Are You Sick?

Insomnia

Is this your symptom?

You often have trouble falling asleep or staying asleep (waking up a lot)
You may wake up too early
The lack of sleep makes you tired, grouchy or you may have trouble focusing

Causes of Insomnia

Insomnia may be the only problem, but it is often triggered by stress, life events, underlying health problems or habits that disrupt or prevent sleep. Common causes include:

Sleep Apnea (serious) causes you to stop and start breathing while you are asleep. You may make a gasping or choking noise while you sleep and wake often. You may not know you have this problem unless someone else (spouse, friend) notices it. It is caused by a partial blockage of the airway and you should contact your doctor. Sleep studies will tell if you have sleep apnea and how severe it is. It may not need any treatment. With more severe sleep apnea, you may need to wear a breathing device at night to keep your airway open. Sleeping pills can make sleep apnea worse.
Anxiety and Depression. Sleep problems are common in people who deal with stress; early waking is common in depression. Concerns about work, health or other life events can all lead to loss of sleep. Also, see care guides for Anxiety and Depression.
Bipolar Disorder (serious). For some people, their mood can change from depression to periods of happiness and overactivity (mania). This is called bipolar disorder (or manic depression). Insomnia may be a significant symptom whether mood is depressed or elated.
Other Sleep Problems. Sleep walking, sleep talking, night terrors, or nightmares can all affect ability to sleep.
Travel or Work Schedules. Your body has its own internal clock (circadian rhythm) which sets your sleep-wake cycle. Changing the normal rhythm due to shift work or travel across different time zones (jet lag) can lead to insomnia.
Medicines. Many meds can interfere with sleep. Talk to your doctor about your medicines if you think they might be affecting your sleep. Examples include:
- antidepressants
- blood pressure meds
- asthma meds
- some over-the-counter pain meds
- allergy and cold meds
- weight loss meds which contain caffeine or other stimulants
Health Problems:
- Insomnia and/or daytime sleepiness can be caused by thyroid problems, diabetes, cancer, heart disease, asthma and other respiratory diseases, gastroesophageal reflux disease (GERD), and Alzheimer's disease.
- Chronic pain from arthritis, nerve entrapments or injuries often affect sleep.
- Urinary problems (prostate or bladder problems) may cause the need to pee several times during the night and interrupt sleep.
- Treatment of the health problem may result in better sleep.
- Limb movement disorders such as Parkinson's and restless leg syndrome may prevent sleep or wake the person from sleep.
- Restless Leg syndrome causes an overwhelming urge to move your legs. There may be a feeling of crawling or creeping in the feet or legs. It is usually worse at night and can prevent sleep. There may also be jerking movements while you are trying to sleep. Symptoms may come and go or be constant. The cause is unclear, but it may be linked to genetics, pregnancy, anemia or kidney failure.
Age. Insomnia is more common the older you get. You may become less physically and socially active and then be less tired and less able to sleep at the end of the day.

When to Call for Insomnia

When to Call for Insomnia
Call Doctor or Seek Care Now You think you need to be seen, and the problem is urgent	Contact Doctor Within 24 Hours You are not taking care of yourself (not eating healthy, not bathing, drinking too much alcohol, using drugs) Feel anxious, scared or worry at night Falling asleep at work or often during the day You think you need to be seen, but the problem is not urgent Contact Doctor During Office Hours You've been told you make choking sounds when you sleep or that you sometimes stop breathing You still have trouble sleeping after using care advice You feel like you need to move your legs often at night and it keeps you from sleeping Moody, grumpy or restless during the day Hard to focus or you feel tired all the time You think an illness or medicine is causing your sleep problems Pain causes insomnia Insomnia lasts more than 1 week You have other questions or concerns	Self Care at Home Your sleeping issue does not cause a problem with your daily activities You recently flew across several time zones (may have jet lag)

Call Doctor or Seek Care Now

You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

You are not taking care of yourself (not eating healthy, not bathing, drinking too much alcohol, using drugs)
Feel anxious, scared or worry at night
Falling asleep at work or often during the day
You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

You've been told you make choking sounds when you sleep or that you sometimes stop breathing
You still have trouble sleeping after using care advice
You feel like you need to move your legs often at night and it keeps you from sleeping
Moody, grumpy or restless during the day
Hard to focus or you feel tired all the time
You think an illness or medicine is causing your sleep problems
Pain causes insomnia
Insomnia lasts more than 1 week
You have other questions or concerns

Self Care at Home

Your sleeping issue does not cause a problem with your daily activities
You recently flew across several time zones (may have jet lag)

Care Advice

What You Should Know about Insomnia:

Most people have trouble sleeping at some stage of their lives.
This can be due to physical problems (such as pain) or behavioral problems (such as anxiety and depression) or both.
You are more at risk of insomnia if you are a woman, older than 60 years, and/or you have other health problems. Also, if you are under a lot of stress or don't have a regular schedule (routines) for work or in your personal life, your sleep is more likely to be affected.
Insomnia affects your quality of life: work, activities and relationships. It can make you at higher risk of accidents (due to sleepiness) and more prone to anxiety or depression.
Here is some care advice that should help.

Have a Bedtime Routine:

Go to bed and wake at the same time each day.
Relax for at least an hour before you go to bed: listen to music, read, meditate, or take a bath.
Make your bedroom dark and quiet. Use curtains, blinds, an eye mask or ear plugs, if you need to.
Be active during the day.
Make sure you have a mattress, pillows and bed covers that are comfortable.
Ask your doctor if any medicines you take could affect your sleep.
Sleep as much as you need to feel rested and then get up.

Things to Avoid:

Avoid smoking, drinking alcohol, tea or coffee at least 6 hours before going to bed.
Avoid eating a large meal late at night
Don't exercise just before you plan to go to bed.
Avoid using electronics (TV, computer, phone) just before going to bed. The bright light will make you more awake.
Avoid stressful work issues late at night. You mind might be too active to allow you to sleep.
Do not sleep in. Stick to your daily routine.
If you know what is keeping you awake, make a change or ask for help.

Maintain a Healthy Lifestyle:

Eat a healthy diet.
Exercise
Stop smoking or do not smoke.
Limit alcohol.
Make small changes. Seek help from your doctor or support groups if you need to.

Stress Management:

We live in a fast-paced world. Managing stress has become an important skill for most people.
Stress is one of the main causes of anxiety, depression and insomnia.
Identify what kind of things cause you to be stressed.
Reduce stress by changing your expectations. Be realistic about what you can achieve. Quiet your inner critic.
Learn to say "No."
Plan time and activities that will allow you to relax.
Ask for help when you need it. It may be that a friend or co-worker can help. Your doctor may also advise you where else you can get help.

Medicines:

Sleeping pills can sometimes be helpful. Talk to your doctor or pharmacist before taking over-the-counter medicines to help with sleep.
Your doctor may suggest a prescription medicine or other therapy once you have talked about your sleep problem.

What to Expect:

Most periods of insomnia are short term. They often go away within a few weeks if the cause is addressed.
If lifestyle changes are not helping, talk to your doctor for advice.

Call Your Doctor If:

You have tried simple changes and still can't get enough sleep
You think you need to be seen
Your problem is getting worse

Remember! Contact your doctor if you or your child develop any "Contact Your Doctor" symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

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