Insomnia can occur in response to a behavioral, physical, or mental health issue. Physical, psychological, environmental, and modifiable lifestyle factors can all play a role in preventing the condition, or alleviating the symptoms if it occurs. Most people experience temporary insomnia at some time. Preventing chronic insomnia from developing requires early treatment.
Chronic disease and pain can cause insomnia for a variety of reasons. Diseases or conditions that may disrupt sleep include:
Discuss with your doctor whether these conditions or any other physical problems can be treated. Proper and timely treatment can reduce symptoms and often lead to an improved night’s sleep.
Certain medicines can cause sleeping difficulties as a side effect. Having to take one or more of these drugs can lead to insomnia. Some medicines that may affect sleep include:
Avoid taking over-the-counter cold medicines if you have difficulty sleeping. If you are taking a prescription medicine that disturbs sleep as a side effect, talk to your doctor. You may be able to take an alternative drug that does not disturb your sleep.
Note: Do not stop taking any prescription medicine without the approval of your doctor.
Stress is considered by most sleep experts to be the number one cause of short-term sleeping difficulties. Common triggers include school- or job-related pressures, a family or marriage problem, and a serious illness or death in the family.
Exercise regularly to help relieve stress. However, do so at least three hours before bedtime. A workout after that time may actually keep you awake because your body has not had a chance to cool down and relax. Other techniques that may reduce stress are meditation and deep breathing.
Habits and activities that you do during the day or night can interfere with getting a good night's sleep. Adjust your time schedule in order to avoid:
Nicotine and caffeine stimulate the nervous system. Although this may give you a sense of energy during the day, these substances may interfere with your ability to go to sleep at night. Alcohol depresses the nervous system and makes you feel drowsy at bedtime, but it interferes with normal sleep patterns during the night and causes restlessness. Avoid using tobacco products and drinking beverages that contain caffeine or alcohol in the afternoon or evening. They can create a vicious cycle of poor sleep at night and an increased use of stimulants during the day to counteract the drowsiness from poor sleep.
Night shift work forces you to try to sleep when activities around you and your own "biological rhythms" signal you to be awake. One study shows that night shift workers are 2-5 times more likely than are employees with regular, daytime hours to fall asleep on the job because of poor sleep quality. If you work the night shift, speak with your employer about how to minimize the dangers of fatigue. Discuss your need for creating a sleep environment in the daytime with your family or those with whom you live. Try to keep a consistent schedule for sleep throughout the week, even on your days off. Make your daytime home environment conducive to sleep by keeping light out of the room you sleep in and minimizing external noise.
A distracting sleep environment, such as a room that is too hot or cold, too noisy, or too brightly lit can be a barrier to sound sleep. Interruptions from pets, children, or other family members can also disrupt sleep. Other influences may be the comfort and size of your bed and the habits of your bed partner. Try to create an environment that is restful by using shades to block light, and playing soothing music or “white noise” (such as a fan). Seek medical help for a partner who snores loudly, or consider separate sleeping arrangements.
Establish a regular, relaxing bedtime routine that will allow you to unwind and send a "signal" to your brain that it is time to sleep. Avoiding exposure to bright light before bedtime and taking a warm bath may help. Do not use your bed for anything other than sleep or sex. Your bed should be associated with sleep. Avoid “clock watching” after going to bed. Also, avoid drinking fluids just before bed.
Jet lag is the inability to sleep as a result of crossing many time zones in a short period of time. This can disturb your biological rhythms and deprive you of good sleep. To help minimize its effect, get a good night’s sleep before traveling, drink plenty of water, and avoid alcohol during the trip.
Buysse DJ. Insomnia. JAMA. 2013;309(7):706-716.
Can't sleep at night? National Sleep Foundation website. Available at: https://sleepfoundation.org/insomnia/home. Accessed March 2, 2016.
Healthy sleep tips. National Sleep Foundation website. Available at: https://sleepfoundation.org/sleep-tools-tips/healthy-sleep-tips. Accessed March 2, 2016.
Insomnia in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114839/Insomnia-in-adults. Updated March 21, 2016. Accessed October 4, 2016.
Jet lag. Centers for Disease Control and Prevention website. Available at: http://wwwnc.cdc.gov/travel/yellowbook/2016/the-pre-travel-consultation/jet-lag. Updated July 10, 2015. Accessed March 2, 2016.
Merrigan JM, Buysse DJ, Bird JC, Livingston EH. JAMA patient page. Insomnia. JAMA 2013;309(7):733.
Shift work and sleep. National Sleep Foundation website. Available at: https://sleepfoundation.org/sleep-topics/shift-work-and-sleep. Accessed March 2, 2016.
Last reviewed March 2016 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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