Insomnia is a sleep disorder in which people have trouble either falling asleep, staying asleep or both. As a result, people with insomnia may not feel refreshed when they wake up.
Insomnia can be divided into 2 categories: primary and secondary. Primary insomnia is insomnia that lasts for more than a month. People with primary insomnia may have poor sleep hygiene or may have increased stress. They tend to have difficulty falling back asleep because their minds tend to race when they awaken from sleep. Conditions that can contribute to primary insomnia include stress, shift work or emotional distress from the loss of a spouse or divorce.
Secondary insomnia is due to an underlying medical problem. Examples of this include chronic pain conditions, congestive heart failure, hyperthyroidism, chronic heartburn, menopause, restless leg syndrome and obstructive sleep apnea. The key to treating secondary insomnia is addressing the underlying medical condition.
The first step in treating insomnia is to improve sleep hygiene. Sleep hygiene refers to practices and habits that are critical for sound sleep. Consumption of caffeine, alcohol and nicotine all contribute to insomnia. Alcohol can initially make it easier to go to sleep, but then as your body begins to metabolize the alcohol, it causes arousal which makes it difficult to fall back asleep. I also generally recommend that patients do not read or watch TV in bed. The bed should be for sleeping and sex only.
Learning deep breathing techniques can be a helpful for learning how to relax. Doing breathing exercises several times a day will make it easier for you to fall asleep. Examples of deep breathing exercises can be found on our website as part of our 8 Week Lifestyle Challenge. Additionally, I have provided an instructional video on my YouTube site.
Writing down a list of things you need to do the next day, before you go to sleep, can also be helpful in allowing you to relax. Knowing that you have a plan for tackling the next day’s tasks can pave the way to a good night’s sleep.
Lastly, cognitive behavioral therapy can be very helpful in addressing underlying stressors that prevent you from sleeping effectively. Prescription medications are generally indicated for short-term insomnia due to stress, or time change issues related to jet lag. They can be very helpful in trying to reset a normal sleep cycle but they are generally not an effective long-term strategy to address insomnia issues.