Do I Have Insomnia?

December 1, 2020 / Sleep Disorders

Living with the symptoms of a sleep disorder can leave you feeling Beyond Tired®. Learn more from the NSF here.

This common sleep disorder can impact your ability to function during the day. Learn how to spot the symptoms and get the right treatment if you need it.

Insomnia—with all its tossing, turning, and nighttime disturbance—can wreak havoc on your sleep routine and the way you feel during the day. This disorder often prevents people from achieving the quality or quantity of sleep that their body needs to function at its best. The end result: daytime fatigue, as well as a decline in focus, concentration, and cognitive performance during waking hours. Learning the risk factors and symptoms associated with insomnia can help you understand ways to improve your sleep habits, plus when to seek professional help to find treatments for this challenging sleep disorder. No matter how long you may have had insomnia, effective treatment is available.

What Is Insomnia?

Insomnia is a sleep disorder that disturbs a person’s ability to fall asleep and/or stay asleep. You may wake up too early or struggle to return to sleep after awakening during the night. Approximately 40 million Americans experience insomnia every year and more than 57 percent of older adults experience a decline in quality of life and overall health due to insomnia. But while this sleep disorder is common, it’s also a complex condition that goes beyond experiencing an occasional sleepless night. Repeated occurrences can take a toll on your energy level, mood, productivity, and cognitive skills.

The two main types of insomnia are acute insomnia and chronic insomnia. Acute insomnia is short-term and often triggered by stressful life events. This form of insomnia typically resolves on its own without medical treatment. Chronic insomnia, a long-term and more serious form of the condition, occurs at least three nights per week for at least three months. Those suffering from chronic insomnia may find relief with lifestyle changes, cognitive therapy, or medical intervention.

Risk Factors for Insomnia

Insomnia sufferers don’t always have an underlying or coexisting condition that causes the sleep disorder. Still, there are certain factors that can make you more likely to experience recurring episodes of insomnia. For example, major life events such as the death of a loved one, job loss, divorce, illness, starting a new job, or moving may trigger stress that leads to insomnia. Women are also more prone to experience insomnia than men due to hormonal changes during their menstrual cycle, pregnancy, and menopause.

Other common risk factors for developing insomnia include:

Chronic medical conditions and mental health disorders, such as asthma, gastroesophageal reflux disease (GERD), arthritis, depression, anxiety, allergies, and thyroid problems
Taking certain medications
Changes in sleep patterns and health as you get older
Jobs with odd working hours, frequent travel, or changes in schedule
Poor sleep habits and sleeping environment
Excessive use of alcohol, caffeine, and nicotine

Look Out for These Symptoms

People with insomnia often complain about its effect on their ability to function during the day. Insomnia symptoms vary from person to person and can range from fatigue to anxiety, mood swings, and difficulty doing routine things. These are some of the common signs that you may have insomnia:

Difficulty sleeping
Waking up repeatedly or for long periods during the night
Waking up too early
Morning fatigue
Moodiness, irritability, or depression
Cognitive impairment
Relationship problems
Forgetfulness
Increased errors or accidents
Ongoing anxiety about sleep

If your symptoms worsen or persist over an extended period of time, talk with your healthcare provider about treatment options to address your insomnia symptoms.

Diagnosing Insomnia

Although there is no single definitive test to diagnose insomnia, your healthcare provider can use a variety of methods to determine the cause and impact of your sleep issues, rule out potential illnesses, and get to the root of the problem. A physical exam and blood test may also be used to determine if other coexisting medical conditions, medications and other substances, or underlying health issues are contributing factors to your sleep problems. It may help to keep a sleep diary to document your sleep patterns and symptoms for a few weeks. Your healthcare provider might suggest additional testing to determine if what appears to be insomnia is another type of sleep disorder.

How to Treat Insomnia

If you’ve tried to self-soothe your way back to sleep during a restless night, you’re not alone. Herbal tea, reading, listening to soft music, and even drinking alcohol are just a few of the tricks people may try to help themselves fall asleep. Self-medicating with alcohol, though, is unwise: It tends to disrupt sleep and causes long-term side effects.

If you tried following a healthy sleep routine, like NSF’s Best Slept Self^® framework, but aren’t getting the insomnia relief you need, it’s time to talk to your healthcare provider about treatment options. Finding an insomnia treatment that works for you is crucial for your mental and physical health. Left untreated, insomnia can increase the risk of developing obesity, hypertension, depression, and other illnesses.

There isn’t a one-size-fits-all solution for treating insomnia. Some people will find relief through cognitive therapy and relaxation techniques, while others might need prescription medication to improve their sleep quality. Cognitive behavioral therapy for insomnia (CBT-I) works by helping patients identify and eliminate beliefs and behaviors that negatively affect their sleep. This treatment option also focuses on implementing strategies to develop good sleep habits and reduce excessive worrying that keeps you up at night.

Over-the-counter sleeping aids with sedating effects include the antihistamines diphenhydramine and doxylamine succinate, and supplements like melatonin and valerian root are available for short-term use.

Prescription sleeping pills are recommended for short-term or longer-term use, depending on the patient’s needs. Some options include:

Benzodiazepine sedatives and non-benzodiazepine sedatives. These work to help people fall asleep. Examples of benzodiazepine sedatives are triazolam, estazolam, temazepam, flurazepam, and quazepam. Examples of non-benzodiazepine sedatives are zolpidem, eszopiclone, and zaleplon.
Orexin receptor antagonists affect the action of the hormone orexin (chemicals involved in regulating the sleep-wake cycle) in the brain to help you sleep. Examples of orexin receptor antagonists include suvorexant and lemborexant.
Low-dose doxepin works to block histamine receptors. It is intended for people who have trouble staying asleep to continue sleeping.

Ramelteon is another insomnia medication that works differently than the other sedative medications by affecting melatonin receptors. It is designed specifically to help people fall asleep.

Many sleeping aids and medications can have side effects, such as daytime dizziness and grogginess. So make sure to talk with your healthcare provider about all the options, as well as any other medications that you might be taking, before making a treatment decision.

In summary, choosing safe and effective treatment options are key to managing insomnia. Start with some lifestyle changes, such as establishing a regular bedtime and reducing your caffeine intake later in the day so it doesn’t interfere with nighttime sleep. You might also benefit from creating a calm, relaxing sleep environment and eliminating distractions such as TV or texting on your phone before bed. As an additional step, you may want to talk to your healthcare provider about CBT-I and medication options. It can be a challenge to know exactly what’s causing your insomnia, but there are ways to help address it. Working with your healthcare provider to develop a personalized insomnia treatment plan can help you find the relief you need for a solid night’s sleep.

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