Summary about Disease
Insomnia is a common sleep disorder that can make it hard to fall asleep, hard to stay asleep, or cause you to wake up too early and not be able to get back to sleep. It can be acute (short-term) or chronic (long-term). It affects your energy level, mood, health, and performance.
Symptoms
Difficulty falling asleep at night
Waking up during the night
Waking up too early
Not feeling well-rested after a night's sleep
Daytime tiredness or sleepiness
Difficulty paying attention, focusing on tasks, or remembering
Increased errors or accidents
Tension headaches
Irritability, depression, or anxiety
Worrying about sleep
Causes
Stress: Significant life stress, such as job loss, death of a loved one, or divorce.
Travel or work schedule: Jet lag or shift work can disrupt your body's internal clock (circadian rhythm).
Poor sleep habits: Irregular bedtime schedules, uncomfortable sleep environment, using electronic devices before bed.
Mental health disorders: Anxiety, depression, post-traumatic stress disorder (PTSD).
Physical conditions: Chronic pain, arthritis, cancer, heart failure, overactive thyroid, restless legs syndrome, menopause.
Medications: Some medications for allergies, colds, high blood pressure, asthma, and depression.
Caffeine, nicotine, and alcohol: These substances can interfere with sleep.
Eating too much late in the evening: This can lead to physical discomfort while lying down.
Medicine Used
Prescription sleep medications: These include medications like zolpidem (Ambien), eszopiclone (Lunesta), zaleplon (Sonata), and doxepin. These should be used under the guidance of a doctor.
Over-the-counter (OTC) sleep aids: These usually contain antihistamines, such as diphenhydramine or doxylamine. Tolerance can develop quickly.
Melatonin supplements: Melatonin is a hormone that helps regulate the sleep-wake cycle.
Antidepressants: Some antidepressants, like trazodone or amitriptyline (prescribed off-label), can be used at low doses to promote sleep.
Dual orexin receptor antagonists (DORAs): Suvorexant and Lemborexant are prescribed medications that block orexin, a chemical that keeps you awake.
Is Communicable
No, insomnia is not a communicable disease. It cannot be spread from person to person.
Precautions
Establish a regular sleep schedule: Go to bed and wake up at the same time every day, even on weekends.
Create a relaxing bedtime routine: Take a warm bath, read a book, or listen to calming music.
Make your bedroom dark, quiet, and cool: Use blackout curtains, earplugs, or a fan if needed.
Avoid caffeine, nicotine, and alcohol before bed: These substances can interfere with sleep.
Avoid large meals or sugary drinks before bed: These can disrupt sleep.
Exercise regularly: But avoid exercising too close to bedtime.
Limit daytime naps: Naps can make it harder to fall asleep at night.
Use your bed only for sleep and sex: Avoid watching TV, reading, or working in bed.
If you can't fall asleep after 20 minutes, get out of bed and do something relaxing: Return to bed when you feel sleepy.
Consider Cognitive Behavioral Therapy for Insomnia (CBT-I): A structured program that helps you identify and change thoughts and behaviors that contribute to insomnia.
How long does an outbreak last?
Insomnia can be acute (short-term) or chronic (long-term). Acute insomnia lasts for a few days or weeks and is often related to stress or a change in schedule. Chronic insomnia lasts for three months or longer and occurs at least three nights per week.
How is it diagnosed?
Physical exam: To rule out underlying medical conditions.
Medical history: Discussion of sleep habits, medications, and other health problems.
Sleep diary: Tracking sleep patterns over a period of time.
Polysomnography (sleep study): A test that monitors brain waves, heart rate, breathing, and eye movements during sleep. This is usually done in a sleep lab and is reserved for more complex cases.
Actigraphy: A wrist-worn device that tracks sleep-wake patterns.
Timeline of Symptoms
The timeline of insomnia symptoms can vary depending on the cause and severity.
Acute insomnia: Symptoms usually appear suddenly, often triggered by a stressful event. They may resolve within a few days or weeks as the stressor resolves.
Chronic insomnia: Symptoms develop gradually and persist for three months or longer. They may fluctuate in severity over time, with periods of better and worse sleep.
Daytime symptoms: Fatigue, irritability, and difficulty concentrating may become noticeable after just one or two nights of poor sleep. These symptoms tend to worsen with prolonged sleep deprivation.
Important Considerations
See a doctor if your insomnia is severe or persistent: It's important to rule out underlying medical or mental health conditions.
Be cautious about using sleep medications: They can have side effects and can be habit-forming.
CBT-I is often the first-line treatment for chronic insomnia: It's a safe and effective alternative to medication.
Address underlying stressors: Identifying and managing stress can improve sleep.
Be patient: It may take time to find the right treatment for your insomnia.
Maintain good sleep hygiene: Even with treatment, it's important to maintain healthy sleep habits.