HomeSleep HealthCan’t Sleep? A Comprehensive Guide to Insomnia

Can’t Sleep? A Comprehensive Guide to Insomnia

By - Last Updated: July 23rd, 2019

I regularly receive messages from desperate individuals around the world begging me to help them figure out why they can’t get a good night’s sleep.

Many of these people claim to have been suffering from poor shut-eye for years, resulting in the debilitating effects of sleep deprivation.

Their lack of sleep means that they stumble through life, barely functioning. Simple tasks are nearly impossible due to the constant fog that falls over their brain.

Not only do these poor people feel mentally impaired but their physical health also begins to suffer. With the constant stress of trying to juggle their responsibilities without any energy, they start to neglect other areas of their life such as relationships and hobbies.

The above is a common scenario in our society. Almost all of us have experienced extended sleep loss at some point in our life.

Unfortunately for people living with insomnia, suffering from sleep loss is a constant lifelong battle.

What is Insomnia?

Most adults need 7 to 9 hours of high-quality sleep per night to function properly the next day. Insomnia is a sleep disorder that reduces your ability to obtain the quantity of high-quality sleep brain and body need to function.

If you have insomnia, you probably find it difficult to fall asleep. In some cases, you might be able to fall asleep initially but find yourself waking up multiple times throughout the night. You’ll often find it difficult to go back to sleep once you’re awake.

Poor quality sleep makes you feel unrested the next day. This can lead to low levels of physical energy, poor work performance, diminished attention span, and altered mood.

Worse yet, long term insomnia can lead to severe sleep deprivation and cause a wide range of health issues.

How Common is Insomnia?

Most doctors agree that insomnia is one of the most common complaints made by patients. Sometimes it even seems like everyone in our society is suffering from the disorder.

In my line of work as a sleep specialist, insomnia is certainly the most common grievance I hear, regardless of whether it’s the real cause of their sleep issues. I’ve even recognized signs of insomnia in myself!

How prevalent is insomnia really?

A major study by the National Sleep Foundation found that around 30% of adults worldwide report experiencing one or more symptoms of insomnia.

That’s an extraordinary amount of lost shuteye.

In fact, most people will experience a short-term period of (acute) insomnia, also referred to as transient insomnia, in their lifetime. These short bouts of sleep loss can last anywhere from a couple of days to a few weeks and are usually caused by stress or illness.

Longer term, chronic insomnia lasts for a month or more and is less common than acute insomnia. Approximately 10% of the population will suffer from a period of chronic insomnia in their lifetime.

Chronic insomnia usually suggests that there’s a sleep disorder present that warrants an appointment with a sleep specialist.

Insomnia Symptoms

If you think you might have insomnia, it’s important to identify common symptoms so you can discuss them with your doctor.

Like most sleep disorders, insomnia is recognized by a specific set of diagnostic criteria. If you’re experiencing any of the following symptoms, you may be suffering from insomnia:

  • Difficulty falling asleep at night (Onset Insomnia). It takes you 30 minutes or longer to fall asleep and sometimes you go without sleep for the duration of the night.
  • Waking up during the night (Maintenance Insomnia). It’s normal to wake up periodically through the night. If you have insomnia, you might wake up frequently and find it difficult to go back to sleep.
  • Waking up too early (Maintenance Insomnia). You might not have any problems going to sleep or staying asleep but find yourself waking up too early. This results in less than the recommended 7-9 hours of sleep.
  • A combination of the above. It’s not unusual for an individual with the disorder to have both onset and maintenance insomnia.

Secondary Symptoms of Insomnia

Like most sleep disorders, insomnia impacts the quality of your life by affecting your health and wellbeing. The following problems are associated with insomnia:

  • Daytime fatigue. A reduction in total sleep and poor sleep results in feeling chronically tired.
  • Reduced physical energy. Poor sleep reduces your metabolic function and energy output. This can affect your ability to perform physical tasks that wouldn’t normally be difficult.
  • Mood swings and Irritability. Studies have shown that even partial sleep deprivation has a significant effect on mood. This is because a lack of sleep can reduce your ability to deal with the normal daily stress of life.
  • Learning and Memory difficulties. Researchers believe that sleep affects learning and memory in two ways:
    1. Lack of sleep impairs your ability to focus and learn efficiently.
    2. Sleep is necessary to consolidate (store) memory so that it can be recalled in the future. Poor quality of sleep inhibits these processes, leading to learning and memory defects.

