Insomnia (Sleepless Nights)

What Is Insomnia?

Insomnia is a sleep disorder in which a person experiences poor sleep or has trouble sleeping. Insomnia can involve:

  • Difficulty falling asleep
  • Difficulty staying asleep (that is, waking up many times during the night), without necessarily having had any difficulty falling asleep
  • Waking up too early in the morning
  • Not feeling refreshed after a night’s sleep

In any of these cases the person feels tired the next day, or feels as if he or she did not have enough sleep.

Poor sleep for any length of time can lead to mood disturbances, lack of motivation, decreased attention span, trouble with concentration, low levels of energy, and increased fatigue.

About one-third of the average person’s life is spent sleeping. Healthy sleep is vital to the human body and important for the optimal functioning of the brain and other organs.

There are three types of insomnia:

  • Transient, or mild, insomnia – sleep difficulties that last for a few days; there is little or no evidence of impairment of functioning during the day
  • Short-term, or moderate, insomnia – sleep difficulties that last for less than a month, that mildly affect functioning during the day, together with feelings of irritability and fatigue
  • Chronic, or severe, insomnia – sleep difficulties that last for more than a month, that severely impair functioning during the day, and cause strong feelings of restlessness, irritability, anxiety, and fatigue

Need To Know:

Q: What is the right amount of sleep I should get?

A: Since everyone has different sleep needs, there is no “correct” amount of sleep. On average, most people need between seven and nine hours of good quality sleep each night in order to feel alert the next day. But some function perfectly well with only four or five hours a night. The key to healthy sleeping seems to be a consistent pattern, rather than the number of hours one sleeps.

Is Insomnia Serious?

Insomnia can have physical and psychological effects. The consequences of insomnia include:

  • Impaired mental functioning. Insomnia can affect concentration and memory, and can affect one’s ability to perform daily tasks.
  • Accidents. Insomnia endangers public safety by contributing to traffic and industrial accidents. Various studies have shown that fatigue plays a major role in automobile and machinery accidents. As many as 100,000 automobile accidents, accounting for 1,500 deaths, are caused by sleepiness.
  • Stress and depression. Insomnia increases the activity of the hormones and pathways in the brain that cause stress, and changes in sleeping patterns have been shown to have significant affects on mood. Ongoing insomnia may be a sign of anxiety and depression.
  • Heart disease. One study reported that people with chronic insomnia had signs of heart and nervous system activity that might put them at risk for heart disease.
  • Headaches. Headaches that occur during the night or early in the morning may be related to a sleep disorder.
  • Economic effects. Insomnia costs the U.S. an estimated $100 billion each year in medical costs and decreased productivity.

Normal Sleep

Sleep is not a simple process. Many different parts of the brain control and influence sleep at different stages. There are two natural daily peak times for sleeping: at night and at mid-day, which in parts of the world is traditional “siesta” time.

Here is how the body initiates sleep:

  • As light fades, cells in the retina of the eye send a signal to a cluster of nerve cells located in the hypothalamus, in the center of the brain.
  • These cells in turn send a message to the pineal gland in the brain to produce the hormone melatonin, which causes a drop in body temperature and sleepiness.
  • At the same time, another cluster of nerve cells in the brain is believed to deactivate three major chemical messengers in the body, that keep us alert: histamine, norephinephrine, and serotonin.

There are two distinct phases of sleep:

  • Non-rapid eye movement (Non REM) sleep – The quiet or restful phase of sleep, also referred to as “slow wave sleep”; it is divided into four stages of progressively deepening sleep
  • Rapid eye movement (REM) sleep – The phase of sleep in which the brain is active and dreaming occurs; it is also known as “dream sleep”

When we first go to sleep, the “brain waves” (the electrical activity normally produced in the brain) slow from a frequency of 10 cycles per second that usually occurs while we’re awake, to about 6 cycles per second as our alertness decreases and we fall asleep. Then after about an hour, there is a sudden increase in brain wave activity for a few minutes when the electrical activity in the brain speeds up, similar to normal waking. This is REM sleep. During this time if the person is woken up, he will say he was dreaming.

Then the electrical activity of the brain slows down again. This cycle may be repeated several times during one night’s sleep. Total REM sleep for the night is about 20% of the total sleep time. So we spend about a fifth of our sleeping time dreaming.

