A healthcare provider can diagnose insomnia using a combination of methods, especially by asking you questions about your health history, personal circumstances, sleep habits, symptoms and more. They may also recommend certain tests to rule out other conditions that could cause or contribute to insomnia.
The causes of insomnia can vary widely, meaning how long you have insomnia can also change and shift over time. Your healthcare provider can tell you more about your insomnia and what you can do to limit how it affects you.
You should talk to your healthcare provider (especially a primary care provider) if you notice that insomnia lasts more than a few nights and/or if it starts to affect your daily routine, tasks and activities. You should also talk to them if you notice the following:
At some point, many adults experience short-term (acute) insomnia, which lasts for days or weeks. It's usually the result of stress or a traumatic event. But some people have long-term (chronic) insomnia that lasts for a month or more. Insomnia may be the primary problem, or it may be associated with other medical conditions or medications.
If insomnia makes it hard for you to function during the day, see your doctor to identify the cause of your sleep problem and how it can be treated. If your doctor thinks you could have a sleep disorder, you might be referred to a sleep center for special testing.
Chronic insomnia may also be associated with medical conditions or the use of certain drugs. Treating the medical condition may help improve sleep, but the insomnia may persist after the medical condition improves.
Sleep is as important to your health as a healthy diet and regular physical activity. Whatever your reason for sleep loss, insomnia can affect you both mentally and physically. People with insomnia report a lower quality of life compared with people who are sleeping well.
Insomnia is a sleep disorder characterized by difficulty with falling asleep, staying asleep, or both. An insomnia diagnosis requires these sleep troubles to also cause daytime impairments, such as sleepiness or difficulty concentrating.
Up to two-thirds of people occasionally experience insomnia symptoms. These bouts of sleeplessness may or may not meet the criteria for a formal diagnosis of insomnia, depending on how long they last and whether they cause distress or interfere with daily functioning. But it is important for anyone who has concerns about their sleep to discuss them with a health professional for proper diagnosis and treatment.
The two main types of insomnia are acute insomnia and chronic insomnia. The primary difference between these two types is that acute insomnia is a short-term condition, while chronic insomnia causes sleep issues for at least three months.
However, the most current evidence shows that understanding whether a person has acute or chronic insomnia carries more significance for making decisions about medical care than these other distinctions.
Acute insomnia describes sleep difficulties that last for a few days or weeks, but not longer than three months. Short-term insomnia can often be traced to an external cause or life stressor like divorce, the death of a loved one, or a major illness.
Chronic insomnia is when a person experiences sleeping difficulties and related daytime symptoms, like sleepiness and attention issues, at least three days per week for longer than three months. It is estimated that about 10% to 15% of people have chronic insomnia.
A doctor can ask questions to better understand your situation and order tests to determine if an insomnia diagnosis is appropriate. Symptoms of insomnia can overlap with symptoms of other sleep disorders, so it is important to work with a doctor rather than try to self-diagnose.
There is no single established cause of insomnia. However, research suggests that in many people insomnia likely results from certain types of physiological arousal at unwanted times, disrupting normal patterns of sleep. Examples of such arousal can include a heightened heart rate, a higher body temperature, and increased levels of specific hormones, like cortisol.
While there is no single cause of insomnia, studies have identified factors that can put a person at a greater risk for experiencing insomnia. These include, but are not limited to Trusted Source American Academy of Sleep Medicine (AASM) AASM sets standards and promotes excellence in sleep medicine health care, education, and research. View Source :
People with short-term insomnia might not need any treatment at all, and care may be focused on discussing practices to support sleep hygiene. Temporary use of a prescription sleep aid may be an option if the insomnia is causing high levels of concern or distress.
It is important to get help with insomnia sooner than later. Sometimes, people with insomnia enter into a difficult cycle in which their sleep issues exacerbate anxiety at night, which then worsens their sleep. Treatment for insomnia can help prevent or break this cycle and keep acute insomnia from becoming chronic.
