Theres No One Test For Insomnia
Currently, there is no specific diagnostic test for insomnia. Instead, your primary care provider or a sleep specialist will use a variety of tools to evaluate your symptoms and determine the best treatment approach. Tools that can be helpful in measuring insomnia symptoms include:
- A sleep log
- A sleep inventory
- Blood tests
- A sleep study
Using all of these tools gives doctors a picture of the factors affecting your sleep and helps them determine if there might be an underlying psychological or medical problem behind your sleep trouble that needs to be addressed, or what type of help you need.
One critical component of diagnosing insomnia is accurately and comprehensively measuring the problems the condition is causing so that all of those symptoms can be addressed in a treatment plan. For instance, if theres an unidentified underlying medical condition, say, arthritis, thats contributing to your insomnia, any amount of behavioral therapy you do may be futile if no ones addressing the chronic pain keeping you awake at night.
If you have sleep problems, here are some topics you may want to bring up with your doctor, according to the National Sleep Foundation:
Suffering From Insomnia : 21 Things To Do When You Cant Sleep
Insomnia has become pandemic. Why cant I sleep! is the 2 a.m. cry of frustration and desperation from millions of bedrooms around the globe. How can you change your lifestyle or bedtime habits to relieve your own insomnia symptoms and remove your name from the list of sufferers?
No one enjoys the results of missed sleep, even for only one night. For those who suffer sleeplessness on a regular basis, there is ever-growing hope for finding a natural solution. If you are searching for relief from persistent insomnia without prescribed medications, there are a variety of ways to make a good start.
Theres a long list of dos and donts to consider. Insomnia can be caused by what you do, what you eat, and even your sleeping environment. Insomnia symptoms may be greatly reduced by changing only one or two bedtime habits, or it may require a major lifestyle commitment to alleviate the causes of sleeplessness.
Why Is Sleep Important
Sleep is essential for good health. During sleep, our bodies and brains repair themselves. Some research suggests our brains use the time during sleep to clear away toxins that build up during the day.25 Sleep is also important to our ability to learn and form memories. Not getting enough sleep puts people at risk for health problems, including high blood pressure, obesity, and depression.
What Should I Ask My Healthcare Provider About Insomnia
If you have insomnia, you may want to ask your healthcare provider:
- Am I taking any medications keeping me awake?
- What changes can I make to sleep better?
- How does cognitive behavioral therapy improve sleep?
- How do I find a therapist?
- Could I have other sleep disorders like sleep apnea?
If you’re suffering from insomnia, don’t hesitate to reach out to your healthcare provider for help. They may offer tips for managing issues that interfere with your sleep. Many people with insomnia rest better after changing their diet, lifestyle and nighttime routines. Or they may also recommend medications or cognitive behavioral therapy.
Last reviewed by a Cleveland Clinic medical professional on 10/15/2020.
What Are Questions To Ask In The Sleep History For Insomnia
To determine the sleep schedule, ask the patient questions such as the following:
What time do you go to bed and get up in the morning?
Do you go to bed and get up at the same times every day? How about during off days?
Has this schedule changed recently?
Inquire about the patient’s sleep environment, as follows:
What are the temperature, bed comfort, and noise and light levels?
Do you sleep better in a chair or when away from home than in your own bed?
Sleep habits can also be determined with questioning. Individuals with insomnia often have poor sleep hygiene. Questions regarding sleep hygiene are as follows:
Before bedtime, do you relax or do you work?
Do you read or watch television in bed?
Is the television or a light kept on during the night?
What do you do if you cannot fall asleep?
If you wake up in the middle of the night, do you fall back to sleep easily? If not, what do you do?
Do you take daytime naps?
Do you exercise? If so, at what time?
Ask patients about symptoms of other sleep disorders, such as obstructive sleep apnea and restless legs syndrome/periodic limb movement disorder .
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What Otc Or Prescription Medications Treat And Cure Insomnia
There are numerous prescription medications to treat insomnia. Generally, it is advised that they should not be used as the only therapy and that treatment is more successful if combined with non-medical therapies. In a study, it was noted that when sedatives were combined with behavioral therapy, more patients were likely to wean off the sedatives than if sedatives were used alone. The most commonly used sleeping pills are listed in the following sections including over-the-counter medications and natural sleep aids.
Prescription Sleep Aids
- Antihistamines with sedative properties have also been used in treating insomnia as they may induce drowsiness, but they do not improve sleep and should not be used to treat chronic insomnia.
- Melatonin: Melatonin is secreted by the pineal gland, a pea-sized structure at the center of the brain. Melatonin is produced during the dark hours of the day-night cycle . Melatonin levels in the body are low during daylight hours. The pineal gland responds to darkness by increasing melatonin levels in the body. This process is thought to be integral to maintaining circadian rhythm. At night, melatonin is produced to help your body regulate your sleep-wake cycles. The amount of melatonin produced by your body seems to decrease as you get older. Melatonin supplements may be beneficial in older patients who have difficulty staying asleep.