The phases of sleep occur in a repeated cycle of Non REM followed by REM sleep, with each cycle lasting about 90 minutes. The sleep cycle is repeated four to six times a night. It is possible to identify which stage of sleep a person is in by measuring different activities of the brain and body.

Each phase of sleep is important. Research suggests that Non REM sleep may play a role in bolstering the immune system and may also be tied to the rhythms of the digestive system. Experts believe that REM sleep is necessary for long-term emotional well-being and may help bolster memory.

Need To Know:

If your insomnia lasts longer than a few weeks and is affecting your mood, relationships, and ability to function well, it is a good idea to see a doctor, therapist, or sleep specialist.

What Are Sleep Disorders?

An estimated 40 million Americans experience some type of sleep disorder, but 95 percent of them go undiagnosed and untreated, simply because they do not realize they have a problem or because they think that nothing can be done for them.

Common sleep disorders include:

  • Insomnia, an inability to sleep or to remain asleep throughout the night
  • Obstructive sleep apnea, in which a person’s breathing passages become temporarily blocked during the night; this condition is often marked by excessive snoring
  • Chronic sleep apnea, a neurological condition in which the brain “forgets” to instruct the body to breathe
  • Restless leg syndrome, in which a person has occasional movement and/or uncomfortable sensations in his or her legs, feet, or toes just before they fall asleep
  • Hypersomnia, an increase in sleep by about one-fourth of a person’s regular sleep patterns
  • Narcolepsy, in which a person gets sudden attacks throughout the day and night of drowsiness and sleep that cannot be controlled
  • Parasomnias, which are vivid dreams and physical activities that occur during sleep, such as sleepwalking (somnambulism) and episodes of screaming and flailing about (night terrors).

Nice To Know:

Chronic sleep deprivation – in which a person sleeps soundly, but just doesn’t get enough sleep – is not classified as a sleep disorder, but it contributes greatly to our sleepy society. Experts say most of us need at least one more hour of sleep per night than we get.


Facts about insomnia:

  • Studies estimate that about one-third of the adult population in the world experiences some insomnia each year.
  • Experts estimate that only about 5 percent of people with insomnia seek medical help, and 69 percent never even mention the problem to their doctor.
  • More than 35 million Americans suffer from long-lasting insomnia, with 20 to 30 million others experiencing shorter-term sleeplessness.
  • Insomnia costs the U.S. approximately $100 billion each year in medical costs and decreased productivity.
  • In the U.S., as many as 100,000 automobile accidents and 1,500 deaths from these accidents are caused by sleepiness.
  • In one study, 40 percent of people with insomnia also had a psychiatric disorder.
  • At least 70 percent of people with depression also experience insomnia.
  • As many as 25 percent of people with anxiety disorders also experience insomnia.
  • Substance abuse – especially alcohol, cocaine, and sedatives – plays a role in an estimated 10 to 15 percent of cases of chronic insomnia.


Who Gets Insomnia?

Over 90 percent of people experience some degree of insomnia at some point in their lives. Studies indicate that insomnia affects one in three adults every year in the United States.

Several factors increase a person’s chances of developing insomnia:

  • Gender. In general, insomnia is more common in women than men. However, older men have more disrupted sleep than older women.
  • Age. As a person ages, sleep becomes more fragmented. Complaints of insomnia are much more frequent in people over age 65 than in younger individuals.
  • Medical conditions and medication. People who have arthritis, ulcers, urinary disorders, heart conditions, and other conditions that cause pain or discomfort, are more likely to get insomnia. In addition, insomnia is a side effect of many common medications, including over-the-counter medicines that contain caffeine.
  • Childhood fears. One study found that people who had experienced long-term insomnia had been prone to nightmares and fear of the dark as children.
  • Lifestyle. People who travel frequently and cross time zones, as well as night-shift workers, are at higher risk. Smoking, overuse of alcohol or other stimulants, and high caffeine intake also contribute. A new phenomenon that is contributing to insomnia is Internet addiction.

Nice To Know:

Motherhood seems to lead most women to develop a high sensitivity to the sounds of their children, which causes them to wake easily. Women who have had children sleep less efficiently than women who have not had children. Some researchers believe that many women never unlearn this sensitivity and continue to wake easily long after the children have grown.

Aging And Insomnia

As people get older, they tend to sleep less, and their sleep stages also change. Though normal, these changes often make older people think they’re not getting enough sleep.