Types of Insomnia

Insomnia is distinguished by the length of time you’ve experienced sleep loss.

There are two main types of insomnia:

  1. Acute insomnia
  2. Chronic insomnia

Acute vs. Chronic Insomnia

Once your doctor has determined that you have insomnia, it’s important to distinguish whether your insomnia is acute or chronic.

1. Acute Insomnia

Acute Insomnia, also known as transient insomnia, is extremely common and usually lasts less than a month. It’s usually brought on by an adverse life event, stress, illness, or injury. Acute insomnia is often resolved without any treatment.

2. Chronic insomnia

Insomnia becomes chronic if it lasts for a month or more. Like short-term sleep loss, chronic insomnia can have a secondary cause like the stress of illness.

Often times, however, chronic insomnia isn’t attributable to a medical, psychiatric, or environmental cause. In this case, chronic insomnia is considered a true sleep disorder due to dysfunction in the brain’s sleep control centers.

Chronic insomnia causes significant impairment to quality of life and is often associated with poor health. It almost always warrants medical intervention.

What Causes Insomnia?

There are many reasons an individual might develop insomnia. This could be due to lifestyle changes, a stressful event, or something more serious like a chronic health condition.

Insomnia Sub Types

Before discussing what causes insomnia, it’s important to recognize and understand that insomnia is not a single disorder. Insomnia is a blanket term for the inability to sleep but there are many subtypes of insomnia.

Below is a list of four main insomnia sub-types currently recognized in medicine.

1. Primary Insomnia

Primary insomnia, also called idiopathic insomnia, is sleeplessness that isn’t caused by a medical or psychiatric disease, genetics, illnesses, injury, or environmental factor (such as drug abuse, medication, shift-work). In simple terms, there’s no discernible reason for your sleeplessness.

2. Secondary Insomnia

Secondary insomnia is sleeplessness that is a direct result of a medical or psychiatric disease, illnesses, injury, medications, alcohol or drug use, lifestyle habits, mental health disorders, stress, chronic pain, and other health conditions. Secondary insomnia is the most common type of insomnia.

3. Psychophysiological Insomnia

One of the most common and difficult types of insomnia to treat. Sufferers of psychophysiological insomnia go through a vicious nightly cycle of hyper-focusing on their sleep. Worrying about whether they’ll get enough sleep causes stress and anxiety, further inhibiting their ability to fall asleep.

4. Fatal Insomnia

Fatal insomnia is the rarest form of insomnia. Only a handful of individuals worldwide suffer from the disorder. Fatal insomnia is caused by prion disease. A prion is a type of protein that can trigger normal proteins in the brain to fold abnormally, causing irreversible damage to the brain. In fatal insomnia, these defective proteins damage the area of the brain that controls sleep.

Fatal insomnia has two forms:

  1. Familial. Fatal familial insomnia is inherited and caused by a mutation in a specific gene.
  2. Sporadic. Sporadic fatal insomnia appears spontaneously, without a genetic mutation.

Causes of Secondary Insomnia

As mentioned above, most people develop insomnia as a result of non-sleep related issues, whether it be related to health or your environment.

Secondary insomnia is commonly caused by:

  1. Health Conditions
  2. Physical Conditions
  3. Hormonal Changes
  4. Substances (Drugs and Alcohol)
  5. Mental Illness
  6. Food and Drink

Keep reading for a more detailed explanation of each of these causes.

