Insomnia

Nearly everyone has difficulty falling asleep or staying asleep at some time. But, if you have trouble sleeping for a month or longer, you may have chronic insomnia. This condition sometimes results from long-lasting stress, shift work or other things that disrupt your sleep routine. In most cases, though, it’s a symptom or side effect of another condition, such as:

• Depression or anxiety.
• Post-traumatic stress disorder.
• An overactive thyroid.
• Brain illnesses such as Alzheimer’s or Parkinson’s disease.
• Chronic pain from conditions such as arthritis or headaches.
• Heartburn and other gastrointestinal disorders.
• Previous stroke.

If you’re taking certain medicines — such as theophylline for asthma and some allergy and cold medicines — you may experience insomnia as a side effect. And, hot flashes and night sweats can cause insomnia in women during and after menopause.

Prevention

Once insomnia takes hold, just worrying about having another sleepless night can make matters worse. That makes prevention your best strategy. Adopting healthy sleep habits, such as regular exercise and a consistent sleep schedule, can help you avoid insomnia. There are other things you can do to prevent insomnia, such as:

• Don’t smoke. Nicotine is a stimulant that can disrupt your sleep, and nicotine withdrawal can cause you to wake up after three or four hours.
• Avoid alcohol. While an alcoholic drink may help you fall into a light sleep, it keeps you from getting the deeper, more restorative sleep you need.
• Stay away from caffeinated drinks. They stimulate your brain and can keep you awake.
• Get some sun in the morning. Exposure to at least an hour of morning sunlight helps reset your body’s biological clock, which tells your body when it’s time to sleep.
• Minimize daily stress. Try to avoid taking on too many responsibilities at work and at home, and schedule some personal relaxation time into your day. El Camino Health offers classes to help you manage stress more effectively.

Symptoms and Diagnosis

People with insomnia typically take more than 30 minutes to fall asleep, wake up too early or both. You may also:

• Lie awake most of the night, sleeping only for short periods.
• Feel exhausted and sleepy during the day.
• Have trouble with concentration and memory.
• Feel anxious, irritable or depressed.

To determine if you have insomnia, your doctor will ask about your symptoms and your sleep habits. It can help if you keep a sleep diary for a week or two before you see your doctor. A sleep diary tracks when you go to sleep and wake up, what you eat or drink before bed, and other information that can provide clues about the causes of insomnia.

Your health history can also provide important diagnostic information. For example, your doctor may ask about painful injuries or ongoing health problems, such as arthritis or asthma, which can disturb your sleep. He or she will do a physical exam and may suggest blood tests to check for medical causes.

If your doctor suspects you have another sleep disorder that’s causing you to lose sleep, he or she may recommend a sleep study, also called a polysomnogram.

Treatment

If your insomnia is linked to a health condition, such as heartburn or an overactive thyroid, it may be resolved when the underlying cause is treated.

Sleep specialists at El Camino Health draw from a variety of techniques to help improve sleep. Your doctor may prescribe a sleep medication for short-term use or may recommend cognitive behavioral therapy, a form of psychological counseling. In addition, your doctor will educate you about healthy sleep habits, which may be enough to alleviate your insomnia or can be used in combination with other therapies.