Insomnia, which is Latin for “no sleep,” is the inability to fall asleep or remain asleep. Insomnia is also used to describe the condition of waking up not feeling restored or refreshed. According to Dr. Mark Mahowald, Professor of Neurology at the University of Minnesota Medical School and Director of the Minnesota Regional Sleep Disorders Center at Hennepin County Medical Center, insomnia refers to the inability to get the amount of sleep you as an individual need to wake up feeling rested.
Insomnia is the most common sleep complaint among Americans. It can be either acute, lasting one to several nights, or chronic, even lasting months to years. When insomnia persists for longer than a month, it is considered chronic. According to the National Center for Sleep Disorders Research at the National Institutes of Health, about 30-40% of adults say they have some symptoms of insomnia within a given year, and about 10-15 percent of adults say they have chronic insomnia. People who have trouble sleeping every night without exception for months or years are fairly rare. More often, people experience chronic-intermittent insomnia, which means difficulty sleeping for a few nights, followed by a few nights of adequate sleep before the problem returns.
Insomnia can be a disorder in its own right, but often it is a symptom of some other disease or condition. Half of all those who have experienced insomnia blame the problem on stress and worry. In the case of stress-induced insomnia, the degree to which sleep is disturbed depends on the severity and duration of the stressful situation. Sometimes this may be a disturbing occurrence like loss of a loved one, loss of a job, marital or relationship discord or a tragic occurrence. Anticipation of such things as weddings, vacations, or holidays can also disturb sleep and make it difficult to fall asleep or remain asleep. Insomnia can also occur with jet lag, shift work and other major schedule changes.
If you have difficulty sleeping, it is essential to determine whether an underlying disease or condition is causing the problem. Sometimes insomnia is caused by pain, digestive problems or a sleep disorder. Insomnia may also signal depression or anxiety. Often times, insomnia exacerbates the underlying condition by leaving the patient fatigued and less able to cope and think clearly. For insomnia related to a medical condition or pain, ask your doctor about nighttime pain aids.
If your sleep trouble is confined to difficulty falling asleep, the time you are choosing to go to sleep may not be synchronized with your biological clock. The biological processes that initiate and maintain sleep in humans are active throughout the night. Opposing this sleep tendency, however, is the alerting action of the biological clock that is active throughout the day. When the biological clock is active at your scheduled bedtime, you will have sleep-onset insomnia.
The prevalence of insomnia is higher among older people and women. Women suffer loss of sleep in connection with menstruation, pregnancy, and menopause. Rates of insomnia increase as a function of age but most often the sleep disturbance is attributable to some other medical condition.
Some medications can lead to insomnia, including those taken for:
- colds and allergies
- high blood pressure
- heart disease
- thyroid disease
- birth control
- pain medications
- depression (especially SSRI antidepressants)
Some common sleep disorders such as restless legs syndrome and sleep apnea can also lead to insomnia.
Sleep is as essential as diet and exercise. Inadequate sleep can result in fatigue, depression, concentration problems, illness and injury.
Symptoms of insomnia include:
- difficulty falling asleep
- waking up frequently during the night
- difficulty returning to sleep
- waking up too early in the morning
- unrefreshing sleep
- daytime sleepiness
- difficulty concentrating
According to NSF polls dating back to 1999, over 1/2 of America’s adults experience one or more symptom of insomnia at least a few nights a week. In 2005, the following percentages of adults reported having the following symptoms this often: 38% woke up feeling unrefreshed; 32% wake often during the night; and 21% of the population reports waking too early, not being able to get back to sleep and difficulty falling asleep. Of this last group, almost 1?4 state that it takes them at least 30 minutes to fall asleep. These people are likely to be women (28% vs. 16%) and not to have a bed partner (27% vs. 19%).
People who drink >4 caffeinated beverages a day are more likely to have difficulty falling asleep and wake unrefreshed. Those who are obese are more likely to have a symptom of insomnia. Adults who have daytime sleepiness at least 3 times a week are experiencing a symptom of insomnia (86%) compared to those who rarely or never have such symptoms (31%). This is also true for those who say sleepiness has a strong impact on their daily activities (83%) versus those who experience very little impact (44%). More people who take >2 naps a day report symptoms of insomnia (62%) compared to those who do not take a nap (48%).