Sleep Disorders: Insomnia

Insomnia is a medical condition where a patient has a very difficult time falling asleep, staying asleep, or waking up from sleep too early and not being able to go back to sleep.   

What are the signs and symptoms?

Patients often lie awake for hours with their minds racing and get up in the morning feeling exhausted.  The condition may worsen the longer it goes on, and the patient may develop further anxiety from worrying about how bad they will feel the next day, which in turn makes insomnia worse.  Symptoms can include excessive fatigue, irritability, difficulty with concentration, memory loss and poor performance at daily tasks.

What are the risk factors and triggers?

Risk factors for insomnia include stress, certain medications which act as stimulants, drinking too much caffeine or alcohol, as well as foods such as chocolate.  Contributing conditions include anxiety, depression, post-traumatic stress disorder, and medical conditions such as congestive heart failure, asthma, chronic bronchitis, restless leg syndrome and high levels of thyroid hormone (a condition known as hyperthyroidism).

How is it diagnosed?

The diagnosis of insomnia is made by a trained clinician who is familiar with the disorder and can identify the cause and who can then hopefully direct successful treatment.

What is the treatment?

The treatment for insomnia depends on the cause and can include addressing an underlying medical or psychiatric problem if there is one.  Many pills (known as hypnotic agents) are used to treat insomnia and are available over the counter and by prescription.  However, it is not healthy to take long-term sleeping pills, and a better option is cognitive behavioral therapy for insomnia.  Trained psychologists or sleep disorders physicians administer this type of therapy, and it is more successful in the long run in treating insomnia than simply taking pills at night.

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