1. Health Conditions

A wide variety of medical conditions can lead to the development of secondary insomnia. Examples of conditions that commonly cause insomnia include:

  • Asthma. A scientific study found that 37% of adults with asthma also have insomnia. Patients with asthma have nighttime coughing, wheezing, and breathlessness that disturb their sleep.
  • Obstructive Pulmonary Disease. Chronic obstructive pulmonary disease (COPD) causes breathing difficulties, chronic cough, fatigue, and chest tightening. Sleep problems common with pulmonary disease, partly due to symptoms but also because of the medications used to treat the disease.
  • Heart Disease. People with heart failure sometimes wake up with trouble breathing due to fluid buildup in the lungs. Heart failure can also lead to central sleep apnea. Other complaints include nocturnal angina (chest pain), palpitations (the sensation of a racing or pounding heart), which can also disturb sleep.
  • Arthritis. Studies show that as many as 80% of people with arthritis have difficulty sleeping. This is typically due to arthritic pain making it difficult to sleep.
  • Renal Disease. People with renal disease (kidney disease) often have trouble falling asleep and staying asleep. This may be due to an increased occurrence of restless leg syndrome (RLS) and sleep apnea. Dysfunctional kidneys also cause a buildup of waste products in the blood, making the individual feel ill and affecting sleep.
  • Diabetes. Like kidney disease, diabetes increases the risk of developing restless legs syndrome (RLS). Common diabetic symptoms can also make it difficult to sleep. These symptoms include thirst and hunger, frequent urination, irritability, nausea, headache, tingling and numbness in the extremities, and a general feeling of being unwell. High blood sugar levels caused by diabetes during the day reduce the quality of sleep at night.
  • Viral Infection. Cold and flu symptoms can keep you from getting a good night’s rest. Respiratory infections increase mucus production and congestion and force you to breathe through the mouth instead of the nose. When you lie down, congestion can seem worse reducing the quality of sleep.
  • Alzheimer’s Disease. People with Alzheimer’s disease develop changes in their sleep patterns. This is likely due to the degenerative effects Alzheimer’s has on the areas of the brain that control sleep.
  • Parkinson’s Disease. Sleep disorders are common in Parkinson’s disease (PD). Like Alzheimer’s disease, this is likely due to the degenerative effect PD has on the areas of the brain that control sleep.

2. Physical Conditions

Any condition that causes physical discomfort can result in insomnia. Below is a list of common physical ailments that can contribute to secondary insomnia:

  • Acute or chronic pain. Pain is one of the most common causes of insomnia. Studies have found that two-thirds of people with acute or chronic pain suffer from sleep disorders. Pain makes it extremely difficult to sleep. Conversely, lost sleep can also make the pain worse.
  • Pregnancy. Insomnia during early pregnancy in the first trimester is usually due to factors such as hormonal changes. Insomnia tends to get worse as the pregnancy progresses due to the discomfort associated with the 2nd and 3rd trimester.

3. Hormonal Changes

Hormones play a large role in sleep regulation. Any changes to these hormones can inhibit sleep. Below is a list of conditions that alter hormones and can lead to the development of secondary insomnia:

  • Menopause in women. During perimenopause through menopause, the ovaries decrease the production of estrogen and progesterone, a sleep-promoting hormone. The shifting of these hormones contributes to the inability to fall asleep. Other symptoms of menopause, such as hot flashes, can also reduce sleep.
  • Premenstrual syndrome in women. Similar to menopause, normal rising and falling of hormones levels during the menstrual cycle can affect a woman’s ability to fall asleep.
  • Low testosterone in men. A reduction in male testosterone can directly affect sleep quality and duration. It can also contribute to the development of sleep breathing disorders like sleep apnea.
  • Medications that alter hormones. Any medication that changes hormone levels can influence the way you sleep. Common hormonal medications include the contraceptive pill, testosterone replacement medications, and androgen blockers.
  • Pregnancy. Insomnia during early pregnancy is extremely common and is usually a result of normal hormonal changes in the first trimester.
  • Endocrine disorders. The endocrine system is responsible for creating all of the body’s hormones. Disorders of this system such as hyper- and hypothyroidism, polycystic ovarian syndrome, and hypopituitarism can disrupt sleep.