An early morning awakening pattern – in which people fall asleep normally but wake up several hours after and are unable to fall asleep again – is more common in the elderly. In some cases, early morning awakening may be a sign of depression.

Experts believe a number of factors may influence sleep in the elderly, including:

  • Naturally reduced levels of melatonin, the hormone that helps control sleep
  • Sensitivity to environmental disruptions, such as noise
  • Illnesses that cause pain or discomfort
  • Neurological conditions such as Alzheimer’s disease and Parkinson’s disease

    For more detailed information about Parkinson’s disease, go to Parkinson’s Disease.

  • Medication with side effects that include insomnia
  • Grief, depression, and anxiety, to which the elderly are especially prone

Need To Know:

Sleep loss is not an inevitable part of aging, however. Treatments for insomnia are just as effective for older people as for younger people. In addition, regular exercise can contribute to healthy and restful sleep.


What Causes Insomnia?

There are many possible causes of insomnia. Sometimes there is one main cause, but often several factors interacting together will cause a sleep disturbance. The causes of insomnia include:

  • Psychological causes
  • Physical causes
  • Temporary events or factors

Psychological Causes

In many people, insomnia can be the result of:

  • Anxiety, a condition in which individuals feel increased tension, apprehension, and feelings of helplessness, fear, worry, and uncertainty. This may be due to the effects that other people at work have on us, financial worries, concerns over relationships outside work or numerous other causes.

    For more detailed information about anxiety, go to Anxiety: How To Stop Worrying.

  • Stress, or how effectively a person copes with any emotional, physical, social, economic, or other factor that requires a response or change.

    For more detailed information about coping with stress, go to Stress And How To Manage It.

  • Depression, a mood disturbance characterized by feelings of sadness, despair, and discouragement.

    For more detailed information about depression, go to Depression: How To Overcome It.

In addition, a lack of a good night’s sleep can lead to these very same psychological problems, and a vicious cycle can develop. Professional counseling from a doctor, therapist, or sleep specialist can help individuals cope with these conditions.

Physical Causes

The physical causes of insomnia include the following:

  • Hormonal changes in women. These include premenstrual syndrome, menstruation, pregnancy, and menopause.

    For more detailed information about premenstrual syndrome, go to Premenstrual Syndrome.

  • Decreased melatonin. The levels of melatonin, the hormone that helps control sleep, decrease as a person ages. By age 60, the body produces very little melatonin.
  • Medical conditions. These include allergies, arthritis, asthma, heart disease, high blood pressure, hyperthyroidism, and Parkinson’s disease.

    For more detailed information about arthritis, go to Osteoarthritis.

    For more detailed information about asthma, go to Asthma.

    For more detailed information about heart disease, go to Heart Disease: How To Reduce The Risk.

    For more detailed information about high blood pressure, go to High Blood Pressure.

    For more detailed information about hyperthyroidism, go to Hyperthyroidism.

    For more detailed information about Parkinson’s disease, go to Parkinson’s Disease.

  • Pain. Pain and discomfort from a medical illness or injury often interfere with sleep.
  • Genetics. Problems with insomnia do seem to run in some families, although researchers have yet to identify how genetics play a role.
  • Other sleep disorders. These include sleep apnea (in which one temporarily stops breathing during sleep) and periodic leg and arm movements during sleep (in which one’s muscles excessively twitch or jerk).

Temporary Events Or Factors

Short-term insomnia can be linked to events and factors that are often temporary, such as:

  • Adjustment sleep disorder. This form of sleeplessness is a reaction to change or stress. It may be caused by a traumatic event such as an illness or loss of a loved one, or a minor event such as a change in the weather or an argument with someone.
  • Jet lag. Air travel across time zones often causes brief bouts of insomnia.
  • Working the night shift or long shifts. Individuals who work at night and those who work long shifts may have trouble adjusting their sleep habits.
  • Medications. Insomnia can be a side effect of various medications, both prescription and over-the-counter.
  • Overuse of caffeine and alcohol. Caffeine most commonly disrupts sleep. While a drink or two before bed may help a person relax, more than that can lead to fragmented sleep and wakefulness a few hours later.
  • Environmental noise, extreme temperatures, or a change in a person’s surrounding environment.

Need To Know:

Insomnia can be a sign of an undiagnosed medical or psychological condition. If insomnia persists for more than a few weeks, it’s best to see your doctor for a physical exam.


