Insomnia can mean difficulty falling asleep, difficulty staying asleep, waking up too early, or sleep that is chronically non-restorative or of poor quality. According to the National Sleep Foundation, about one-half of America’s adults say they frequently experience at least one symptom of insomnia. Insomnia is characterized as being acute, chronic, or primary. Acute insomnia lasts less than one month. Chronic insomnia occurs consistently for one month or longer and is likely to be associated with an underlying medical or psychological condition. Primary insomnia is often lifelong and occurs without an underlying cause. When acute insomnia is not addressed, poor sleep can become a habit. The insomniac continually expects that he or she will have difficulty sleeping, a vicious cycle occurs, and insomnia can become long term.
There are pharmacological and behavioral treatments for insomnia and these two approaches are often combined. For acute or chronic insomnia, a sleep specialist will determine if there is an underlying problem and treat this condition first. Behavioral treatments include stimulus control, sleep restriction, cognitive behavioral therapy and relaxation training.
Pharmacological treatments for insomnia include over-the-counter (OTC) medications and prescription hypnotics. OTCs are usually antihistamines and have ingredients that may leave a person feeling groggy and less alert in the morning. They stay in the body longer and side effects may include headaches, nausea, reduced reaction times and dizziness. The Food and Drug Administration (FDA) has approved many sleep promoting medications, called hypnotics. These sleep medications are effective with fewer side effects than other sleeping medications, and are usually prescribed for short periods of time.
A careful sleep history, including a review of current medications, and sometimes an overnight sleep study are used to determine the cause of insomnia.