Primary Insomnia Health Article

Definition

Primary insomnia is difficulty getting to sleep or staying asleep, or having non-refreshing sleep for at least 1 month without any known physical or mental condition.

See also: Insomnia concerns

Alternative Names

Insomnia - psychophysiological (learned); Chronic insomnia

Causes, incidence, and risk factors

Insomnia is caused by many different things. The most common causes of insomnia are:

• Alcohol
• Anxiety
• Coffee
• Stress

About 25% of elderly people and about 10% of people in general have insomnia.

Secondary insomnia is insomnia caused by a medical condition. Depression is a very common cause of secondary insomnia. Often, insomnia is the symptom for which people with depression seek medical help.

Symptoms

• Difficulty falling asleep
• Feeling tired
• Waking up several times during sleep

People who have primary insomnia tend to keep thinking about getting enough sleep. The more they try to sleep, the greater the sense of frustration and distress, and the more difficult sleep becomes.

Signs and tests

Your health care provider will do a physical exam and ask you questions about your current medications, drug use, and medical history. Usually, these are the only methods needed to diagnose insomnia.

Polysomnography, an overnight sleep study, can help rule out other types of sleep disorders (such as sleep apnea).

Treatment

The following tips can help improve sleep. This is called sleep hygiene.

• Avoid caffeine, alcohol, or nicotine before bed.
• Don't take daytime naps.
• Eat at regular times each day (avoid large meals near bedtime).
• Exercise early in the day.
• Get out of bed if you are not asleep after 5 - 10 minutes and do something else (going to another room may help reduce your anxiety about falling asleep).
• Go to bed at the same time every night.
• Keep comfortable sleeping conditions.
• Remove the anxiety that comes with trying to sleep by reassuring yourself that you will sleep or by distracting yourself.
• Use the bed only for sleep and sex.
• Practice evening relaxation routines such as muscle relaxation or meditation.

If you follow these recommendations and still have insomnia, your doctor may prescribe medications such as benzodiazepines.