How Is Insomnia Diagnosed?

Insomnia is almost always the result of some other problem and is not an ‘illness’ in its own right. Discovering its cause is the most important step in relieving it. Your doctor will ask questions such as:

  • How would you describe your sleep problem (for example, do you have trouble falling asleep, or is the problem waking up too early)?
  • How long have you been experiencing the problem?
  • Does it occur every night?
  • Does it affect your daytime functioning?
  • Do you snore?
  • Do you have any medical conditions?
  • Are you taking any medication?

Nice To Know:

Keeping a sleep diary can help your doctor make a diagnosis. You should record all sleep-related information such as how long it took you to fall asleep, how restful the sleep was, what you ate or drank before bed, how often you woke during the night, etc. Your bed partner can also help by adding observations about whether you snored, moved in your sleep, etc.

Most of the time, a physician can make a diagnosis of insomnia from the information provided by the person. But if unexplained insomnia persists, or if there is evidence that the sleep disorder is caused by a breathing problem, a doctor may suggest a sleep study at a sleep lab to identify the root of the problem.

Getting Help At A Sleep Lab

There are many excellent sleep labs throughout the U.S. that are designed to diagnose sleep disorders through a sleep study. Most require spending one or more nights in the lab. The American Sleep Disorders Association has a list of the accredited sleep labs in the United States.

Most sleep labs require a referral from your doctor. However, you may want to call and find out if you can have an evaluation done independently. Once you have made an appointment, you will receive complete instructions as to what tests will be done and what is required of you.

How-To Information:

How is a sleep study done?

A sleep study is conducted overnight. The individual arrives in the early evening and plans to spend the night in a bed in the sleep lab. Although a sleep study may look high-tech, it is pain-free and individuals are usually quite comfortable.

Electrodes will be attached with soft tape to various parts of the body, including the head, chest and legs. A belt may be placed around the abdomen and chest. These devices are linked to computerized equipment that record the body’s sleep patterns through the night.

Recordings are made of brain wave activity, respiration (breathing), heart rhythm, eye movements, chest movements, arm and leg movements, and pulse oximetry, which measures the level of oxygen in the blood. In the morning, there is a wealth of data that can be analyzed.

Nice To Know:

Q: Will my insurance pay for a sleep study?

A: Most authorized sleep studies are considered medical procedures and are covered by most insurance companies, including Medicare. Check with your insurance provider to determine if your policy covers a sleep study.


How Is Insomnia Treated?

Sleep research has led to major advances in the treatment of insomnia. Many experts now consider sleeping pills to be overused, as well as dangerous because they can become addictive. They suggest that medication be used a last option, after other treatments have been tried.

Non-medicine treatment options include:

  • Physical relaxation
  • Mental relaxation
  • Other techniques

Physical Relaxation

If you are anxious about falling asleep, certain muscles in your body become tense and sometimes painful, interfering with sleep. Physical relaxation techniques can help.

Find a quiet, peaceful place in which to practice the following technique about 30 minutes a day:

  • Lie perfectly still until you find the most comfortable position for yourself. Now deliberately tense up the muscles in your arms and legs as tightly as you can. Try to hold this tension for about a minute and then let the muscles relax gradually-first your legs, and then your arms.
  • Now let your whole body feel as relaxed as it possibly can. Take a rest for five minutes and then repeat the procedure twice more.
  • At the end of the session, try to concentrate on the feeling of your muscles and let them go as limp and relaxed as possible for the rest of the period. Try to make your breathing slow and steady as you relax.

This technique is designed to teach individuals how their body relaxes and how to control relaxation and tension.

Mental Relaxation

Since stress and worry, including the worry about not being able to fall asleep, are often at the core of insomnia, many people have found that mental relaxation techniques can help them to feel less anxious and therefore sleep better.

This method also requires finding a peaceful, quiet place to practice this technique for about 30 minutes a day:

  • Try to relax your body first, by finding the most comfortable position for yourself. Then empty your mind of all thoughts by concentrating on one particular object in the room or a particular part of the room.
  • After a minute, sit up, and then walk around for a bit. Then return to your position and repeat the exercise.
  • Now think of a particularly happy time in your life that you really enjoyed. If you cannot immediately think of something, find a poster of some exotic place or beautiful scenery. Concentrate on imagining yourself in this place for about five minutes.
  • Try to feel the sensations first in your neck muscles, and then in your arm and leg muscles, as they gradually become relaxed. After another few minutes, get up and walk around the room a bit. Then repeat the process.

