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Patient education: Insomnia (The Basics)

Patient education: Insomnia (The Basics)

What is insomnia? — Insomnia is a problem with sleep. People with insomnia have trouble falling or staying asleep, or they do not feel rested when they wake up. Insomnia is not about the number of hours of sleep a person gets. Everyone needs a different amount of sleep.

Short-term insomnia is when a person has trouble sleeping for a few days or weeks. This is usually related to temporary stress and often gets better on its own. Long-term or "chronic" insomnia is when sleep problems last for 3 months or longer.

What are the symptoms of insomnia? — People with insomnia often:

Have trouble falling or staying asleep

Feel tired during the day

Forget things or have trouble thinking clearly

Get cranky, anxious, irritable, or depressed

Have less energy or interest in doing things

Make mistakes or get into accidents more often than normal

Worry about their lack of sleep

These symptoms can be so bad that they affect a person's relationships or work life. They can happen even in people who seem to be sleeping enough hours.

Are there tests I should have? — Probably not. Most people with insomnia need no tests. Your doctor or nurse will probably be able to tell what is wrong just by talking to you. They might also ask you to keep a daily log for 1 to 2 weeks, where you keep track of how you sleep each night.

In some cases, people do need special sleep tests, such as "polysomnography" or "actigraphy."

Polysomnography – Polysomnography is a test that usually lasts all night. It can be done in a sleep lab or in your home. During the test, monitors are attached to your body to record movement, brain activity, breathing, and other body functions.

Actigraphy – Actigraphy records activity and movement with a monitor or motion detector that is usually worn on the wrist. The test is done at home, over several days and nights. It will record how much you actually sleep and when.

Should I see a doctor or nurse? — Yes. If you have insomnia, and it is troubling you, see your doctor or nurse. They might have suggestions for how to treat the problem.

How is insomnia treated? — It depends. If your insomnia is related to stress, pain, or a medical problem, treating that problem can help you sleep better. If you have chronic insomnia, meaning insomnia that lasts longer than 3 months, there are specific treatments that can help. They include:

Cognitive behavioral therapy – Cognitive behavioral therapy for insomnia, or "CBT-I," involves working with a counselor or therapist over several weeks. You will work on understanding your insomnia, learning ways to build better sleep habits, and changing negative thinking patterns that can make insomnia worse. Your therapist can also teach you relaxation exercises that can help.

Part of CBT-I involves learning about "sleep hygiene." These things can also be helpful for people who don't have chronic insomnia but have trouble sleeping sometimes. Having good sleep hygiene means you:

Sleep only long enough to feel rested and then get out of bed

Go to bed and get up at the same time every day

Do not try to force yourself to sleep. If you can't sleep, get out of bed and try again later.

Have coffee, tea, and other foods that have caffeine only in the morning

Avoid alcohol in the late afternoon, evening, and bedtime

Avoid smoking, especially in the evening

Keep your bedroom dark, cool, quiet, and free of reminders of work or other things that cause you stress

Solve problems you have before you go to bed

Get plenty of physical activity, but avoid heavy exercise right before bed

Avoid looking at phones, computer screens, or reading devices ("e-books") that give off light before bed. This can make it harder to fall asleep.

Medicines – There are also medicines that can help with sleep. But doctors usually recommend trying cognitive behavioral therapy first. In some cases, they might recommend starting both at the same time. If your doctor or nurse thinks medicine might help you, they will talk to you about the benefits and risks. Doctors generally do not recommend over-the-counter "sleep aids" for treating chronic insomnia.

If your insomnia is related to problems like depression or anxiety, it can help to treat those problems directly.

Can I use alcohol to help me sleep? — No, do not use alcohol as a sleep aid. Even though alcohol makes you sleepy at first, it disrupts sleep later in the night.

More on this topic

Patient education: Restless legs syndrome (The Basics)
Patient education: Daytime sleepiness (The Basics)
Patient education: Jet lag (The Basics)
Patient education: What is a sleep study? (The Basics)
Patient education: Sleep insufficiency (The Basics)

Patient education: Insomnia (Beyond the Basics)
Patient education: Insomnia treatments (Beyond the Basics)

This topic retrieved from UpToDate on: Mar 03, 2022.
This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider's examination and assessment of a patient's specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms ©2022 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.
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