Is All Insomnia The Same
Not all insomnia is the same people can experience the condition in distinct ways. Short-term insomnia happens only over a brief period while chronic insomnia lasts for three months or more. For some people, the primary problem is falling asleep while others struggle with staying asleep .
How a person is affected by insomnia can vary significantly based on its cause, severity, and how it is influenced by underlying health conditions.
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Do Complementary Or Alternative Sleep Aids Work
There isn’t enough scientific evidence to say whether most complementary and alternative sleep aids help treat insomnia.24
- Certain relaxation techniques may be safe and effective in treating long-term insomnia. These techniques include using music, meditation, and yoga to relax the mind and body before sleeping.24
- Some dietary supplements also claim to help people sleep. Manufacturers may label dietary supplements like melatonin as a “natural” product. Most of these products have not been proven to help people with insomnia. Melatonin may be useful for treating short-term insomnia for shift workers or people who have jet lag, but you should probably not take it long-term.24
The Food and Drug Administration does not regulate dietary supplements like vitamins, minerals, and herbs in the same way it regulates medicines. Use this Understanding Drug-Supplement Interactions tool to learn how dietary supplements may interact with the prescription and over-the-counter medicines you take.
What Are The Causes Of Insomnia During Pregnancy
Multiple factors can cause insomnia during pregnancy:
- Discomfort: Increased weight and changed body composition can affect positioning and comfort in bed.
- Disrupted Breathing: Growth of the uterus places pressure on the lungs, creating potential for breathing problems during sleep. Hormonal changes can increase snoring and the risk of central sleep apnea, which involves brief lapses in breath.
- Reflux: Slower digestion can prompt disruptive gastroesophageal reflux in the evening.
- Nocturia: Greater urinary frequency can create the need to get out of bed to go to the bathroom.
- Restless Leg Syndrome: The exact cause is unknown, but pregnant women have a greater risk of RLS even if they have never had symptoms before becoming pregnant.
Studies have found that more than half of pregnant women report sleeping problems consistent with insomnia. In the first trimester, pregnant women frequently sleep more total hours, but the quality of their sleep decreases. After the first trimester, total sleep time decreases, with the most significant sleeping problems occurring during the third trimester.
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Why Do Teens Have Trouble Sleeping
Most teens should get 8 to 10 hours of sleep a night. You don’t need to be a math whiz to figure out that if you wake up for school at 6 a.m., you’d have to go to bed at 10 p.m. to get enough sleep. But many teens have trouble falling asleep that early because their brains naturally work on later schedules.
During the teen years, the body’s internal sleep clock is reset to fall asleep later at night and wake up later in the morning. This change happens because teen brains make the sleep hormone melatonin later at night than kids and adults brains do. So, teens have a harder time falling asleep. Sometimes this delay in the sleepwake cycle is so severe that it affects a person’s daily activities. In those cases it’s called delayed sleep phase syndrome or “night owl” syndrome.
This isn’t the only reason teens lose sleep, though. Bright lights and the blue light from electronic devices also delay the release of melatonin, making it even harder to sleep.
Lots of people have insomnia trouble falling asleep or staying asleep. All sorts of things can make it hard to sleep, including:
- feeling uncomfortable or sick
- uncomfortable sleeping environment
- stress or anxiety, like worrying about school, relationships, or problems at home
- mental health problems, such as depression or post-traumatic stress disorder
- some medical problems
- some medicines
- poor sleep habits
Habits That Cause Insomnia And Disrupt Sleep
While treating underlying physical and mental issues is a good first step, it may not be enough to cure your insomnia. You also need to look at your daily habits. Some of the things youre doing to cope with insomnia may actually be making the problem worse.
For example, maybe youre using sleeping pills or alcohol to fall asleep, which disrupts sleep even more over the long-term. Or maybe you drink excessive amounts of coffee during the day, making it harder to fall asleep later. Other daytime habits that can negatively impact your ability to sleep at night include having an irregular sleep schedule, napping, eating sugary foods or heavy meals too close to bedtime, and not getting enough exercise or exercising too late in the day.
Not only can poor daytime habits contribute to insomnia, but a poor nights sleep can make these habits harder to correct, creating a vicious cycle of unrefreshing sleep:
Oftentimes, changing the habits that are reinforcing sleeplessness is enough to overcome the insomnia altogether. It may take a few days for your body to get used to the change, but once you do, youll sleep better.
If youre having trouble identifying insomnia-causing habits
Some habits are so ingrained that you may overlook them as a possible contributor to your insomnia. Maybe your Starbucks habit affects your sleep more than you realize. Or maybe youve never made the connection between that late-night glass of wine and your sleep difficulties.
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What To Do When Insomnia Wakes You Up In The Middle Of The Night
Many people with insomnia are able to fall asleep at bedtime, but then wake up in the middle of the night. They then struggle to get back to sleep, often lying awake for hours. If this describes you, the following tips may help.