This exercise differs from the physical technique in that it emphasizes controlling the psychological components of anxiety before attempting to relax your body.

Other Techniques

Other relaxation techniques to try include:

  • Yoga or meditation
  • Exercise (shown in studies to be an effective way to achieve a healthy sleep)
  • Mind-body therapies such as guided imagery or hypnotherapy
  • Reading while lying in a relaxed position
  • Listening to music while lying in a relaxed position
  • Having a soothing bath or shower before bed
  • Massage, especially of the neck, shoulder, and leg muscles

Need To Know:

Some people find psychotherapy (the treatment of mental and emotional disorders with professional counseling) very helpful in relieving anxiety or depression that could be contributing to insomnia.


Can Medication Help Insomnia?

Sleep medications should not be taken lightly. Low-dose sleep medication can help short-term insomnia but is rarely helpful for long-term sleep problems. Many experts today recommend only trying medications as a last resort, after other treatments for insomnia have failed, because they can be addictive and can have serious side effects.

Hypnotics (sedatives, minor tranquilizers, and antianxiety drugs) are among the most commonly used medications for insomnia.

  • Most hypnotics require a doctor’s prescription because they may be habit-forming or addictive, and overdose is possible.
  • Many hypnotics can lose their effectiveness once a person has become accustomed to them.
  • Hypnotics also may produce withdrawal symptoms, and this can make the insomnia return. For this reason, doctor’s recommend reducing the dose slowly; complete withdrawal can take several weeks.

Sleep medications are available as:

  • Over-the-counter medications (no prescription needed)
  • Prescription medications

Over-The-Counter Medications

Two inexpensive medications available without a prescription that can relieve mild or occasional sleeping problems are diphenhydramine anddimenhydrinate.

  • These medications can leave you drowsy the next day, but they are not addictive.
  • Side effects include dizziness, blurred vision, and dry mouth.
  • They should not be used be used by people with angina, heart arrhythmias, glaucoma, prostate problems, or urinary problems.

Over-the-counter medications for insomnia are purchased more than any other type of drug.

  • Commonly used over-the-counter sleep medications include Nytol, Sleep-Eez, and Sominex.
  • When sleeplessness is caused by minor pain, over-the-counter pain relievers such as acetaminophen (Tylenol) or a nonsteroidal anti-inflammatory drug (Advil, Motrin) can be very helpful.
  • Some newer medicines (such as Anacin P.M., Excedrin P.M., and Tylenol P.M.) contain both a sleeping medication and a pain reliever.
  • Antihistamines have a sedating effect and may be used as mild sleep inducers. They include chlorpheniramine (Chlor-Trimeton)and diphenhydramine (Benadryl).

Need To Know:

About melatonin supplements

You may have heard about the treatment of insomnia with melatonin supplements. Despite its widespread use, little is actually known about the long-term safety of melatonin supplements. The U.S. Food and Drug Administration does not monitor melatonin, and many of the melatonin products sold in health food and supplement stores contain unknown substances.

Prescription Medications

Prescription medications for insomnia should be taken at the lowest dose possible. Various types of prescription medication include:

  • Benzodiazepines. These are the most common and safest hypnotics. They include lorazepam (Ativan), alprazolam (Xanax), triazolam (Halcion), and temazepam (Restoril), among others. Side effects include respiratory symptoms, daytime drowsiness, memory loss, and odd mood states. Benzodiazepines are potentially dangerous when combined with alcohol and should not be taken by people who use the ulcer medication cimetidine (Tagamet).
  • Non-benzodiazephines. These hypnotics may pose less of a risk of dependence. They include zolpidem (Ambien), zopiclone, and zaleplon. Side effects include nausea, dizziness, nightmares, agitation, and headache.
  • Antidepressants. These can relieve insomnia associated with depression or early morning awakening. Newer antidepressants include trazodone (Desyrel), nefazodone (Serzone), andparoxetine (Paxil). These medications have far fewer side effects, and much less danger for overdose, than other anti-insomnia drugs.

Need To Know:

What are the ground rules for being prescribed sleeping medication for insomnia?

Simply put, the focus should be on what’s causing the insomnia and not simply on giving treatment to help someone sleep. For example, is the insomnia due to a brief short-lasting worry, or is it a symptom of an underlying disorder such as depression? Sleeping pills do not relieve such an underlying disorder, whereas antidepressants usually do.

