Struggling with Sleep: A Primer on Insomnia

Insomnia is a sleep disorder characterized by the inability to fall asleep, stay asleep, or both. The most common sleep disorder in the U.S, Insomnia, affects an estimated forty million Americans annually. The disorder can either be acute or chronic. Acute insomnia lasts from 1 night to a few weeks and is generally triggered by stress or bad news. Chronic insomnia, on the other hand, occurs at least 3 nights a week for 3 months or longer. Chronic insomnia can either fall into primary or secondary.


Primary insomnia is a diagnosis when the sleep issues aren’t a result of any medical conditions. There is still ongoing research to better understand primary insomnia and its causes, but it is most likely due to altering brain chemical levels. Secondary insomnia, the more common of the two, is caused by an underlying medical condition including but not limited to arthritis, depression, cancer, heartburn, and substance abuse.


Apart from trouble falling asleep and failure to sleep through the night, insomnia can cause various symptoms during the day such as drowsiness, inability to focus on tasks, anxiety, depression, and irritability. For the diagnosis of insomnia, your doctor will most likely ask about your sleeping history and take a physical exam. They also may recommend a sleep study at a sleep center or do it at home with a portable diagnostic device. You will have sensors that detect brain waves, breathing rate, and oxygen levels on your scalp, face, eyelids, chest, limbs, and finger. Once the doctor reviews the sleep study results, they will discuss with you a treatment plan to mediate the symptoms associated with the sleep disorder and fix your irregular sleeping through the implementation of therapy, good sleep habits, and medication.


Lifestyle changes and home remedies are efficacious in treating insomnia. Having a consistent routine of sleeping and waking up at the same time every day, avoiding naps, limiting caffeine and alcohol, and staying active can make falling asleep easier. It is obviously easier said than done, but implementing small changes can help in the long run, such as making your bed sleep-friendly, avoiding your phone or laptop right before bedtime, and ensuring the temperature of your bedroom is cool and comfortable. If anxiety over the next day’s tasks is an issue, write a to-do list before bed as it helps to compartmentalize your thoughts and free the extra baggage in your mind that’s causing unnecessary stress. It is not worth losing your sleep over. Take care of your mind and body, and sleep will surely follow.


There are also nonprescription supplements like melatonin and valerian root tea.   Both work well when done in conjunction with improved sleep habits, to help patients acquire better quality sleep.   Sleep chews by Neora have also been shown to improve time to fall asleep and sleep quality using all-natural ingredients.   Diphenhydramine (Benadryl) and doxylamine (Unisom) are over the counter medications that help with drowsiness.   Their effectiveness in helping with quality sleep is very person dependent.  Some people feel pretty groggy the next morning.


The following are more aggressive therapeutic strategies that can help achieve proper sleep:


  1. Cognitive Behavioral Therapy (CBT) is effective in that it promotes good thoughts, behaviors, and habits. CBT works towards reducing the anxiety and stress that generally keeps people from falling asleep.
  2. Stimulus Control Therapy helps people reverse the patterns that inhibit them from sleeping well.
  3. Light Therapy uses light to correctly adjust one’s internal clock; it’s especially for individuals who tend to fall asleep or wake up early. Therapy is achieved by going outside when there’s still light in the evenings or using a lightbox.


Common medications prescribed to patients are Lunesta and Ambien. Lunesta and Ambien lower brain activity and help you feel calm. Both medications are used for a short-term period as long-term use results in dependency.


Good quality sleep is an extremely important part of physical and mental well-being.  If you’re struggling in this area, trying over the counter supplements for a short time is reasonable.  If you don’t feel like you’re getting better, it’s important to see your primary care.  Over the long run, poor sleep is associated with many mental and physical health conditions as well as a shortened lifespan.