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- A life crisis or stress, including the loss of a life partner, divorce, or loss of a job
- Environmental noise
- Extreme temperatures (like a room that is too hot or too cold)
- Change in the surrounding environment
- Sleep/wake schedule problems, such as those due to jet lag
- Heart disease
- Asthma or chronic obstructive pulmonary disease (COPD)
- Sleep apnea
- Gastroesophageal reflux disease (GERD) or ulcer
- Behavioral factors, including:
Certain medicines such as:
- Allergy medicines
- Blood pressure medicines
- Psychiatric medicines
- Age: adults 50 years or older are more likely to have insomnia
- Sex: female (especially during and after menopause)
- A history of mental disorders (such as anxiety , depression )
- Chronic pain
- Having chronic medical conditions
- Using alcohol , drugs , or certain medicines
- Shift work
- Use of multiple medicines
- Difficulty falling asleep
- Waking up frequently during the night with difficulty returning to sleep
- Waking up too early
- Not feeling refreshed after sleep
- Daytime sleepiness
- Irritability, anxiety , inability to concentrate
When Should I Call My Doctor?
|Monitored Breathing During Polysomnography|
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Treat Underlying Medical Conditions
Identify and Modify Behaviors That Worsen Insomnia
- Reduce or avoid caffeine especially late in the day
- Reduce or avoid alcohol and drug use.
- Quit smoking. If you smoke, avoid doing so near bedtime.
- Avoid eating or drinking close to bedtime.
- Go to bed and wake up at the same time each day.
- If you must take naps, keep them short.
- Only use the bedroom for sleep or sex. Avoid watching TV or worrying in bed.
- Keep your bedroom at a comfortable temperature and dark. Minimize disruptions such as pets.
- If you work at night and sleep during the day, make sure to block daylight from the room. Decrease the amount of noise. Use a fan to block out noise.
Herbal Therapies and Supplements
Cognitive Behavioral Therapy
- Minimize intake of caffeinated food and drinks after lunch (like coffee, tea, chocolate, cola drinks).
- Avoid drinking alcohol.
- Avoid eating too fast or too much. Do not eat too close to bedtime.
- Avoid drinking fluids before bedtime.
- Do not smoke.
- Exercise regularly, but not within less than three hours of bedtime.
- Use the bedroom only for sleep and sex. Do not use electronics or watch TV while in bed
- Schedule relaxing bedtime routines. Listen to quiet music or soak in warm water.
- Make sure that the bedroom is not too cold or too hot.
- Use a humidifier or dehumidifier as needed.
- Get sunlight during the day.
- Use shades or lined drapes; or wear an eye mask to reduce sleep disruption.
- Use earplugs, or listen to relaxing music or white noise. This helps reduce the disturbing effects of noise.
- Make sure your mattress is supportive and the bedding is comfortable.
- Avoid "clock watching" after going to bed.
- Keep bedtimes and wake-times consistent throughout the week.
- If you cannot avoid naps, keep them short.
National Center on Sleep Disorders Research http://www.nhlbi.nih.gov
National Sleep Foundation http://www.sleepfoundation.org
Better Sleep Council Canada http://www.bettersleep.ca
Canadian Sleep Society http://www.canadiansleepsociety.ca
American Sleep Apnea Association website. Available at: http://www.sleepapnea.org. Accessed July 1, 2009.
Insomnia. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated July 9, 2012. Accessed August 14, 2012.
Jacobs GD, Pace-Schott EF, et al. Cognitive behavior therapy and pharmacotherapy for insomnia: a randomized controlled trial and direct comparison. Arch Intern Med . 2004 Sep 27;164(17):1888-96. http://archinte.jamanetwork.com/article.aspx?articleid=217394
Insomnia. Family Doctor.org. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/insomnia.html. Accessed August 14, 2012.
Insomnia. EBSCO Publishing Health Library, Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/healthLibrary/. Accessed March 8, 2012.
Insomnia: quick answers to medical diagnosis and therapy. Access Medicine website. Available at: http://www.accessmedicine.com.ezp-prod1.hul.harvard.edu/quickam.aspx . Accessed November 8, 2009.
Insomnia and sleep. National Sleep Foundation website. Available at: http://www.sleepfoundation.org/article/sleep-related-problems/insomnia-and-sleep. Accessed August 14, 2012.
Morin CM, Vallieres A, et al. Cognitive behavioral therapy, singly and combined with medication, for persistent insomnia: a randomized controlled trial. JAMA. 2009;301(19):2005-2015.
National Center on Sleep Disorders Research website. Available at: http://www.nhlbi.nih.gov/about/ncsdr/index.htm. Accessed August 14, 2012.
Sleep insomnia, lack of sleep. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/inso/. Published March 2009. Accessed August 14, 2012.
- Reviewer: Brian Randall, MD
- Review Date: 09/2012
- Update Date: 05/11/2013