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Symptoms and treatment of insomnia

What is insomnia?

Characterized by difficulty falling or staying asleep, insomnia is a condition that affects nearly one-third of adults at some point in their lives and is separated into three different categories:

  • Transient: Short term sleeping difficulties that recur infrequently or not at all.
  • Intermittent: Recurring bouts of insomnia, followed by periods of relatively normal sleep.
  • Chronic: Persistent sleeping difficulties that last for more than one month.

Although transient insomnia often requires no treatment and resolves on its own, individuals with intermittent and chronic insomnia find it difficult to maintain their personal and professional lives, since they are too groggy to think clearly and focus on vital tasks. Family members may notice that insomnia sufferers can be confused, forgetful and irritable. Further, since insomniacs often toss and turn in bed or get up entirely in the middle of the night, their partners may suffer from disrupted sleep as well. If you believe that your insomnia is having a negative impact on your work, your family, or your enjoyment of any aspect of your life, it may be time to discuss the situation with your doctor.

Each person's experience is unique, and the insomnia treatment recommended by your doctor will depend on your condition's underlying causes. Medical conditions, particularly those that include chronic pain or breathing difficulties, can make it difficult to sleep soundly. Additionally, stress, anxiety and the excessive use of stimulants, like caffeine, can result in disrupted sleep. Frequent travel, with or without the complication of jet lag, can also negatively impact your sleep cycle.

While there is no definitive insomnia cure, there are a number of steps that can be taken to help re-establish a normal sleeping pattern. Initially, your doctor will likely recommend addressing any "sleep hygiene" issues that may be contributing to your insomnia. As much as possible, bedrooms should be maintained for sleeping, and you should avoid working, watching television and even reading books while in bed. Your doctor will also probably direct you to eliminate caffeine, herbal energy supplements and other potential stimulants, as well as alcohol (which, although technically a depressant, can lead to insomnia), from your diet. If your insomnia is linked to anxiety or stress, relaxation techniques, such as breathing exercises and guided meditation, may be another component of your treatment.

If you have adopted positive habits but are still experiencing difficulty falling or staying asleep, your doctor may prescribe a medication like Ambien (zolpidem), Lunesta (eszopiclone), Restoril (temazepam) or Valium (diazepam) for insomnia. Benzodiazepine drugs, like Restoril and Valium, are intended only for short term treatment, as patients can develop a tolerance (needing progressively higher doses) or dependence after just a few weeks. Nonbenzodiazepines, like Ambien and Lunestra, can be taken for longer periods, although dependence on these drugs is also possible. All sleeping aids, including over the counter medications, carry a risk of "rebound insomnia" when coming off the drug, and none are intended to be taken for more than 30 days at a time.

Insomnia is a treatable condition, which often responds well to changes in lifestyle and, if necessary, short term use of medication. Your doctor can work with you to help you identify the underlying causes of your sleeplessness and get you back on the path to a regular, restful sleep cycle.

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