INSOMNIA

What It Is
While some cases are unrelated to other health issues, insomnia is often directly associated with health conditions, including asthma, depression, and heartburn.  Alcohol use, medication side effects, and pain may also lead to sleepless nights in some individuals.

Depending on how long the insomnia episode persists and how often they occur, insomnia is classified as acute or chronic. Acute insomnia, which can last from one night to a few weeks, can be incited by stress, illness, short-term medications, emotional or physical discomfort, environmental factors such as an intemperate room, and interference in one’s normal sleep schedule due to work or travel. When a person experiences symptoms three nights per week for a month or longer, the condition escalates to chronic insomnia, which can be caused by depression, anxiety, continual stress, and pain or discomfort at night.

Women are two times more likely to experience insomnia during their lifetime, and the likelihood increases with age. During pregnancy and a few years before the onset of menopause, women’s sleep schedules are interrupted and their quality of sleep is diminished.

Symptoms
Sleepiness during the day due to a lack of sleep or lack of quality sleep; difficulty falling asleep or inability to stay asleep; early morning wakefulness; irritability; problems with concentration or memory; and feeling tired after a night’s sleep

Standard Treatments
Enhancing your sleep hygiene may be one of the most effective techniques for treating insomnia, but cognitive behavioral therapy and over-the-counter and prescription medications are also available.

Drugs

OTC Sleep Aids
Histamines, biogenic substances found in the brain, enable one to stay alert and awake. Over-the-counter sleep-aids, such as Benadryl, Nytol, Tylenol PM, and Sominex, are antihistamines, which inhibit the release or action of histamines, thus inducing drowsiness. Long-term use is not recommended as patients can develop an unhealthy dependence.

Prescription medications
Ambien, ZolpiMist, Sonata, Lunesta, Dalmane, Restoril, and ProSom induce a calming effect in the brain by altering the central nervous system, allowing for relaxation that helps you fall asleep and sleep more soundly.

Cognitive behavioral therapy

Sleep Restriction Therapy
This treatment entails going to bed later or getting up earlier and slowly increasing the amount of time in bed until the patient is able to sleep normally through the night. Ideally, the sleepiness will help the patient to fall asleep at an earlier time the following evening, gradually increasing sleep times until they reach a normal length.

Reconditioning
Learning to use the bed only for what it’s truly intended for — sleep and sex — will help your body start to relate your bed to sleep. So removing the TV from the bedroom or to stop using the space for work or other busywork can help increase the likelihood you’ll fall asleep faster.  

Relaxation exercises
Deep-breathing or guided meditation may help some people reach a sleepy state, allowing them to fall asleep.

Sleep Hygiene

Avoiding naps, nicotine, and caffeine, particularly in the latter part of the day, will help your body feel tired when it’s time to sleep, and be sure to exercise at least four hours before bedtime. Going to bed around the same time each night and waking around the same time each day and making sure your bedroom is dark, quite, and a moderate temperature can also help.

Living With Insomnia
If you’re experiencing sleepless nights, there are a number of ways Philadelphia’s Top Doctors and Hospitals can help with insomnia, both acute and chronic.