Additionally, maintaining healthy sleep habits after insomnia treatment may help keep insomnia from returning Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source . These include:
Chronic insomnia lasts for a month or longer. Most cases of chronic insomnia are secondary. This means they are the symptom or side effect of some other problem, such as certain medical conditions, medicines, and other sleep disorders. Substances such as caffeine, tobacco, and alcohol can also be a cause.
Sometimes chronic insomnia is the primary problem. This means that it is not caused by something else. Its cause is not well understood, but long-lasting stress, emotional upset, travel and shift work can be factors. Primary insomnia usually lasts more than one month.
Persistent insomnia can have a significant impact on your quality of life. It can limit what you're able to do during the day, affect your mood, and lead to relationship problems with friends, family and colleagues.
Taking OTC sleeping tablets regularly isn't usually recommended if you have insomnia, because it's not clear how effective they are, they don't tackle the underlying cause of your sleeping difficulties and they can cause side effects.
Benzodiazepines are prescription medicines that can reduce anxiety and promote calmness, relaxation and sleep. Your GP may prescribe them for a short time if you have severe insomnia or it's causing extreme distress.
For adults aged 55 or over, a medication called Circadin is sometimes used to help relieve insomnia for a few weeks. It contains a naturally occurring hormone called melatonin, which helps to regulate the sleep cycle.
Research has shown that among the daytime consequences of insomnia, the increased occurrence of accidents poses the greatest health risk. Insomniacs are 2.5 to 4.5 times more likely than controls to have an accident.20,21 In a sample of 8,625 community respondents in France, Léger et al. reported that 8% of insomniacs and 1% of non-insomniacs had an industrial accident in the past 12 months.22 Work productivity is also compromised among insomniacs due to work-related problems (ie, higher rates of absenteeism, decreased concentration, and difficulty performing duties). Kuppermann and colleagues23 found that individuals reporting a current sleep problem were more likely than good sleepers to have decreased job performance and to have been absent from work in the last month due to health problems. Simon and VonKorff24 evaluated insomnia in a staff-model health maintenance organization population (N=1,962). After adjusting for age, gender, and chronic disease, days of restricted activity due to illness and days spent in bed were about twice as common among insomniacs compared with non-insomniacs. Additionally, mean total health care expenditures were 60% higher in the insomnia group relative to the controls.
Population- and clinic-based studies have demonstrated a high rate of psychiatric comorbidities in patients with chronic insomnia. In fact, insomnia is more frequently associated with psychiatric disorders than any other medical illness.25 For example, in the Epidemiologic Catchment Area study, 40% of insomniacs had a comorbid psychiatric disorder compared with 16.4% of those with no sleep complaints.8 Additionally, depression and anxiety are the most common comorbid psychiatric disorders in insomniacs. It has traditionally been assumed that insomnia is secondary to the psychiatric disorder; however, given the chronicity of insomnia, it is possible that in some, if not most, cases the insomnia precedes the psychiatric disorder. In fact, it is possible that insomnia represents a significant risk for the development of a subsequent psychiatric disorder. In a large-scale European population-based study (N=14,915), it was found that insomnia more often preceded rather than followed incident cases of a mood disorder.26 This effect is even more pronounced for relapses of the mood disorder, where in 56.2% of cases, insomnia symptoms preceded symptoms of a mood disorder relapse. In contrast, in chronic insomnia patients with a comorbid anxiety disorder, the first occurrence of anxiety or a relapse preceded insomnia in most instances.
In parallel with the cognitive models, another model of the evolution of insomnia proposes that hyperarousal is primarily due to physiologic or neurophysiologic factors. Physiological arousal has been evaluated through measurements of the whole body metabolic rate, heart rate variability, neuroendocrine measures, and functional neuroimaging. Whole body metabolic rate may be measured by oxygen consumption (VO2). Recent studies compared good sleepers with patients diagnosed with insomnia. The insomnia patients exhibited significantly higher metabolic rates (measured at intervals across the 24-hour day) than the healthy controls. Heart rate variability may provide a measure of arousal in that it is regulated by both sympathetic and parasympathetic nervous system activities. A 36-hour study37 found that average heart rates were increased and variability was decreased in all stages of sleep in insomnia patients compared to healthy normal sleepers. 781b155fdc