?
• Too hot or cold?
• Too bright or dark?
• Record what do you eat and drink in the evening.
• Do you smoke or drink alcohol?
• Identify any medications or sleeping pills you take.
• Let the doctor know if you are experiencing a stressful life or work event. 
• Do you take sleeping pills?
• What type of work do you do?
• What is your exercise routine?
• Do you worry about falling asleep or staying asleep?
• Are there sleep problems in your family?
• Have you recently travelled?