January 11, 2011

Sleep Disorders - Insomnia


Insomnia

Insomnia (in-SOM-ne-ah) is a common condition in which you have trouble falling or staying asleep. This condition can range from mild to severe, depending on how often it occurs and for how long. 

Insomnia can be chronic (ongoing) or acute (short-term). Chronic insomnia means having symptoms at least 3 nights a week for more than a month. Acute insomnia lasts for less time. 

Some people who have insomnia may have trouble falling asleep. Other people may fall asleep easily but wake up too soon. Others may have trouble with both falling asleep and staying asleep. 

As a result, insomnia may cause you to get too little sleep or have poor-quality sleep. You may not feel refreshed when you wake up.

Overview

There are two types of insomnia. The most common type is called secondary or comorbid insomnia. This type of insomnia is a symptom or side effect of some other problem. 

More than 8 out of 10 people who have insomnia are believed to have secondary insomnia. Certain medical conditions, medicines, sleep disorders, and substances can cause secondary insomnia. 

In contrast, primary insomnia isn't due to a medical problem, medicines, or other substances. It is its own disorder. A number of life changes can trigger primary insomnia, including long-lasting stress and emotional upset. 

Insomnia can cause excessive daytime sleepiness and a lack of energy. It also can make you feel anxious, depressed, or irritable. You may have trouble focusing on tasks, paying attention, learning, and remembering. This can prevent you from doing your best at work or school. 

Insomnia also can cause other serious problems. For example, you may feel drowsy while driving, which could lead to an accident.

Outlook

Secondary insomnia often resolves or improves without treatment if you can stop its cause—especially if you can correct the problem soon after it starts. For example, if caffeine is causing your insomnia, stopping or limiting your intake of the substance may cause your insomnia to go away.
Lifestyle changes, including better sleep habits, often help relieve acute insomnia. For chronic insomnia, your doctor may recommend a type of counseling called cognitive-behavioral therapy or medicines.

Causes of Insomnia

Secondary Insomnia

Secondary insomnia is the symptom or side effect of another problem. This type of insomnia often is a symptom of an emotional, neurological, or other medical or sleep disorder.

Emotional disorders that can cause insomnia include depression, anxiety, and posttraumatic stress disorder. Alzheimer's disease and Parkinson's disease are examples of common neurological disorders that can cause insomnia.
A number of other conditions also can cause insomnia, such as:
  • Conditions that cause chronic pain, such as arthritis and headache disorders
  • Conditions that make it hard to breathe, such as asthma and heart failure
  • An overactive thyroid
  • Gastrointestinal disorders, such as heartburn
  • Stroke
  • Sleep disorders, such as restless legs syndrome and sleep-related breathing problems
  • Menopause and hot flashes
Secondary insomnia also may be a side effect of certain medicines. For example, certain asthma medicines, such as theophylline, and some allergy and cold medicines can cause insomnia. Beta blockers also may cause the condition. These medicines are used to treat heart conditions.

Commonly used substances also may cause insomnia. Examples include caffeine and other stimulants, tobacco or other nicotine products, and alcohol or other sedatives.

Primary Insomnia

Primary insomnia isn't a symptom or side effect of another medical condition. This type of insomnia usually occurs for periods of at least 1 month. 

A number of life changes can trigger primary insomnia. It may be due to major or long-lasting stress or emotional upset. Travel or other factors, such as work schedules that disrupt your sleep routine, also may trigger primary insomnia.
Even if these issues are resolved, the insomnia may not go away. Trouble sleeping may persist because of habits formed to deal with the lack of sleep. These habits may include taking naps, worrying about sleep, and going to bed early.

Researchers continue to try to find out whether some people are born with a greater chance of having primary insomnia.

Signs and Symptoms of Insomnia

The main symptom of insomnia is trouble falling and/or staying asleep, which leads to lack of sleep. If you have insomnia, you may:
  • Lie awake for a long time before you fall asleep
  • Sleep for only short periods
  • Be awake for much of the night
  • Feel as if you haven't slept at all
  • Wake up too early
The lack of sleep also can cause other symptoms. You may wake up feeling tired or not well-rested, and you may feel tired during the day. You also may have trouble focusing on tasks. Insomnia can cause you to feel anxious, depressed, or irritable. 

Insomnia may affect your daily activities and cause serious problems. For example, you may feel drowsy while driving. Driving while sleepy leads to more than 100,000 car crashes each year. In older women, research shows that insomnia raises the risk of falling. 

If insomnia is affecting your daily activities, see your doctor. Treatment may help you avoid symptoms and problems related to the condition. Also, poor sleep may be a sign of other health problems. Finding and treating those problems could improve both your health and your sleep.

Source: National Heart Lung and Blood Institute