The common symptoms of insomnia include difficulty falling or staying asleep, unpredictable sleep (good days and bad days), fatigue during the day, forgetfulness, concentration problems, irritability, depression/anxiousness, less motivation/energy, an increase in errors/accidents, and an ongoing worry about getting enough sleep. 2
Insomnia can affect your personal relationships, your job and daily functioning. 2 Insomnia is a problem when it has a significant effect on your life.
If you have insomnia, start by seeing your doctor, as insomnia can be caused by many different conditions (i.e. stress, metabolic disturbances, mental health, medical illnesses, etc.)
Your doctor will likely do appropriate testing. A good treatment start is behavioral therapy, which can be very effective alone or with medications. 3
Several techniques you can try are:
- Working to develop good sleep habits like going to sleep and waking up at the same time every day
- Relaxation therapy (including muscle relaxation)
- Use your bed for sleeping (and sex) only, not for reading, watching TV or using a computer
- Getting out of bed if you can’t fall asleep and returning to bed only when you feel sleepy
You may consider seeing a specialist to help with the following techniques: cognitive behavioral therapy, phototherapy (controlled light exposure), chronotherapy (to adjust circadian rhythms), or biofeedback (to have visual cues about your tension levels). 3,4
Limited use of medications can also help, but should be done with close supervision by your doctor. 3,4
Although these medications can be beneficial for the treatment, serious side effects can occur. Many of these medications have an addictive potential and should only be used over a limited duration.
These medications include the sedative-hypnotics such as benzodiazepines (ex: lorazepam, temazepam), the non-benzodiazepines (ex: zaleplon, eszopiclone and zolpidem) 3. Other medications include ramelteon and doxepin. 3 Over-the-counter antihistamines have also been used for insomnia (ex: diphenhydramine), but they are of little benefit. 2,3
Alcohol and street drugs are not a safe or recommended method of getting adequate sleep and can actually decrease the quality of sleep. Alternative treatments for insomnia that have shown some benefit can include acupressure, Tai Chi, massage and yoga.
Other methods can include herbal/complementary medications such as valerian root, melatonin, or aromatherapy—although these methods show very limited to no support from scientific studies. 3,4
Please refer to the references below and talk to your medical professional in order to adequately treat insomnia.
1Bonnet, et al. “Overview of Insomnia.” UptoDate. 23 April 2014.
2Bonnet, et al. “Patient Information: Insomnia (Beyond the Basics).” UptoDate. 23 April 2014.
3Bonnet, et al. “Patient Information: Insomnia (Beyond the Basics).” UptoDate. 19 March 2014.
4Bonnet, et al. “Treatment of Insomnia” UptoDate. 30 April 2014.
This blog post was contributed by Dr. Roberto B dela Cruz, Jr., a family medicine specialist on the medical staff at Baylor Family Health Center at Richardson.