4. Substances

A large list of medications and illicit drugs can dramatically reduce your ability to sleep. Examples of medications that are commonly associated with secondary insomnia include:

  • Selective Serotonin Reuptake Inhibitors (SSRI) antidepressants.
  • Dopamine agonists. Includes medications for Parkinson’s disease.
  • Psychostimulants and amphetamines. Includes recreational drugs and medications for attention deficit disorder (ADD).
  • Anticonvulsants. Includes medications for seizure disorders.
  • Cold and flu medications.
  • Steroids.
  • Beta-agonists. Includes medications for asthma and COPD.
  • Theophylline. Treatment for respiratory diseases like asthma and COPD.
  • Blood pressure medications. Includes alpha agonists and beta blockers.
  • Diuretics. Includes medications for hypertension, renal and liver disorders.
  • Appetite Suppressants. Acts as a stimulant and can inhibit sleep.
  • Niacin. Treatment for high cholesterol.
  • Cocaine. Acts as a stimulant and can inhibit sleep.
  • Methamphetamines. Acts as a stimulant and can inhibit sleep.
  • Nicotine (smoking). Acts as a stimulant and can inhibit sleep.
  • Alcohol. Although alcohol is a depressant, it makes it difficult for the brain to reach deep sleep and REM sleep.

5. Mental Illness

Insomnia is a common symptom of mental illnesses.

Chronic insomnia can lead to the development or exasperate existing mental illness. On the other hand, having a mental illness increases the risk of developing insomnia.

Research found that about 50% of adults with insomnia have a mental health problem, while up to 90% of adults with depression experience sleep problems.

Sleep problems can also slow recovery from mental illness. People with depression who continue to experience insomnia, for instance, are less likely to respond to treatment for depression. They are also at greater risk of relapse than those without sleeping problems.

Mental health disorders commonly associated with insomnia include:

  • Anxiety
  • Depression
  • Schizophrenia
  • Bipolar disorder
  • Panic Disorders

6. Food and Drink

Many types of food and drink consumed before bedtime can disrupt your sleep. Here is a list of foods that can commonly result in insomnia symptoms.

  • Caffeinated food and beverages. Caffeine is a stimulant. High doses of caffeine such as from coffee or energy drinks can make it extremely difficult to fall asleep and stay asleep. It can also reduce the overall quality of sleep and makes it harder to enter deep sleep.

    Some people are more sensitive to caffeine’s effects on sleep quality than others. As a general rule, you should always attempt to avoid caffeine at least 6 hours before you go to sleep.

    Food and beverages that contain caffeine include:
    • Coffee
    • Most tea
    • Energy drinks
    • Soft drinks
    • Chocolate
    • Icecream
  • Food and drink that triggers acid reflux. Several types of food can trigger acid reflux, or gastroesophageal reflux disease (GERD). Acid reflux often occurs at night and can make getting to sleep very difficult. Individuals with acid reflux also note that the sensation worsens every time you lie down.

    If you suffer from acid reflux, it’s important to avoid foods that trigger GERD a few hours before bed. It’s also essential that you don’t go to sleep on a full stomach.

    Foods that commonly trigger GERD include:
    • Spicy foods
    • Fatty or rich foods
    • Acidic food like citrus fruits
    • Carbonated beverages
    • Dairy
    • Caffeine

Consequences of Chronic Insomnia

It’s well known in the medical community that sleep loss has a detrimental effect on health. Chronic insomnia is associated with the development of several diseases and conditions:

  • Obesity. Long term insomnia is correlated with an increased risk of obesity. There is also a direct negative relationship between the average length of sleep a person achieves with the severity of their obesity.

    This means that the shorter you sleep on average, the more overweight you’re likely to. Obesity contributes to poor health and plays a role in the development of many diseases.
  • Diabetes and impaired glucose tolerance. There is a strong relationship between sleep loss and impaired glucose tolerance. Impaired glucose tolerance is a precursor to diabetes.

    Science has found that adults that sleep 5 hours or less on average are 2.5 times more likely to have diabetes. Even individuals that sleep 6 hours per average are 1.7 times more likely to have diabetes. Both groups are also more likely to develop impaired glucose tolerance.
  • Cardiovascular disease and hypertension. Sleep loss increases your risk of heart attack or stroke. Long term sleep deprivation causes an increase in blood pressure and heart rate, which can result in heart disease.

