Insomnia: a symptom to many possible causes



Insomnia is the inability to sleep well. Insomnia may make it hard for you to get to sleep, stay asleep, or sleep as long as you need to. This can make you tired and grouchy during the day. It can also make you forgetful, less effective at work, and unhappy. Insomnia can be linked to many things. These include health problems, medicines, and stressful events.

Treatment may include treating problems that may be linked with your insomnia. Treatment also includes behavior and lifestyle changes. This may include cognitive behavioral therapy for insomnia (CBT-I). CBT-I uses different ways to help you change your thoughts and behaviors that may interfere with sleep. Your doctor can recommend specific things you can try. Examples include doing relaxation exercises, keeping regular bedtimes and wake times, limiting alcohol, and making healthy sleep habits. Some people decide to take medicine for a while to help with sleep.


Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.



How can you care for yourself at home?

Cognitive behavioral therapy for insomnia (CBT-I)

  • If your doctor recommends CBT-I, follow your treatment plan. Your doctor will give you instructions that are unique for you.

  • Your plan will likely include a few things that you can try at home. For example:

  • Try meditation or other relaxation techniques before you go to bed.

  • Go to bed at the same time every night, and wake up at the same time every morning. Do not take naps during the day.

  • Do not stay in bed awake for too long. If you can't fall asleep, or if you wake up in the middle of the night and can't get back to sleep within about 15 to 20 minutes, get out of bed and go to another room until you feel sleepy.

  • If watching the clock makes you anxious, turn it facing away from you so you cannot see the time.

  • If you worry when you lie down, start a worry book. Well before bedtime, write down your worries, and then set the book and your concerns aside.


Healthy sleep habits

  • If your doctor recommends it, try making healthy sleep habits. For example:

  • Keep your bedroom quiet, dark, and cool.

  • Do not have drinks with caffeine, such as coffee or black tea, for 8 hours before bed.

  • Do not smoke or use other types of tobacco near bedtime. Nicotine is a stimulant and can keep you awake.

  • Avoid drinking alcohol late in the evening, because it can cause you to wake in the middle of the night.

  • Do not eat a big meal close to bedtime. If you are hungry, eat a light snack.

  • Do not drink a lot of water close to bedtime, because the need to urinate may wake you up during the night.

  • Do not read, watch TV, or use your phone in bed. Use the bed only for sleeping and sex.


Medicine

  • Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.

  • Talk with your doctor before you try an over-the-counter medicine, herbal product, or supplement to try to improve your sleep. Your doctor can recommend how much to take and when to take it. Make sure your doctor knows all of the medicines, vitamins, herbal products, and supplements you take.

  • You will get more details on the specific medicines your doctor prescribes.


When should you call for help?

Watch closely for changes in your health, and be sure to contact your doctor if:

  • Your efforts to improve your sleep do not work.

  • Your insomnia gets worse.

  • You have been feeling down, depressed, or hopeless or have lost interest in things that you usually enjoy.


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