Insomnia

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Insomnia

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· What is insomnia?

· What are the symptoms of insomnia?

· What causes insomnia?

· Insomnia and PTSD

· What treatments are available for insomnia?

· More information about insomnia

What is insomnia?

Insomnia is a condition which results from trouble falling asleep, staying asleep, waking earlier than desired, and/or complaints that one’s sleep is not restful.. These difficulties may occur several times a week and are accompanied with problems functioning during the day. Many people will experience occasional problems sleeping at night, but, for some, sleep problems become chronic and develop into insomnia, a condition that impacts everyday life.

What are the symptoms of insomnia?

Symptoms of insomnia may include:

trouble falling asleep
not being able to sleep through the night
waking too early in the morning
not feeling rested after a night of sleep
daytime fatigue
trouble thinking, concentrating, or focusing
feeling irritable, depressed, or anxious
worrying about sleep or lack of sleep

What causes insomnia?

There are many causes of insomnia. Some of these can cause short term insomnia (insomnia lasting only a few days) and others can lead to a more chronic form of insomnia. While it can be diagnosed as its own disorder, it is commonly considered a symptom of another diagnosis, such as depression or posttraumatic stress disorder (PTSD). Some causes of insomnia include:

depression
anxiety disorders (like PTSD)
nightmares
major life changes, like returning from combat / deployment
stress
worrying
sleep schedule changes due to work (e.g., during readjustment to civilian sleep schedule after deployment)
pain
taking certain medications
caffeine, nicotine, alcohol use
changes in shift work
noise or other uncomfortable bedroom conditions (temperature, bed partner, too much light, etc.)

Insomnia and PTSD

Insomnia is one of the most frequently reported and chronic symptoms in PTSD. Specifically, insomnia is part of a category of PTSD symptoms that involve hyperarousal, or feeling “keyed up.” Patients who have already been treated for PTSD will often continue to experience difficulty sleeping and a separate treatment for insomnia may be required.

What treatments are available for insomnia?

Cognitive Behavioral Therapy for Insomnia (CBT-I) has been shown to be an effective behavioral treatment for insomnia among diverse groups of patients in several research studies. The focus of this behavioral treatment is on learning new sleep behaviors that will decrease sleep fragmentation, increase the total amount of time spent sleeping at night, and improve overall sleep quality. CBT-I involves closely tracking one’s sleep schedule and meeting with a therapist weekly to determine the most effective way to increase the chances of a better night of sleep.

There are also several medications that are available. As with any medication, they come with certain side effects that may be aversive and a decision regarding their use should be made in conjunction with your physician.

Beneficial effects of medication do not last as long as those associated CBT-I for insomnia. Studies have shown that people report improved sleep for longer periods of time when CBT-I is used alone (without medication) to treat insomnia.

More information about insomnia

American Academy of Sleep Medicine

National Sleep Foundation

National Heart, Lung and Blood Institute