    As stated above, sleep loss leads to impaired glucose tolerance, which can increase the risk of developing cardiovascular disease. Current estimates suggest that getting five hours of sleep or less is associated with a 45% increased risk of having a heart attack.
  • Depressed mood. Sleep loss and mental illness are highly correlated. People with insomnia have higher levels of depression and anxiety than those who sleep normally.

    Those that regularly experience sleep loss are more likely to have or develop clinical depression and clinical anxiety.
  • Early Death. Can you die from a lack of sleep? Sleep loss is associated with an increased risk of early death. Studies have shown that sleeping 5 hours or fewer increases mortality risk, from all causes, by roughly 15%. That’s a terrifying statistic!

Insomnia Diagnosis

Nobody likes going to the doctor so having your insomnia evaluated may seem like a daunting task. 

As someone who has personally gone through two in-clinic sleep studies, I can attest that it can be an inconvenient process but it’s nothing compared to years of suffering from sleep issues.

It’s important to remember that getting a diagnosis for your insomnia is the first step to living a happier and healthier life.

Getting a Referral to a Sleep Clinic

Diagnosis of insomnia starts with an evaluation by your doctor to determine if you have primary or secondary insomnia.

During the exam, your doctor will attempt to identify any medical or psychological illness that may be contributing to your insomnia.

You may be asked about chronic snoring and recent weight gain, which might suggest another sleep disorder such as sleep apnea.

You will be asked questions to identify if you’re suffering from depression or other mental health conditions that may be affecting your ability to sleep.

If your physician believes your insomnia is secondary, they may opt to focus on treating the condition that is causing your sleeplessness.

If no specific reason for your sleepiness can be identified, your doctor might suspect you have primary insomnia and will refer you to see a qualified sleep specialist.

Evaluation by a Sleep Specialist

Diagnosis of primary insomnia starts with an evaluation by a trained sleep specialist. There are various methods your specialist may use for assessment.

These commonly include:

  1. Sleep Diary
  2. Epworth Sleepiness Scale
  3. Actigraphy
  4. In-Clinic Sleep Study

1. Sleep Diary

Your specialist may ask you to keep a sleep diary to better determine if a sleep study should be prescribed. Over the course of at least two weeks you might keep a record of the following information:

  • What time you went to bed.
  • The amount of time it took you to fall asleep.
  • What time you got out of bed in the morning.
  • The number of times you awoke during the night.
  • How refreshing you perceived your sleep to be.
  • A list of factors which may have disturbed your sleep (noise, temperature, pain, illness).
  • The number of caffeinated beverages you consumed during the day and the time of consumption.
  • The number of alcoholic beverages you consumed during the day and the time of consumption.
  • The medication you used during the day.
  • The time you spent exercising.
  • The activities you performed immediately prior to bed.

2. Epworth Sleepiness Scale

To get to the bottom of how severe your insomnia is, your doctor may score you with the Epworth Sleepiness Scale (ESS). The ESS is a scientifically validated questionnaire that is used to evaluate daytime sleepiness.

The ESS asks you to rate your likelihood of falling asleep while engaged in eight different activities. These activities might include watching television, reading a book, attending a meeting, or driving.

A high ESS score indicates your average sleep propensity (ASP), or your ‘daytime sleepiness’. A higher ASP often indicates that you are suffering from a sleep disorder such as insomnia.

3. Actigraphy

Before sending you to complete an in-hospital sleep evaluation, your doctor may instead decide to use a less invasive method of monitoring your sleep. A simple way of achieving this is by wearing an actigraph.  

Actigraphy is a test to assess your sleep and wake patterns over time. A small device called an actimetry sensor, is worn like a wristwatch.

The device determines whether you are awake or sleeping by your movement. It can therefore not only determine when you fall asleep but also how long you slept, and whether you woke up during the night.

