Insomnia sucks. Most of us get a bout of it every so often, usually because we are stressed, worried about getting up early, overly excited, etc. However, some people suffer from chronic insomnia, which can last for three nights, a week, or three months or more.
So, what is insomnia, and what types of insomnia are there?
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Insomnia is the difficulty in falling asleep, staying asleep, or waking up early in the morning and not being able to sleep again. Other symptoms include drowsiness, fatigue, irritability, variable sleep (some days you sleep well and others not), increased errors, ongoing worry about sleep, and difficulty concentrating.
There are many causes of insomnia, and these are generally divided into factors associated with short-term or long-term insomnia. Short-term or acute insomnia can last for a few days or weeks, while long-term or chronic insomnia occurs for at least three nights a week for at least three months.
Acute insomnia is much more common than chronic insomnia, but overall they cause a significant healthcare burden¹, with combined costs in the United States exceeding $100 billion annually. We all have the occasional sleepless night, and life circumstances can cause a run of them.
Short-term or acute insomnia is usually associated with stress or changes to your schedule or environment. Some examples include:
Negative life events such as losing a loved one, issues at work or school, relationships, finances, and worrying or constantly thinking about these problems.
Insomnia is common when you throw off your body's circadian rhythm. This can result from traveling across time zones.
Working a shift you are not used to, frequently changing shifts, or trying to live on a schedule your body is adjusting to.
Poor sleep hygiene
A lot of us have habits that result in insomnia. This might include not having a regular sleep schedule, taking too many naps, using screens too close to bedtime, exercising too close to bedtime, etc. Another thing is using your bed for anything but sleep. Doing this can mean your brain is trained to associate your bed with reading, work, etc., rather than sleep.
An uncomfortable sleeping environment
This can be because your mattress is not the right firmness, a room that is not dark enough, too much noise, etc. Sometimes the cure for insomnia is as simple as using a white noise generator to block out the city noises from outside or changing your pillow.
Eating too late in the evening
Especially if you are prone to heartburn or other digestive problems.
Drinking caffeine too late in the evening
Caffeine is a stimulant and is designed to keep you awake. Avoid drinking caffeinated beverages after midafternoon.
Excessive consumption of alcohol
This can cause you to sleep, but not to sleep properly. Some people with insomnia may get into a vicious cycle of using a "nightcap" to try and sleep, which only makes things worse.
Nicotine, another stimulant, can also keep you awake at night.
In most cases, short-term insomnia goes away once the cause is identified and dealt with. This might involve simple lifestyle changes, or it might mean something more complicated, such as learning better stress management techniques.
As a note, women are more likely to experience insomnia than men, and it is more common during pregnancy or menopause.
Long-term or chronic insomnia often occurs with other conditions, which include:
Medications, including over-the-counter medications and caffeine.
Medical illnesses, including respiratory disorders, diabetes, and disorders that cause pain, stress, or limitation of movement.
Neurological disorders, including Parkinson's and Alzheimer’s disease.
Sleep disorders, including sleep apnea and restless leg syndrome.
Treating the underlying condition is the best way to treat insomnia. Your doctor may prescribe medication to help you sleep, but usually only after other treatments have failed or as a stop-gap measure while the underlying issue is handled. Sleep aids tend to be habit-forming and are not generally given long-term.
Typical solutions for most people with insomnia include improved sleep hygiene, cognitive behavioral therapy (CBT)¹, and medication as needed.
If you have difficulty falling or staying asleep and it has persisted for a few weeks, you should talk to your doctor about the issue and possibly get a referral to a sleep specialist. Insomnia is annoying, but not something you have to just live with. Rather, it is a problem that can, in fact, be addressed.