You’ve probably had nights when you couldn’t fall asleep, no matter how desperately you tried.
Nearly 70 million Americans have a sleep disorder. Insomnia is the most common sleep disorder, with 30% of adults experiencing short-term insomnia. About 10% of people have long-lasting insomnia. Almost 40% of people report accidentally falling asleep during the day.
Combined direct and indirect costs for insomnia in the United States exceed $100 billion annually.
Insomnia, whether short-term or chronic, is a common condition. It has a negative impact on vulnerable patient groups, including active military personnel and veterans, patients with coexisting psychiatric and medical disorders, those in life transitions such as menopause, and elderly persons.
Women are more likely to have insomnia than men.
Insomnia, which means difficulty initiating or maintaining sleep, is a symptom, not a diagnosis or a disease. It may be due to a lack of sleep or poor quality of sleep.
▪ Medications that interfere with sleep.
▪ Dietary choices, such as caffeine late in the day, that interfere with sleep.
▪ Stressful thoughts.
▪ Depression.
▪ Recent upheavals in your life, such as a divorce or death of a loved one.
▪ Hormone changes, such as those accompanying menopause.
▪ Bedtime habits that don’t lead to restful sleep.
▪ Sleep disorders.
▪ Chronic pain.
▪ Medical conditions such as acid reflux, thyroid problems, stroke, or asthma.
▪ Substances like alcohol and nicotine.
▪ Travel, especially between time zones.
Common symptoms of insomnia are:
▪ Frustration and preoccupation with your lack of sleep.
▪ Physical aches and pains, such as headaches and stomachaches.
▪ Impaired performance at work.
▪ Daytime drowsiness or low energy.
▪ Difficulty paying attention.
▪ Anxiety.
▪ Tension and irritability.
▪ Depression and mood swings.
Insufficient sleep has been linked to cardiovascular and cerebrovascular disease, cancer, hypertension, and diabetes. Epidemiologic studies have linked insomnia symptoms to the development of other diseases, including type 2 diabetes, dementia, stroke, and chronic kidney disease.
Insomnia is also linked to higher rates of workplace injuries and traffic accidents. Insomnia is a significant predictor for depression, anxiety, and alcohol abuse.
Diagnosis of insomnia begins with a good medical history, as well as screen for drug and alcohol use.
You could be asked about chronic snoring and recent weight gain, which may lead to the possibility of obstructive sleep apnea. In such cases the doctor may request an overnight sleep test, or polysomnogram.
Studies have shown that combining medical and nonmedical treatments is more successful in treating insomnia than either one alone:
- Medications to help you get to sleep and stay asleep
- Change in existing medication
- Counseling to help relieve stress
- Change in lifestyle choices that may interfere with sleep
More than 90% of veterans with posttraumatic stress disorder (PTSD) report sleep disturbances, primarily insomnia and nightmares. Insomnia helps drive the suicide epidemic in veterans.
Approximately 15% to 30% of people report drinking to manage insomnia. Drinking to fall asleep can build a tolerance, forcing you to consume more alcohol each successive night in order to experience the sedative effects. However, research has shown sleepers who drink large amounts of alcohol before going to bed are often prone to delayed sleep, meaning they need more time to fall asleep.
Cannabis withdrawal can cause severe insomnia characterized by trouble falling asleep and staying asleep, as well as vivid dreams, all of which make it difficult to quit.
It takes nearly six hours for half of the caffeine from your favorite coffee, tea or cola to exit the body. Caffeine too late in the day can cause lighter, more disturbed sleep, or keep you from sleeping at all.
Sedative-hypnotic drug products are a class of drugs used to induce and/or maintain sleep.
- Ambien (zolpidem)
- Belsomra (suvorexant)
- Butisol (butabarbital)
- Doral (quazepam)
- Edluar (zolpidem)
- Estazolam
- Flurazepam
- Halcion (triazolam)
- Hetlioz (tasimelteon)
- Intermezzo (zolpidem)
- Lunesta (eszopiclone)
- Restoril (temazepam)
- Rozerem (ramelteon)
- Seconal (secobarbital)
- Silenor (doxepin)
- Sonata (zaleplon)
- Zolpimist (zolpidem)
In January 2022, the Food and Drug Administration approved daridorexant (Quviviq) to treat insomnia in adults. It belongs to a group of medications called orexin receptor antagonists (ORAs). Daridorexant is in the same class as Belsomra (suvorexant) and Dayvigo (lemborexant).
Any establishment engaged in the manufacture, repacking, relabeling, or salvaging of a drug product for commercial distribution is required to register with the U.S. Food and Drug Administration, and list its products.
One in three adults gets by on six hours or less of nightly sleep, when most of us really need seven to nine hours. If you’re longing to wake up energized after a night of deep, refreshing sleep, you’re in good company.