For more detailed information about depression, go to Depression: How To Overcome It

Many experts suggest the following ground rules:

  • Try to avoid benzodiazepine sleeping pills and use a nonaddictive one instead.
  • Try to take them only occasionally and not make a habit of it.
  • Accept that the course of treatment will be short (no more than two weeks) and the prescription will not be repeated.

Nice To Know:

For women who have reached menopause, hormone replacement therapy (HRT) helps prevent insomnia caused by hot flashes, a common symptom of menopause. Studies have shown that women who take HRT seem to fall asleep faster, have fewer wakeful periods, and sleep longer than those not taking estrogen.

For more detailed information about hormorne replacement therapy, go to Hormone Replacement Therapy.


How Can I Avoid Insomnia?

Prevention of sleeplessness is very much dependent on your ability to relax and learn techniques for sleeping well.

How-To Information:

Here are some tips to help improve your sleep:

  • Learn to use physical and mental relaxation techniques.
  • Establish a regular sleep schedule. This involves setting a regular bedtime and wake-up time and making every attempt to stick to it, including on the weekends. This will help to set the body’s clock in a way that will make nighttime sleep deeper and more consistent.
  • Avoid taking naps, especially in the afternoon.
  • Exercise regularly during the day.
  • Use the bed only for sleep and sex, not reading or watching television.
  • If you do not fall asleep fairly quickly, get out of bed. Do not return until you are feeling drowsy.
  • Try to reduce stress in your life, or find better ways to cope with stress.

    For more detailed information about coping with stress, go to Stress And How To Manage It.

  • If it is noisy in your bedroom, introduce some form of “white noise” such as a rotating fan.
  • Do not over-focus on falling asleep by watching the clock.
  • Create a bedroom environment that is quiet, relaxing and peaceful.
  • Set up a regular bedtime routine that revolves around an activity that helps you unwind.
  • Avoid caffeine, and other stimulants, especially late in the day.
  • Eliminate smoking. It has a detrimental effect on the lungs, heart, sinuses, and circulation, and it also interferes significantly with sleep, as nicotine is a stimulant that prevents the brain from resting. Cutting back on cigarette smoking may lead to nicotine withdrawal in the middle of the night, which can awaken you, so it is important to stop smoking completely.

    For more detailed information about how to quit smoking, go to Smoking: How To Stop.

  • Avoid alcohol. Even if it helps you fall asleep quicker, it actually worsens insomnia by causing shallow, unrefreshing sleep.

Insomnia: Frequently Asked Questions

Here are some frequently asked questions related to insomnia.

Q: What is the right amount of sleep I should get?

A: Since everyone has different sleep needs, there is no “correct” amount of sleep. On average, most people need between seven and nine hours of good quality sleep each night in order to feel alert the next day. But some function perfectly well with only four or five hours a night. The key to healthy sleeping seems to be a consistent pattern, rather than the number of hours one sleeps.

Q: How can I tell if I am getting enough sleep?

A: Here are some simple questions to ask yourself to test for sleepiness:

  • Do I need to set an alarm clock in order to wake up in the morning?
  • If so, do I usually press the snooze button?
  • Do I feel like I need a nap during the day?
  • Do I fall asleep while watching TV?
  • Does reading a book make me feel sleepy?

If you answer yes to more than one of these questions, you are not getting enough quality sleep to meet your needs.

Q: What can I do to avoid insomnia?

A: Here are some rules to abide by:

  • Don’t exercise just before going to bed.
  • Don’t read or watch television in bed.
  • Don’t use alcohol to help you sleep.
  • Don’t take another person’s sleeping pills.
  • Don’t partake in stimulating activities just before bed.
  • Avoid all foods and drinks containing caffeine close to bedtime.
  • Don’t lie in bed fretting. If you can’t sleep, get up and do some quiet activity. Only return to bed when you are sleepy. Do this as many times in a night as necessary.

Q: Does insomnia ever go away on its own?

A: Sometimes insomnia does go away on its own. Usually this happens with short-term insomnia that is due to some temporary stress in your life. When it persists, however, it may be a sign of another illness, such as anxiety or depression, and you should seek treatment.

Q: What is REM sleep and why is it important?

