What Is Insomnia?
There are three manifestations of insomnia:
Sleep Onset Insomnia -difficulty falling asleep
Sleep Maintenance Insomnia -difficulty staying asleep, and/or
Early Morning Awakening Insomnia -waking early with difficulty returning to sleep
For a diagnosis of insomnia to be appropriate, individuals must also report distress about sleep or difficulties functioning (at work, school, or socially) because of sleep problems.
Signs And Symptoms
Common Signs & Symptoms Of Insomnia
Can’t Sleep? Signs of Insomnia
Below are some common signs of insomnia:
You’re more than ready for bed but once the lights are off and your head hits the pillow, you’re wide awake. Your mind doesn’t want to turn off…
It’s two o’clock in the morning and you’ve woken up. Again. You can’t get back to sleep. The more you try, the more frustrated you become…
You’ve awoken two hours before the alarm is set to go off. A busy day lies ahead and you need to be well-rested, but you won’t return to sleep…
Characteristics of Insomnia
Insomnia is characterized by one or more of the following complaints:
Difficulty getting to sleep
Difficulty staying asleep
Waking too early in the morning
Poor quality sleep
Insomnia affects daytime functioning causing fatigue, depressed mood, impaired attention and concentration. It worsens your ability to cope with stress, lessens enjoyment of social activities and quality of life. Existing health conditions and physical ailments can also be worsened by insomnia.
Most people will experience short term insomnia at some point in their lives. “Acute” insomnia is a temporary response to factors such as stress or jet lag and normal sleep returns on its own. Your doctor may offer medication as an option for immediate relief.
What is Chronic Insomnia
One in ten adults experience chronic insomnia which can persist for months, years or even decades. When insomnia persists for longer than four weeks, it is referred to as “chronic” insomnia.
There are many causes of chronic insomnia and the condition should be carefully evaluated. Chronic insomnia may be caused by the following factors:
Personal and Health Factors
Examples include individual physical health factors, medications, pregnancy, stress responsiveness, and hormonal changes associated with menopause.
Examples include a tense body, a “racing” mind, reduced sleep drive, and a non-regulated sleep phase cycle.
Cognitive factors refer to your thoughts and thinking styles. Examples include excessive worry, feeling pressure or anxiety about sleeping, and focusing on things that prevent or impair sleep.
Examples of this include “poor” sleep hygiene, conditioning oneself into heightened states of alertness while trying to sleep, and maintaining a counterproductive sleep environment. In fact, often patients feel they engage in “poor” sleep hygiene because of the very problem they are told “good” sleep hygiene will correct.
Many factors create and sustain insomnia. All too often insomnia patients are simply told to follow “good sleep hygiene” or prescribed medication. While important, these recommendations alone are not an effective treatment. Because sleep is a natural physiological process, long term medication use should be done with caution, as it may worsen sleep as patients develop tolerance over time. Getting to the root of the problem is what is really helpful. An insomnia evaluation provides you with a comprehensive understanding of your insomnia and most importantly, gets you on track for improved sleep.
The Insomnia Evaluation includes:
Consultation with a board certified sleep medicine specialist. During this consultation medical factors will be assessed. A sleep study may be ordered to rule out other contributing sleep disorders.
If deemed necessary or desired, consultation with a clinical sleep psychologist trained in behavioral sleep medicine. This consultation will assess psychophysiological, psycho-social, cognitive and behavioral factors that cause insomnia.
Education about the factors that sustain your insomnia.
Recommendations and development of a treatment plan that considers your individual treatment needs.
Clear communication about assessment findings and treatment recommendations with your referring physician.
Treatment For Insomnia (Drug-Free)
A complete answer to your insomnia should include improved understanding of what you can do to improve your sleep without relying on medications every night.
Treatment at Dream Sleep Medicine is individually tailored to your needs and preferences. While we work with you to find the best treatment, we emphasize a non-pharmacological approach. Chances are your physician has already prescribed a sleep medication. We provide alternatives:
Drug-free or Non-pharmacological Treatment Options for Insomnia
At the Dream Sleep Medicine, we offer “Cognitive Behavioral Treatment for Insomnia (CBT-I).” CBT-I is a non-pharmacological treatment for Insomnia. It involves making changes to the sleep wake schedule to impact the cycle of thoughts, behaviors, and emotions perpetuating insomnia. It is the National Institutes of Health Treatment Consensus recommended treatment for insomnia.
Short-term, CBT-I is as effective as taking sleep medications
Long-term, CBT-I is more effective than taking sleep medications
70% to 80% of patients with insomnia see significant results from CBT-I with 4 to 6 hours of treatment
Each case of insomnia is different and may required different strategies to resolve. Treatment can include short term medication use. More commonly, patients with insomnia are already psychologically, if not physiologically dependent on sleep medications, which can make their insomnia worse. Our treatment can incorporate structured and assisted reductions in medication. We work with your referring physician, or assist you in this process.
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