Unlike polysomnography, the method used during an in-clinic sleep study, actigraphy allows you to move around and go about your normal routine. Actigraphy is also more affordable than polysomnography so it’s particularly useful for collecting sleep data over a long period of time.

Because actigraphy can record data for weeks or even months, the data is more relevant than the result of polysomnography in assessing circadian rhythms disorders like insomnia.

4. In-Clinic Sleep Study

A sleep study, called polysomnography, takes place in a specialized sleep clinic and is conducted by trained sleep specialists.

During your study, a trained technician will track your brain activity, breathing, blood oxygen levels, and heart rate. Specialized sensors will also test the movement of your body and legs to help determine if you’re restless.

The data collected during your sleep provides detailed information on your sleep quality and can point out the presence of sleep disorders, like hypersomnia.

Insomnia Treatment

Once you’re formally diagnosed with insomnia, your doctor will create a tailored treatment plan. How your insomnia is treated largely depends on the cause and severity.

Below is a list of common insomnia treatments.

Behavioral and Lifestyle Changes for Insomnia

Insomnia isn’t always caused by genetics, a sleep disorder, or a health condition. Sometimes sleep loss is completely self-inflicted by bad habits and a poor sleeping environment.

The first action an individual with insomnia can take is to address their personal sleep habits. These habits, termed ‘sleep hygiene‘ by professionals, is a variety of practices necessary to have good nighttime sleep.

The following is a list of good sleep hygiene practices.

1. Adhere to a Strict Sleep Schedule

In order to keep your internal clock working properly, it’s important to go to bed and wake up at the same time every day.

Even though it’s tempting to sleep in on weekends, you should try your best to maintain a routine. This will train your brain to get into a rhythm which will help you fall asleep faster.

2. Avoid Caffeine Before Bedtime

Not consuming caffeine before bed may seem obvious but it’s easy to trip yourself up by drinking a small cup of tea or eating a few bars of chocolate. It’s important to avoid anything containing caffeine at least 6 hours before bedtime.

3. Avoid Electronic Devices Before Bedtime

A few hours before you go to bed your brain starts producing the hormone melatonin. Melatonin signals to the brain that it’s time for sleep and makes you feel tired.

Melatonin is only created at night when our eyes receive less light input. Sunlight and other types of bright light directly inhibit the release of melatonin.

Electronic devices that emit artificial blue light such as mobile phones and computers mimic sunlight and inhibit the production of melatonin. This stimulates your brain to stay awake and alert. So it’s important to avoid using these devices too close to bedtime.

4. Remove Your Alarm From Your Line of Sight

You should move the position of your alarm clock so it’s not visible while you sleep. Many people with psychophysiological insomnia find themselves constantly checking the time and stressing about not getting enough sleep. Stress can quickly turn into anxiety, which can make it even more difficult to fall asleep.

5. Start a Pre-sleep Routine

Your brain is excellent at learning new routines and habits. Creating a strict bedtime routine can, therefore, signal to your body that it’s time to settle down.

Common pre-sleep routines include:

  • Taking a warm bath
  • Having a glass of non-caffeinated tea
  • Reading a book
  • Listening to peaceful music

6. Create a Bedroom Environment Conducive for Sleep

Try to create a bedroom environment that is relaxing and favorable for sleep.

It’s important to block as much light pollution as possible. Using high-quality blinds or curtain will keep your room dark. Also, avoid using fluorescent light bulbs and decorating with bright colors.

Avoid keeping a TV and other electronics in your room. The bed itself should be supportive but comfortable, with bedding that doesn’t cause overheating. Make sure your pillow offers proper head and neck support so you don’t experience muscle pain during the night.

Finally, your brain goes through a cooling process before it can sleep so scientists recommend keeping the room temperature at 65°F or 18°C.

7. Only Use Your Bed for Sleep and Romance

To get proper sleep, it’s best that you only use your bed for sleep and romance. Your brain quickly makes associations between your actions and your environment. Thus, it’s difficult to relax if your brain links your bedroom to more stimulating activities.

Therapy and Mental Health Management for Insomnia

Most with insomnia benefit greatly from seeing a mental health care professional in order to help develop good sleep habits and avoid behaviours that keep you from sleeping well.

