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Insomnia - The Most Common Sleep Complaint
Image July 2017


Insomnia is the most common sleep complaint and affects as many as 30% of adults. The causes, symptoms, and severity vary from person to person.

Those that have trouble transitioning from a state of wakefulness to sleep have the most common type of insomnia known as "sleep-onset insomnia." Those with an inability to stay asleep are said to have "sleep-maintenance insomnia."

Acute insomnia lasts for a short time (from a few nights up to three weeks), and goes away on its own without treatment. Chronic insomnia lasts more than three weeks and nearly 1 in 10 people have chronic insomnia, which often requires treatment.

Insomnia is most often associated with something else.

These factors may include:

Stress: This can vary from minor things like work or personal stress to more severe changes such as death, divorce, or job loss.

Other Sleep Disorders: Some sleep disorders can cause insomnia or make it worse such as obstructive sleep apnea (OSA) or restless legs syndrome (RLS).

Medical Conditions: Many physical illnesses can cause insomnia. Those who experience pain, discomfort, or limited mobility from medical problems may have difficulty falling asleep or staying asleep.

Mental Health Disorders: The relationship between sleep and mental health is complex. Insomnia is sometimes caused by a mental health disorder. Often a mental health disorder such as depression or other mood disorders will be diagnosed after a complaint of insomnia.

Medication or Substance Abuse: Insomnia can be an unwanted side effect of many prescription or over-the-counter medications. Alcohol and sleep aids are actually common causes of insomnia. Both alcohol and sleep aids alter sleep architecture and therefore worsen sleep disorders such as insomnia, OSA, or RLS. Finally, caffeine and other stimulants can delay sleep onset and may cause frequent awakenings at night.

Environmental Factors: Disruptive factors such as noise, light or extreme temperatures can interfere with sleep. Bed partners who are loud snorers and pets can cause sleep disruption. Irregular sleep schedules can also cause insomnia.

Treatment options for insomnia depend on the underlying cause. Sleep hygiene, cognitive behavioral therapy (CBT) including stress reduction, relaxation, and sleep schedule management may be effective treatment options for insomnia. Therefore, promote thorough sleep evaluations ruling out a sleep disorder.


"Cognitive behavioral therapy for insomnia should be the first-line treatment for adults with chronic insomnia."

-American College of Physicians

Guidelines for Taking Sleep Aids

According to the AASM, follow these guidelines to make sure that sleep medications are used safely and properly. Never take a sleep aid without first getting approval from a physician:

  • Never drink alcohol in an attempt to fall asleep faster. Alcohol will only disrupt sleep and promotes frequent arousals.
  • Combining medications can be very dangerous, therefore consult with a physician to ensure other medications, including non-prescription medications such as pain relievers and allergy medicines are safe to take with a sleep aid.
  • Over the counter (OTC) sleep aids can cause side effects. OTC does not mean the medication is harmless.
  • Make sure that the physician is aware of all other medical conditions. Some drugs can have serious side effects for people with other medical problems such as those with high blood pressure and liver problems.
  • Carefully read the package insert that comes with the medication. Pay careful attention to the potential side effects that it describes.
  • Follow the dosage instructions and only take it for as many weeks as the physician recommends.
  • Never take a sleep aid for any other reason than to promote sleep.
  • Take the sleep aid at the right time of day. Many sleep aids must be taken just before bedtime and on an empty stomach.
  • Only take a sleep aid when there is enough time to get a full night of sleep (7 to 8 hours). Otherwise, drowsiness may occur the next day.
  • Never drink alcohol near the time when the sleep aid is taken.
  • Never drive a motor vehicle after taking a sleep aid.
  • Contact the physician or pharmacist right away if any problems occur while taking a sleep aid.
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