Each year nearly 60 million Americans suffer from insomnia, which can lead to serious sleep deficits and problems.
Insomnia tends to increase with age and affects about 40 percent of women and 30 percent of men.
Characterized by difficulty in falling asleep, staying asleep or feeling less than refreshed after a full night’s sleep, insomnia is associated with the waking conditions of fatigue, irritability and problems in concentration.
Insomnia is not defined by the number of hours someone sleeps each night. The amount of sleep an individual needs may vary, but the amount obtained should be enough to feel fully refreshed upon awakening. The average person requires at least seven to eight hours of sleep a night. Occasionally, people do well with less sleep, while others require more.
Insomnia can vary in how long it lasts and how often it occurs. Short-term or acute insomnia can disrupt sleep patterns from a single night to several weeks. The symptoms can also be intermittent, or come and go, resulting in periods of time where there is no problem with sleeping. Short-term insomnia can be caused by significant life stress, illness and environmental factors such as noise or light, or shift work changes.
Having insomnia for three nights a week for a month or longer is considered to be long-term or chronic insomnia. Although it can be caused by many things, it most often occurs with other health problems. Common causes of chronic insomnia include depression, chronic stress, and pain or discomfort at night. A person with insomnia may also have an underlying sleep disorder such as sleep apnea, narcolepsy, and restless legs syndrome.
A sleep specialist can determine whether an individual suffers from primary insomnia or secondary insomnia.
In primary insomnia, the difficulty in sleeping is independent of other medical problems. In secondary insomnia, an underlying health problem causes the person’s inability to sleep.
These health problems may include sleep disorders such as obstructive sleep apnea syndrome or restless legs syndrome, or other medical conditions such as depression, asthma, heartburn, cancer, and arthritis. Many prescription or over the counter medications can also interfere with sleep.
The history and physical examination performed at the initial office visit are the most important step in accurately diagnosing insomnia. Often the cause is clear from history, and treatment will be initiated without further testing.
In other cases, the physician may feel further testing is appropriate. These tests may include polysomnography, actigraphy or psychological testing. Once the testing results are available, a treatment plan will be formulated.
Treatments for insomnia can vary depending upon the underlying cause. In secondary insomnia, treatment of the underlying sleep disorder or medical condition is essential.
In primary insomnia, treatment plans are individualized by the physician and may include referral to our behavioral therapist to discuss sleep hygiene, and often other behavioral methods such as progressive muscle relaxation. Medications may be used when the physician feels it is appropriate.
To refer a patient or to consult with a sleep medicine specialist please call the Sleep Medicine Center at 314-362-4342.