A: REM sleep stands for rapid eye movement sleep. For most of the night, our eyes are still. However, every so often the eyeballs of a sleeping person will make rapid side-to-side movements under the lids. People woken up during these times report that they have been dreaming. During REM sleep the muscles of the body are very relaxed and movements are difficult. Some believe this semi-paralysis of the muscles stops us from walking around or otherwise acting out the scenes being played out in our dreams. Although adults spend only a fifth of the night in REM sleep, a newborn baby may spend half of its sleep in this stage. Some studies suggest that REM sleep is particularly useful for growth and repair of the brain itself, while the other type of deep, or slow-wave, sleep is useful for repair of the rest of the body.

Q: Why is alcohol detrimental to sleep?

A: After we have had a few drinks, alcohol often causes drowsiness and lets us get off to sleep quite easily. Later in the night, however, when the alcohol level in our blood decreases, our body’s arousal mechanism is stimulated and our normal sleep pattern is impaired. In addition, one of the effects of alcohol is to stimulate the pouring of adrenalin into the bloodstream, causing arousal, sweating and palpitations. This can result in waking up half-way through the night, or earlier than normal, with the heart pounding, making it quite difficult to get to sleep again.

Q: Will my insurance pay for a sleep study?

A: Most authorized sleep studies are considered medical procedures and are covered by most insurance companies, including Medicare. Check with your insurance provider to determine if your policy covers a sleep study.

Insomnia: Putting It All Together

Here is a summary of the important facts and information related to insomnia.

  • Insomnia is a sleep disorder in which individuals experience poor sleep or have trouble sleeping.
  • Poor sleep for any length of time can lead to mood disturbances, lack of motivation, decreased attention span, trouble with concentration, low levels of energy, and increased fatigue.
  • Factors that increase a person’s chances of developing insomnia include being female, being elderly, having certain medical conditions, taking certain medications, having had childhood fears, and having a lifestyle that includes frequent travel, smoking, or overuse of alcohol or caffeine.
  • Insomnia has psychological causes (such as anxiety or depression), physical causes (such as illness or pain), and other causes (such as jet lag or environmental noise).
  • The consequences of insomnia include impaired mental functioning, a higher risk for accidents, stress and depression, heart disease, and headaches.
  • Treatment options for insomnia include physical and mental relaxation techniques, other techniques (such as yoga, massage, or meditation), and medications (over-the-counter or prescription).
  • Prevention of sleeplessness is very much dependent on your ability to relax and learn techniques for sleeping well.

Insomnia: Glossary

Here are definitions of medical terms related to insomnia.

Early morning awakening: A sleep disorder in which people fall asleep normally but wake up several hours after and are unable to fall asleep again.

Insomnia: An ongoing inability to sleep or to remain asleep throughout the night.

Melatonin: A hormone (a chemical produced by the body and carried by the bloodstream to another part of the body to stimulate or retard its function) produced in the hypothalamus of the brain that causes a drop in body temperature and sleepiness.

Non-rapid eye movement (NREM) sleep: The early stages of sleep.

Rapid eye movement (REM) sleep: A stage of deep sleep marked by movement of the eye muscles; dreaming occurs during REM sleep.

Sleep apnea: A sleep disorder characterized by periods when breathing temporarily stops; the person is momentarily unable to move respiratory muscles or maintain an air flow through the nose and mouth.

Sleeping pill: A sedative, usually available over the counter, that is taken for insomnia.

Insomnia: Additional Sources Of Information

Here are some reliable sources that can provide more information on insomnia.

National Center on Sleep Disorders Research NIH National Heart, Lung, and Blood Institute 
Phone: 301-435-0199


  • The Complete Book of Sleep, by Dianne Hales (Addison-Wesley, Reading, Ma., 1981)
  • Insomnia and Other Sleeping Problems, by Peter Lambley (Pinnacle Books, New York, 1982)
  • A Good Night’s Sleep, by Elliott Richard Philips (Prentice-Hall, Englewood Cliffs, NJ, 1983)
  • Getting to Sleep, by Ellen Catalano (New Harbinger Publications, Oakland, CA)

Web sites

An excellent site that attempts to link all sleep materials available on the Internet can be found at – This informational site is intended to raise awareness of insomnia, including information on its causes, symptoms, and treatments. The site also offers an online test to determine if a person is at risk or has symptoms of insomnia. There are also games and a sleep sweeps along with a newsletter.

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