Insomnia

Basic Facts

  • Insomnia is a sleep disorder that can make it hard to fall asleep and/or remain asleep.
  • While many people suffer from short-term insomnia because of stress or a traumatic event, some people have long-term (chronic) insomnia that lasts for months or years. 
  • Chronic insomnia can significantly impair a patient’s quality of life and is associated with a higher risk of developing diseases. 
  • Most adults need seven to eight hours of sleep at night, although sleep needs can vary from person to person.

Insomnia can undermine a person’s school or work performance, as well as contribute to obesity, depression, memory problems and poor immune system function. It is more common in adult females than adult males.

Those more likely to suffer from insomnia include shift workers, the elderly, and menopausal women.

 

While difficulty falling asleep and/or staying asleep is the primary symptom of insomnia, other symptoms include: 

  • Daytime sleepiness
  • Irritability, depression or anxiety
  • Poor concentration and focus
  • Lack of coordination, leading to an increase in error or accidents (driver sleepiness is a major factor in non-alcohol related car crashes)
  • Tension headaches

Insomnia itself may be a symptom of an underlying medical condition.

There are many medical conditions, such as chronic pain, reflux or Parkinson’s disease, that can lead to insomnia. Also, certain medications, such as those taken for high blood pressure or heart disease, can cause insomnia.

In addition, insomnia may be a symptom of an underlying sleep disorder such as restless leg syndrome (a person feel an uncomfortable sensation to move his or her legs) or sleep apnea (blocked airways causes a person to repeatedly stop breathing). 

Because caffeine, nicotine and alcohol are stimulants, these substances can affect sleep.

 

In the course of diagnosing insomnia and searching for its cause, a physician may conduct a physical exam to look for signs of medical problems related to insomnia and may ask a series of sleep-related questions. 

The physician may recommend one of the sleep studies performed at Virginia Heart Sleep Centers, including: 

  • Polysomnogram (PSG) – This is a nighttime study monitors sleep stages and cycles to identify when sleep patterns may be disrupted. The study records a variety of bodily functions during sleep such as the electrical activity of the brain, blood oxygen levels, heart rate, and breathing, as well as eye and leg movements. 
  • Multiple Sleep Latency Test (MSLT) -- MSLT is a daytime study, which involves a series of naps, to assess sleepiness during the day. The equipment used in an MSLT study is less extensive than a nighttime study.

 

Cognitive behavioral therapy, which focuses on developing habits that promote a healthy pattern of sleep, is often a first line of treatment for insomnia. This treatment for insomnia often includes:

  • Relaxation training – These techniques, which help to calm the body and induce sleep, may include breathing exercises, mindfulness skills, meditation practices, and guided imagery. 
  • Stimulus control – By limiting activities around the bedtime hour and in the bedroom, this technique helps remove factors that condition your mind to resist sleep. Suggestions may include not having a TV in the bedroom and having a consistent bedtime and wake time.
  • Sleep hygiene – This method of therapy involves changes habits that influence sleep including limiting the use of caffeine, tobacco and alcohol, as well as increasing exercise. 

Medical treatments for insomnia include over-the-counter sleep aids, prescription sleeping pills, antidepressants, and melatonin. Determining which medication may be best depends on insomnia symptoms and many different health factors; it’s important to consult with a physician about the use of sleep aids.

Meet the Sleep Center Specialists:

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Amit V. Patel MD, FCCP, ABIM Sleep Medicine

  • Sleep Medicine
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Alireza Maghsoudi MD, FACC

  • Echocardiography
  • General Cardiology
  • Vascular Disease
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