An in-depth report on the causes, diagnosis, treatment, and prevention of insomnia.
What Is Insomnia?
Insomnia can be a short-term or long-term condition, but it always involves problems with falling asleep or staying asleep. Short-term (acute) insomnia can be caused by illness, stress, travel, or environmental factors. Long-term (chronic) insomnia may be due to underlying psychological or physical conditions.
Who Is at Risk?
Anyone can get insomnia, but it is generally more common in women than in men. The elderly are particularly at risk for insomnia.
A doctor will make a diagnosis of insomnia based on information about your sleep patterns. Your doctor may ask:
- How long does it take for you to fall asleep at night?
- How many times during the night do you wake up?
- Do you experience daytime fatigue?
- Do you have a medical condition that may interfere with sleep?
- What medications do you take (including prescription drugs, over-the counter drugs, and herbs or supplements)?
- Do you drink alcohol or smoke?
Your doctor may also ask you to keep a sleep diary to record specific sleep-related information.
- Sleep hygiene is the most important step for controlling insomnia. These simple self-help measures include establishing a regular bedtime routine, regulating mealtimes and fluid consumption, and limiting caffeine consumption.
- Behavioral therapy can help treat insomnia in people of all ages. It includes various approaches for establishing new sleep behaviors and for helping people relax and sleep well.
- If self-help or behavioral therapies do not solve the problem, a doctor may prescribe medications for use on a short-term basis.
Non-benzodiazepine sedative hypnotics are usually the preferred type of drugs. They include zolpidem (Ambien, generic), zaleplon (Sonata, generic), and eszopiclone (Lunesta, generic). Newer types of sedative hypnotics include ramelteon (Rozerem, generic) and suvorexant (Belsomra). These drugs can cause side effects, so make sure that your doctor explains the risks of these drugs and the precautions you need to take.
New Drug Approval
In 2014, the FDA approved a new type of sleep drug called suvorexant (Belsomra). Suvorexant is an orexin receptor antagonist. Orexins are chemicals produced in the hypothalamus part of the brain. These chemicals are involved in regulating the sleep-wake cycle and keeping people awake. Suvorexant targets and blocks the action of orexin to promote sleep. The FDA approved four different dose strengths for suvorexant and advises people to use the lowest effective dose.