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Insomnia - overview

Definition

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.

Sleep Myths and Facts

What percent of adults are getting 6 hours or less of sleep each night?

The correct answer is 30%. Nearly 30% of adults sleep an average of 6 hours or less each night. If you’re getting less than 7 - 9 hours of sleep each night, talk to your doctor about how you can get more sleep.

Lack of sleep is linked to which if the following?

The correct answer is all of the above. Lack of sleep can cause you to nod off while driving or lose focus at work. This can lead to serious accidents and work errors. Do not drive a car, operate heavy machinery, or try to do difficult or risky tasks when you are tired.

Getting too little sleep put you at risk for:

The correct answer is all of the above. Over time, not getting enough sleep can harm your health. People who don't get enough sleep are more likely to have the health problems listed above, and may die earlier than people who get enough sleep.

Which of the following is NOT a good sleep habit?

The correct answer is sleeping in on the weekends. You'll sleep better if you go to bed and wake up at the same times every day, even on weekends. Also be sure to get 7-9 hours of sleep a night. Talk with your doctor if you are having trouble sleeping.

You need the same amount of sleep throughout your lifespan.

The correct answer is false. Sleep patterns change with age. Plus, not everyone needs the same amount of sleep. Children 5-10 years old should get 10-11 hours of sleep daily, teens 10-17 years old need 8.5-9 hours, and adults need about 7-9 hours.

Which of the following can make it hard to get to sleep and stay asleep?

The correct answer is all of the above. Insomnia occurs when you have trouble getting to sleep and staying asleep. The factors listed above all make it harder to sleep. Try making some changes in your TV watching, exercise, and sleep habits, and see what works for you.

Sleeping pills are the best treatment for insomnia.

The correct answer is false. Sleeping pills don't treat the underlying cause of your sleeping problems, but they may help you get some rest. Changing the habits that make it hard to sleep works for most people. Talk to your doctor to find out which approach is best for you.

Getting less than 8 hours of sleep at night is bad for your health.

The correct answer is false. Different people have different sleep needs. Some people only need 6 hours of sleep each night. Others need 9 hours of sleep to work at their best. Find out if you need more sleep by paying attention to how sleepy or tired you are during the day.

Some people stop breathing while they’re asleep.

The correct answer is true. If you stop breathing while you’re sleeping, you may have a condition called sleep apnea. Sleep apnea causes your breathing to stop and start. Breathing pauses can last from a few seconds to minutes. If you’re getting enough sleep but still feel sleepy during the day, ask your doctor if you might have sleep apnea.

Which of the following is a symptom of sleep apnea?

The correct answer is all of the above. If you notice symptoms of sleep apnea, talk with your doctor. Losing weight can decrease the number of apnea spells you have during the night. Your doctor will talk with you about other treatments, including a using a machine to help you breathe while you sleep.

Which group of people is at risk for sleep apnea?

The correct answer is all of the above. Being overweight can make your airways narrower, so it's harder to breathe when you are asleep and your mouth and throat relax. So can enlarged tonsils. Men are also more likely to get sleep apnea.

Drinking alcohol before bed will help you sleep better.

The correct answer is false. Drinking alcohol might make you sleepy, but it keeps you from getting deep sleep. If you have sleep apnea, drinking alcohol can make symptoms worse. You should avoid alcohol close to bedtime.

Alternative Names

Sleep disorder - insomnia; Sleep issues; Difficulty falling asleep; Sleep hygiene - insomnia

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 a different time 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 medicines 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 medicines, herbs, or supplements

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

  • Bipolar disorder.
  • Feeling sad or depressed. (Often, insomnia is the symptom that causes people with depression to seek medical help.)
  • 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.

Health problems may also lead to problems sleeping and insomnia:

  • Pregnancy
  • Physical pain or discomfort.
  • Waking up at night to use the bathroom, common in men with enlarged prostate
  • Sleep apnea

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.

Video: Insomnia

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 health care provider will do a physical exam and ask 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 health problems that may be causing or worsen insomnia, such as:

  • Enlarged prostate gland, causing men to wake up at night
  • Pain or discomfort from muscle, joint, 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.

Some people may need medicines to help with sleep for a short period of time. But in the long run, making changes in your lifestyle and sleep habits is the best treatment for problems with falling and staying asleep.

  • Most over-the-counter (OTC) sleeping pills contain antihistamines. These medicines are commonly used to treat allergies. Your body quickly becomes used to them.
  • Sleep medicines called hypnotics can be prescribed by your provider to help reduce the time it takes you to fall asleep. Most of these can become habit-forming.
  • Medicines used to treat anxiety or depression can also help with sleep

Different methods of talk therapy may help you gain control over anxiety or depression.

Outlook (Prognosis)

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

When to Contact a Medical Professional

Call your provider if insomnia has become a problem.

References

Chokdroverty S, Avidan AY. Sleep and its disorders. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 102.

Morin CM, Benca R. Chronic insomnia. Lancet. 2012;379(9821):1129-1141. PMID: 22265700 www.ncbi.nlm.nih.gov/pubmed/22265700.

Schutte-Rodin S, Broch L, Buysse D, Dorsey C, Sateia M. Clinical guideline for the evaluation and management of chronic insomnia in adults. J Clin Sleep Med. 2008;4(5):487-504. PMID: 18853708 www.ncbi.nlm.nih.gov/pubmed/18853708.

Vaughn BV. Disorders of sleep. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 405.

Wakefield TL, Lam DJ, Ishman SL. Sleep apnea and sleep disorders. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 18.

Review Date: 
2/2/2016
Reviewed By: 
Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.