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Insomnia, The Most Common Sleep Complaint

From Dr. Scott Johnson, Sleep Disorders Specialist with Crossing Rivers Health Center for Specialty Care

Did you know insomnia is the most common sleep complaint and affects as many as 30% of adults? The causes, symptoms, and severity vary from person to person.

Those that have trouble transitioning from a state of wakefulness to sleep have the most common type of insomnia known as “sleep-onset insomnia.” Those with an inability to stay asleep are said to have “sleep-maintenance insomnia.”

Acute insomnia lasts for a short time (from a few nights up to three weeks), and goes away on its own without treatment. Nearly 1 in 10 people suffer from chronic insomnia that lasts more than three weeks. Chronic insomnia often requires treatment.

Insomnia is most often associated with other factors:

  • Stress: This can vary from minor things like work or personal stress to more severe changes such as death, divorce, or job loss.
  • Other Sleep Disorders: Some sleep disorders can cause insomnia or make it worse such as obstructive sleep apnea (OSA) or restless legs syndrome (RLS).
  • Medical Conditions: Many physical illnesses can cause insomnia. Those who experience pain, discomfort, or limited mobility from medical problems may have difficulty falling asleep or staying asleep.
  • Mental Health Disorders: The relationship between sleep and mental health is complex. Insomnia is sometimes caused by a mental health disorder. Often a mental health disorder such as depression or other mood disorders will be diagnosed after a complaint of insomnia.
  • Medication or Substance Abuse: Insomnia can be an unwanted side effect of many prescription or over-the-counter medications. Alcohol and sleep aids are actually common causes of insomnia. Both alcohol and sleep aids alter sleep architecture and therefore worsen sleep disorders such as insomnia, OSA, or RLS. Finally, caffeine and other stimulants can delay sleep onset and may cause frequent awakenings at night.
  • Environmental Factors: Disruptive factors such as noise, light or extreme temperatures can interfere with sleep. Bed partners who are loud snorers and pets can cause sleep disruption. Irregular sleep schedules can also cause insomnia.

Treatment options for insomnia depend on the underlying cause. Sleep hygiene, cognitive behavioral therapy (CBT) including stress reduction, relaxation, and sleep schedule management may be effective treatment options for insomnia.

If you have trouble sleeping on a regular basis, it may be time for you to visit with your health care provider to discuss any medical conditions that could cause insomnia or if you have a sleep disorder. When patients are referred to me, my first step in helping them get good quality sleep is to complete an assessment of their sleep problems. To make an accurate diagnosis and create a treatment plan, sometimes an overnight sleep study is necessary. As a patient sleeps, brain waves, breathing, muscle activity, and eye movements are measured and recorded. The data is reviewed in detail to determine if the patient has a sleep disorder.