Insomnia

Insomnia is defined by repeated difficulty with sleep initiation, duration, consolidation or quality that occurs despite adequate time and opportunity for sleep and results in some form of daytime impairment. Consolidation refers to a neurological process during sleep that involves gradually converting information from short-term memory into long-term memory. People who have difficulty falling asleep or staying asleep are often diagnosed with insomnia, but there are several types of insomnia.

Insomnia can be categorized based on its duration.

• Adjustment insomnia is usually brought on by excitement or stress, lasting no longer than four weeks (a month).
• Short-term insomnia is trouble falling or staying asleep and lasts between four weeks and six months (a month to half a year). Short-term insomnia is also usually brought on by a stressful situation. Once the problem subsides or the sleeper adjusts to it, the insomnia will disappear.
• Chronic insomnia is when the condition lasts longer than six months. More than 20 million people in the United States say they have chronic insomnia; however,research has shown that physical ailments and other sleeping disorders are often mistaken for this type of insomnia.

Causes of Insomnia
Some people are more vulnerable to insomnia than others, just as some of people are prone to headaches or any other illness. Persistent stress, whether due to relationship problems or trouble at work, can also cause insomnia. Many lifestyle decisions, for example the misuse of stimulants (caffeine and tobacco), alcohol, or sleeping pills, keeping erratic bedtime hours and inactive behavior may contribute to insomnia. Often there are underlying physical or psychiatric problems, such as a breathing disorder (obstructive sleep apnea, central sleep apnea) or depression, which cause insomnia. These conditions require special medical attention and do not respond to the common insomnia treatments.

Behavioral Treatments for Insomnia
Your difficulty sleeping may respond to simple changes in behavior that you can try on your own or with the help of a professional .

• Sleep Restriction
• Stimulus Control
• Relaxation
• Cognitive Therapy

Sleep Restriction
Allow less time between bedtime and rise time. This may seem like a contradiction, but it is not. Excess time in bed spreads your sleep out over a longer period of time, which may lead to more fragmented sleep and more frustration.

Stimulus Control
To improve the chances of falling asleep quickly, remove all non-sleeping activities (TV, computer, reading or work) from the bedroom. Also, do not try to go to sleep until you feel drowsy. If you cannot fall asleep in 20 minutes, or if you wake up in the middle of the night and cannot go back to sleep within 20 minutes, get up and go to another room. Do not return to the bedroom until you are sleepy. Also, maintain a regular wake time, even on weekends and days off, and avoid napping during the day.

Relaxation
Do an activity that you find calming, such as reading, bathing, meditating or daydreaming.

Cognitive Therapy
Use reading and reasoning to pinpoint ideas or thoughts about sleep that may be incorrect. This will help to alleviate daytime stress about it and bedtime wakefulness will decrease as well.

Doctors at Houston Methodist employ a multidisciplinary approach to diagnose and treat insomnia.