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If you often feel so tired and exhausted that you have trouble doing everyday tasks during the day, you are not getting enough sleep. It is estimated that about one out of five people have trouble sleeping. But the good news is that there are a number of things you can do about this problem on your own. Find out about the different options here.

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Insomnia - overview

Sleep disorder - insomnia; Sleep issues; Difficulty falling asleep

Last reviewed: May 11, 2014.

Insomnia is trouble falling asleep, staying asleep through the night, or waking up too early in the morning.

Episodes of insomnia may come and go or be long-lasting.

The quality of your sleep is as important as how much sleep you get.

Causes

Sleep habits we learned as children may affect our sleep behaviors as adults. Poor sleep or lifestyle habits that may cause insomnia or make it worse include:

  • Going to bed at different times each night
  • Daytime napping
  • Poor sleeping environment, such as too much noise or light
  • Spending too much time in bed while awake
  • Working evenings or night shifts
  • Not getting enough exercise
  • Using the television, computer, or a mobile device in bed

The use of some medications and drugs may also affect sleep, including:

  • Alcohol or other drugs
  • Heavy smoking
  • Too much caffeine throughout the day or drinking caffeine late in the day
  • Getting used to certain types of sleep medicines
  • Some cold medicines and diet pills
  • Other over-the-counter or prescription medicines, herbs, or supplements

Physical, social, and mental health issues can affect sleep patterns, including:

  • Overactive thyroid gland.
  • Waking up at night to use the bathroom.
  • Feeling sad or depressed. (Often, insomnia is the symptom that causes people with depression to seek medical help.)
  • Physical pain or discomfort.
  • Stress and anxiety, whether it is short-term or long-term. For some people, the stress caused by insomnia makes it even harder to fall asleep.

With age, sleep patterns tend to change. Many people find that aging causes them to have a harder time falling asleep, and that they wake up more often.

Symptoms

The most common complaints or symptoms in people with insomnia are:

  • Trouble falling asleep on most nights
  • Feeling tired during the day or falling asleep during the day
  • Not feeling refreshed when you wake up
  • Waking up several times during sleep

People who have insomnia are sometimes consumed by the thought of getting enough sleep. But the more they try to sleep, the more frustrated and upset they get, and the harder sleep becomes.

Lack of restful sleep can:

  • Make you tired and unfocused, so it is hard to do daily activities.
  • Put you at risk for auto accidents. If you are driving and feel sleepy, pull over and take a break.

Exams and tests

Your doctor will do a physical exam and ask you questions about your current medications, drug use, and medical history. Usually, these are the only methods needed to diagnose insomnia.

Treatment

Not getting 8 hours of sleep every night does not mean your health is at risk. Different people have different sleep needs. Some people do fine on 6 hours of sleep a night. Others only do well if they get 10 to 11 hours of sleep a night.

Treatment often begins by reviewing any drugs or medical conditions that may be causing or worsen insomnia, such as:

  • Enlarged prostate gland, causing men to wake up at night
  • Pain or discomfort from arthritis or nerve disorders

You should also think about lifestyle and sleep habits that may affect your sleep. This is called sleep hygiene. Making some changes in your sleep habits may improve or solve your insomnia.

Using medicine to treat insomnia can sometimes be useful. But there can be risks. It may help to see a psychiatrist or another mental health provider to test for mood or anxiety disorders that can cause insomnia.

  • They may use talk therapy, such as cognitive-behavioral therapy, to help you gain control over anxiety or depression.
  • A psychiatrist may also prescribe antidepressants or another medicine to help you sleep and to address any mood or anxiety disorders you might have.

Outlook (prognosis)

Most people are able to sleep by practicing good sleep hygiene.

When to contact a medical professional

Call your doctor if insomnia has become a problem.

References

  1. Morgenthaler T, Kramer M, Alessi C, Friedman L, Boehlecke B, Brown T, et al. Practice parameters for the psychological and behavioral treatment of insomnia: an update. An American Academy of Sleep Medicine report. Sleep. 2006;29:1415-1419. [PubMed: 17162987]
  2. Morin CM, Benca R. Chronic Insomnia. The Lancet. 2012 March24; vol. 379 (9821):1129-1141. [PubMed: 22265700]
  3. Vitiello MV, Rybarczyk B, Von Korff M, Stepanski EJ. Cognitive behavioral therapy for insomnia improves sleep and decreases pain in older adults with co-morbid insomnia and osteoarthritis. J Clin Sleep Med. 2009 Aug 15;5:355-362. [PMC free article: PMC2725255] [PubMed: 19968014]
  4. Wickwire EM, Collop NA. Insomnia and sleep-related breathing disorders. Chest. 2010;137:1449-1463. [PubMed: 20525657]

Review Date: 5/11/2014.

Reviewed by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

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  • Overview: InsomniaOverview: Insomnia
    We have all had nights where we toss and turn in bed and worry about getting enough sleep to make it through the next day. But if constant worry or bad sleep habits are preventing you from sleeping properly, there are many products and approaches you could try out to get a better night's sleep. These include relaxation techniques and improving your "sleep hygiene." Sleeping pills are usually not a good idea - they are only considered for people with severe insomnia, and are then only used temporarily.
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