Stay out of your head. Hard as it may be, try not to stress over your inability to fall back to sleep, because that stress only encourages your body to stay awake. To stay out of your head, focus on the feelings in your body or practice breathing exercises. Take a breath in, then breathe out slowly while saying or thinking the word, Ahhh. Take another breath and repeat.
Make relaxation your goal, not sleep. If you find it hard to fall back to sleep, try a relaxation technique such as visualization, progressive muscle relaxation, or meditation, which can be done without even getting out of bed. Even though its not a replacement for sleep, relaxation can still help rejuvenate your mind and body.
Do a quiet, non-stimulating activity. If youve been awake for more than 20 minutes, get out of bed and do a quiet, non-stimulating activity, such as reading a book. Keep the lights dim and avoid screens so as not to cue your body that its time to wake up.
Relaxation techniques that can help you get back to sleep
Mindfulness meditation. Sit or lie quietly and focus on your natural breathing and how your body feels in the moment. Allow thoughts and emotions to come and go without judgment, always returning to focus on breath and your body.
Relieving Anxiety That Keeps You From Falling Or Staying Asleep
If sleep worries are getting in the way of your ability to unwind at night, the following strategies may help. The goal is to train your body to associate the bed with sleep and nothing elseespecially not frustration and anxiety.
Use the bedroom only for sleeping and sex. With many of us working from home now, it can be difficult to avoid, but if possible dont work, use your computer, or watch TV in your bedroom. The goal is to associate the bedroom with sleep alone, so that your brain and body get a strong signal that its time to nod off when you get into bed.
Move bedroom clocks out of view. Anxiously watching the minutes tick by when you cant sleepknowing that youre going to be exhausted when the alarm goes offis a surefire recipe for insomnia. You can use an alarm, but make sure you cant see the time when youre in bed.
Get out of bed when you cant sleep. Dont try to force yourself to sleep. Tossing and turning only amps up your anxiety. Get up, leave the bedroom, and do something relaxing, such as reading, meditating, or taking a bath. When youre sleepy, go back to bed.
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What Are Common Causes Of Insomnia
There are numerous potential causes of insomnia, and in many cases, multiple factors can be involved. Poor sleep can also trigger or worsen other health conditions, creating a complex chain of cause-and-effect for insomnia.
On a holistic level, insomnia is believed to be caused by a state of hyperarousal that disrupts falling asleep or staying asleep. Hyperarousal can be both mental and physical, and it can be triggered by a range of circumstances and health issues.
Signs And Symptoms That Mean You May Have Insomnia
Insomnia, which you might have after just one night of bad sleep, involves any one of these three main characteristics or symptoms, explains Sara Nowakowski, PhD, a clinical psychologist and sleep researcher at the University of Texas Medical Branch in Galveston.
If you have insomnia, youll experience one of those symptoms. But its likely that sleep problems at night will also cause some daytime symptoms, too. Daytime red flags to watch for:
- Fatigue or sleepiness
- Lack of energy or motivation
- Concerns or frustration about your sleep
While acute insomnia is short-lived, usually ending after whatever triggered the disruption in sleep disappears, chronic insomnia can linger for weeks or months, even years. Its official definition means sleep woes that occur at least three nights a week for a period of three months. Individuals with chronic insomnia may not even be aware that theyre not sleeping, Dr. Nowakowski says.
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The Symptoms Of Insomnia
While acute insomnia often resolves on its own, chronic insomnia usually needs treatment. How do you know if its chronic? Its the rule of threes: If your sleep problems happen more than three times a week and last more than three months, you may have chronic insomnia.
People with chronic insomnia also experience daytime symptoms, including:
- Feeling tired or fatigued.
- Irritability or a depressed mood.
- Problems with concentration or memory.
Losing your sleep battle can affect every part of your life. It can spill into your day as you struggle with fatigue and decreased attention. Its also associated with conditions such as depression, bipolar disorder and substance use disorder. Eventually, it can lead to heart disease, depression and injury from falls or other accidents.
Risk Factors For Insomnia
Insomnia sufferers dont always have an underlying or coexisting condition that causes the sleep disorder. Still, there are certain factors that can make you more likely to experience recurring episodes of insomnia. For example, major life events such as the death of a loved one, job loss, divorce, illness, starting a new job, or moving may trigger stress that leads to insomnia. Women are also more prone to experience insomnia than men due to hormonal changes during their menstrual cycle, pregnancy, and menopause.
Other common risk factors for developing insomnia include:
- Chronic medical conditions and mental health disorders, such as asthma, gastroesophageal reflux disease , arthritis, depression, anxiety, allergies, and thyroid problems
- Taking certain medications
- Changes in sleep patterns and health as you get older
- Jobs with odd working hours, frequent travel, or changes in schedule
- Poor sleep habits and sleeping environment
- Excessive use of alcohol, caffeine, and nicotine
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