What is Insomnia? 

Insomnia is characterized by the inability to sleep in three ways; falling asleep, staying asleep or waking too early. Many people will experience insomnia at some point in their lives as there are many causes and these can sometimes be temporary. When insomnia becomes chronic is when you may be referred to a sleep specialist at Baptist Health. 

Types of Insomnia 

How do you know if you have Insomnia. The main symptom of Insomnia is the inability to go to sleep or stay asleep but this can also lead to sleepiness during the day. Since sleepiness can be a symptom of many sleep disorders it is important to talk to your doctor about all possible symptoms. Certain disorders like Periodic Limb Movement Disorder (PLMD) can happen during sleep and you may never know it is happening or waking you up. 

Insomnia can be classified as either a sleep disorder or as a side effect of another type of medical problem or disease:

• Primary insomnia: Primary insomnia is a sleep disorder that occurs independently of any other medical issue or condition. 
• Secondary insomnia: Secondary insomnia refers to the sleeping problems that someone may experience have while suffering from another medical condition, such as asthma, arthritis, acid reflux, cancer, or depression. Secondary insomnia is a symptom rather than a disorder. 

A second means of classifying insomnia is based on frequency and duration:

• Acute insomnia: Acute insomnia is short-term insomnia, lasting from one night to a few weeks at a time. 
• Chronic insomnia: Chronic insomnia is long-term insomnia, occurring at least three nights a week for periods of three months or more. The chronic form can stop suddenly and then reoccur at a later date. 

If you are unsure if you have a cause for concern or believe you may have insomnia use the Epworth Sleepiness Scale or Stop-BANG assessment to rate your symptoms. 

Diagnosis 

Most cases of insomnia can be diagnosed by symptom description to your doctor. A physical exam and detailed sleep history along with symptom description is sometimes all that is used to diagnose this disorder. If other factors are of concern your doctor may recommend you to a sleep specialist at Baptist Health where a sleep study can be performed in the lab or at home and the proper treatment can begin. 

Insomnia Causes 

Insomnia is thought to be caused by the brain’s inability to regulate sleep and wake times. The sleep and wake cycles do not operate at the same time, it is one or the other. When your brain is unable to turn off the wake signals and turn on the sleep signals, insomnia is the result.

In addition to the brain being the cause of sleeplessness, there are other factors that can keep you from getting sleep.

1.  Medical Conditions: Some other sleep disorders can cause disruptions in sleep, such as Restless Legs Syndrome (RLS) or Sleep Apnea. Other non-sleep specific causes also include asthma, arthritis, and chronic pain or sinus conditions. 
2. Medications: Some decongestants or cold medicines can cause difficulty sleeping as well as those taken for heart, thyroid, high blood pressure or depression. 
3. Sleep Habits: Going to sleep and waking at irregular times each day and night, using electronic devices too close to bedtime, eating or drinking caffeine or alcohol in the evening. 

Prevention 

While there is no way to prevent Insomnia there are some things you can do to relieve your symptoms and develop healthy habits for sleep. 

• Avoid sugar, caffeine, alcohol and nicotine at night. 
• Exercise regularly. 
• Nap at the same time each day for short periods to reduce daytime sleepiness. 
• Sleep/Wake at the same time each night/day to set your internal clock. 

There is a higher risk of developing Insomnia if: 

• You work swing shift, night shift of irregular hours. 
• You are over the age of 60. 
• You are female. 
• You have a temporary or permanent stressor, like the unexpected loss of a job. 
• You have a corresponding health condition that can affect sleep. 

Prognosis 

Insomnia can be chronic and while it cannot be cured, its symptoms can be managed with treatment and normal daily activities can continue for most people. 

Insomnia Treatment and Recovery 

For temporary cases of insomnia due to stress, such as an unexpected job loss, your doctor may recommend lifestyle changes surrounding sleep or medications if insomnia is not thought to be from another medical condition. 

When insomnia becomes chronic and other treatments do not alleviate symptoms, cognitive behavioral therapy (CBT-I) may be needed for treatment, and is oftentimes the first treatment as it has proven to be as effective, if not more effective, than medications. 

Your doctor may recommend using specific strategies to help you reduce and eliminate worrisome thoughts and stresses, particularly those associated with falling asleep. When you have insomnia, even for a short period of time, you can develop a fear of not being able to fall asleep, which only furthers your inability to fall asleep. CBT-I can help eliminate those thoughts by using: 

• Relaxation: Muscle relation techniques (where you tense up and slowly release the tense muscles one section at a time), breathing techniques and biofeedback therapy (to help you control involuntary processes by watching monitors). 
• Paradoxical intention: In order to reduce the anxiety of being afraid to fall asleep, paradoxical intention is like the reverse psychology of sleep in that you get into bed trying to stay awake, not trying to fall asleep. 
• Modified sleep schedule: By decreasing the time spent in bed and eliminating naps for a short stint sleep deprivation can make you more tired and able to sleep once you are in bed. Over time the amount of time in bed can be stretched to a normal amount of required sleep. 

Appointments can be made to speak with any of our physicians by calling the sleep center, however you may need a referral to have a study or other tests performed, which can be obtained from your primary care physician.

Learn More About Insomnia from Baptist Health

Insomnia can be conquered. Start by scheduling an appointment with a Baptist Health primary care or sleep specialist today.