Insomnia

Having trouble falling asleep or staying asleep is a problem for one in three people.  It can disturb your waking hours as well as your sleeping hours and can cause problems with concentration.

 

Types of Insomnia

• Transient - Insomnia lasts only a few nights, perhaps brought on by excitement or stress.
• Short term - Insomnia lasting 2-3 weeks can be due to ongoing stress at work or home.  After the stressful problem subsides, or when the person gets used to a new level of stress, then sleep will return to normal.
• Chronic - Someone reports poor sleep most nights.  In more than half of all cases, physical problems are the cause of the poor sleep.  In these cases, we need to find out the cause of the sleep problem in order to treat it safely.  Insomniacs who are not aware of their own breathing problems can put themselves in danger when they take sleeping pills.   Talk with your doctor if you suspect you have trouble with breathing during your sleep.  Many of those with breathing trouble can solve their sleep issues with the use of a treatment called CPAP(continuous positive airway pressure).

 

What causes it?	What helps?
Occasional stress.	Know that it will go away may help you to get through it.  Good sleep habits (see p. 3) will help you a return to good sleep.
Persistent stress.	Counseling, making life changes.
Psychiatric problems such as depression, anxiety, schizophrenia.	Medicine and psychotherapy.
Use of stimulants such as caffeine, nicotine, non-prescription drugs for weight loss, asthma, and colds.	Stop use of the stimulant.
Use of alcohol. Decrease drinking.	While a nightcap may help you get to sleep, it is likely to cause you to wake up throughout the night.
Erratic hours such as shift work.	Keep a sleep schedule.  Those who do not keep to one are likely to have sleep problems.
Low or restricted levels of daytime activity.	Increase your activity during the day to decrease sleep problems at night.
Learned insomnia or worry over sleep.	Improve sleep habits and do something to diffuse anxiety.  This can lessen a wakeful feeling when bedtime nears.
Misuse or overuse of sleeping pills.  Sleeping pills stop being effective after a few weeks.  When they are stopped suddenly, sleep can be made worse for a time.	Cut back gradually on the use can prevent this.  A health care provider should help with this process.
Noise and light can disrupt sleep even if they don't cause you to wake fully.	Try to reduce noise, use earplugs or white noise, reduce light in the room where you sleep.
Physical problems such as pain, breathing problems, leg movements, reflux.	Talk with your doctor.

 

 

When to seek help

 

If your sleep has been disturbed for more than a month and if it impacts the way you feel or function during the day, you should see someone.

 

Can sleeping pills help?

 

Sleeping pills are not a cure for insomnia.  There are times when they can help provide a sounder sleep and reduce daytime fatigue, but they should be used with caution.  To use them safely, you should first rule out that your sleep problem could be due to breathing problems.  As mentioned above, those people who have loud snoring or periods when their breathing stops should not use sleeping pills.  Sleeping pills may help with these issues:

• Jet lag
• Shift work schedule changes
• Acute stress (e.g. the start of a new job)
• Predictable stress (e.g. the night before an important meeting)
• Chronic insomnia.  Flare-ups can be lessened with periodic use.
• Certain medical problems (e.g. limb movements which disturb sleep)

How do I use sleeping pills?

 

You should take a sleeping pill for a night or two and then skip it if sleep has improved.  Sleeping pills most often are not prescribed for longer than 3 weeks.  Nightly use is seldom advised.  Sleeping pills should never be combined with alcohol.

 

Good sleep habits

• Get up about the same time daily.
• Go to bed only when sleepy.
• Do pre-sleep routines such as a bath, 10 minutes, or reading.
• Exercise regularly.  Confine hard exercise to early daytime hours, and do mild exercise (stretching or walking) at least four hours before bedtime.
• Keep a regular schedule for meals, chores, and medicines.
• Avoid caffeine within six hours of bedtime.  Do not drink alcohol, especially when sleepy.
• Avoid smoking close to bedtime.
• Try to nap at the same time every day, if you nap.
• Avoid sleeping pills or use them wisely.  Do not drink alcohol while taking sleeping pills.

 

The Spanish version of this Health Facts for You is #6437.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 07/11/2008

Copyright © 07/11/2008 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. UWH #6195

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