Insomnia is characterized by having difficulty both falling and staying asleep and waking up feeling unrefreshed. Sleep problems may be caused by stress, anxiety, depression, sleep disorders, pain, poor sleep habits, or as a side effect from a particular disease or medication. Your sleep environment and lifestyle choices also have an effect on your sleep.
Certain medications can cause insomnia, such as those used to treat cold and allergies, hypertension, heart disease, thyroid disease, and birth control. Medications containing caffeine, such as those used for asthma and pain relief, can also lead to sleep disturbances. The elderly are 1.5 times more likely to experience insomnia, possibly due to the medications they take to treat specific conditions.
Sleep disorders also cause poor sleep, ranging from rest leg syndrome to coping with obstructive sleep apnea (OSA). A partner who has sleep apnea, marked by loud snoring with brief periods of waking up to resume breathing, can also disturb others trying to sleep.
Insomnia may be acute if it lasts for a short period or it can be chronic if it is an ongoing problem. Chronic insomnia is more difficult to treat because it won’t go away its own and often requires the treatment of a physician or sleep specialist. About one in five people experience chronic insomnia.
Women are 1.3 times more likely to report insomnia than men, according to a National Sleep Foundation poll. Women may experience insomnia due to the fluctuation of hormones before and at the onset of menstruation, during pregnancy, and menopause.
Symptoms of Insomnia
Identifying the cause of your insomnia is just as important as treating the condition. Your doctor may ask about your sleep habits, mood, medications, and medical history. If your insomnia isn’t a result of something which can be easily identified, you may be diagnosed with primary insomnia.
Insomnia can affect quality of life, productivity and safety. Here are some of the effects of insomnia:
- Depression is common for insomnia sufferers, and people with insomnia are four times as likely to experiencedepression as those who sleep well.
- Sleep deprivation can contribute to illnesses, such as heart disease, obesity, and diabetes.
- Personal safety may be affected by chronic drowsiness.
- People with insomnia as not as productive and may accomplish fewer daily tasks.
Cost of Insomnia
Insomnia causes both direct and indirect financial burdens to the nation. Direct costs can be measured by the money spent on treatment, healthcare services, hospital, and nursing home care. The direct costs of insomnia in the US have been estimated to be approximately $14 billion.
Indirect costs can include work loss, transportation to healthcare providers, and property damage from accidents. These costs are nearly double the direct costs and total about $28 to $35 billion.
Treatment for Insomnia
Insomnia can be effectively treated with medication. About one-quarter of Americans take some form of sleep aid medication every year.
Medications may be prescribed when:
- The cause of the condition is best treated with medication.
- Sleep problems lead to difficulty accomplishing daily tasks.
- Behavioral interventions are ineffective or the person is unwilling to change their behavior.
- For temporary, short-term insomnia.
- Insomnia occurs in conjunction with a known medical condition such as PMS or an event such as traveling across time zones, which causes jet lag.
Prescription medications used to treat insomnia are called hypnotics, which aim to induce and maintain sleep. Hypnotics are effective in reducing the time it takes for a person to fall sleep and increasing total sleep time with fewer awakenings.
Treatment with medications should be approached very carefully as it can lead to tolerance and dependence. The use of high doses can lead to rebound insomnia, when the problem is worse than it was before treatment. To lessen the risk of rebound insomnia, a patient will most likely be tapered off medication rather than abruptly stopping all at once. A physician should prescribe the lowest possible effective dose and recommend good sleep hygiene and behavioral approaches, as well.
Length of treatment with medication depends on various circumstances. Accepted insomnia guidelines call for short-term use, but it is not uncommon for patients to use medication for longer than the four week recommended limit. More studies are needed to determine long-term effects of the use of sleep aids.
Depending upon a patient’s diagnosis, medical condition, age, and use of alcohol or other drugs, medication type and dosage will vary. For instance, patients with depression may respond best to antidepressant medication instead of hypnotics. However, some antidepressants may worsen insomnia, so patients should discuss this with their physician.
Patients who take sleep aid medication need to focus on improving their sleep practices.
Side effects of sleep aids are dependent on the patient’s age, dose, and half-life of the medication.
People at increased risk for complications while taking hypnotics include:
- People who drink alcohol, as the two drugs taken at the same time intensify the action of both. Alcohol mixed with sleep aids can lead to serious complications, including death.
- The elderly, who are at an increased risk of falls.
- Those who operate heavy machinery upon awakening. The risk of accidents is higher due to the long half-life of the medication. “Half-life” refers to how long the medication remains in the body.
- People who have sleep apnea, as hypnotics may further impair breathing.
If you are interested in finding out more about insomnia and treatment options, call The Los Angeles Sleep Study Institute at 1-855-690-0563 and one of our representatives will be happy to answer any of your questions.