Cognitive Behavioral Therapy – Insomnia is an insomnia-specific program structured to helps you identify and replace thoughts and behaviors that cause or worsen sleep problems with habits that promote sound sleep.

Most medical professionals agree that CBT-I is a better approach to insomnia treatment than sleeping pills because it helps you overcome the underlying causes of your sleep problems.

According to the Mayo Clinic, there are several techniques your therapist may use to address your insomnia.

  • Stimulus control therapy. The goal of stimulus control therapy is to reduce the anxiety the patient individuals feels when they go to bed. The therapist will create a set of instructions designed to help the patient associate the bedroom with sleep and establish a strict sleep schedule.
  • Sleep restriction. Sleep restriction aims to eliminate mid-sleep awakenings. It doesn’t restrict actual sleep time but instead initially restricts the time spent in bed.
  • Sleep hygiene. Improving sleep hygiene involves making minor changes to habits and behaviors that influence sleep, such as watching tv before bed, consuming caffeine late in the day, or not maintaining a strict sleep schedule.
  • Relaxation training. Your therapist may suggest relaxation techniques to help calm you before sleep. Meditation is often included in relaxation training.
  • Paradoxical Intention. Paradoxical intention is a technique that requires the patient to actively avoid trying to fall asleep. Worrying about getting enough sleep causes anxiety that inhibits sleep onset. If the patient stops trying to fall asleep and instead stays awake for as long as possible, the anxiety is reduced and sleep may occur more easily.
  • Biofeedback. Biofeedback uses sensors placed on the body to track muscle tension or brain rhythms. This allows the patient to gauge their tension level or activity, allowing them to develop strategies to reduce this tension. Learning to control overs these activities can help the patient fall asleep.

Prescription Medication for Insomnia

Most medical professionals agree that sleeping medication should be a last resort for treating insomnia. This is because like most drugs, sleep pills can have side adverse effects.

While sleeping pills have a powerful hypnotics effect that can induce sleep, they’re not good at allowing you to cycle through your sleep stages naturally. This means that sleep medications don’t provide the same restorative benefits as natural sleep.

Despite the drawbacks of using medication, some with severe insomnia may still require them to get sleep. Before using any sleep aid it’s important to understand the risk and common side effects associated with sleeping pills.

Side effects of sleeping pills include:

  • Oversleeping
  • Being too groggy to drive or operate heavy machinery
  • Being too drowsy to work o
  • With some prescription sleeping pills, doing activities while you are not fully awake is not uncommon. Patients have reported eating, walking, leaving the house, having sex, making phone calls, carrying on conversations, or driving while not fully awake. Most are not aware of these activities.
  • Allergic reaction (anaphylaxis)
  • Facial swelling (angioedema)
  • Memory loss
  • Mental and behavioral problems
  • Learning difficulties
  • Worsening of insomnia symptoms when the pills are discontinued

There are many sleep aids currently available. Each medication is slightly different and which drug you are prescribed depends on your individual needs.

If your doctor has determined you should use a sleep aid for your insomnia, they may prescribe one of the following drugs:

  • Zolpidem tartrate (Ambien®)
  • Flurazepam hydrochloride (Dalmane®)
  • Triazolam (Halcion®)
  • Eszopiclone (Lunesta®)
  • Estazolam (Prosom®)
  • Temazepam (Restoril®)
  • Ramelteon (Rozerem®)
  • Doxepin (Silenor®)
  • Zaleplon (Sonata®)
  • Trazodone (Desyrel®)
  • Suvorexant (Belsomra®)

Over The Counter (OTC) Sleep Aids for Insomnia

If you only experience occasional insomnia, keeping an OTC sleep aid handy is an excellent alternative to prescription medication. The most common sleep aids publicly available include:

  • Diphenhydramine (Benadryl, Aleve PM, others). The antihistamines in Diphenhydramine has a sedating effect.
  • Doxylamine succinate (Unisom SleepTabs). Doxylamine is also a sedating antihistamine.