Insomnia

What is insomnia?

From: MedlinePlus, National Library of Medicine

Insomnia is a common sleep disorder. If you have it, you may have trouble falling asleep, staying asleep, or both. As a result, you may get too little sleep or have poor-quality sleep. You may not feel refreshed when you wake up.

What are the types of insomnia?

From: MedlinePlus, National Library of Medicine

Insomnia can be acute (short-term) or chronic (ongoing). Acute insomnia is common. Common causes include stress at work, family pressures, or a traumatic event. It usually lasts for days or weeks.

Chronic insomnia lasts for a month or longer. Most cases of chronic insomnia are secondary. This means they are the symptom or side effect of some other problem, such as certain medical conditions, medicines, and other sleep disorders. Substances such as caffeine, tobacco, and alcohol can also be a cause.

Sometimes chronic insomnia is the primary problem. This means that it is not caused by something else. Its cause is not well understood, but long-lasting stress, emotional upset, travel and shift work can be factors. Primary insomnia usually lasts more than one month.

Who is at risk for insomnia?

From: MedlinePlus, National Library of Medicine

Insomnia is common. It affects women more often than men. You can get it at any age, but older adults are more likely to have it. You are also at higher risk of insomnia if you:

• Have a lot of stress
• Are depressed or have other emotional distress, such as divorce or death of a spouse
• Have a lower income
• Work at night or have frequent major shifts in your work hours
• Travel long distances with time changes
• Have an inactive lifestyle

What are the symptoms of insomnia?

From: MedlinePlus, National Library of Medicine

Symptoms of insomnia include:

• Lying awake for a long time before you fall asleep
• Sleeping for only short periods
• Being awake for much of the night
• Feeling as if you haven't slept at all
• Waking up too early

What other problems can insomnia cause?

From: MedlinePlus, National Library of Medicine

Insomnia can cause daytime sleepiness and a lack of energy. It also can make you feel anxious, depressed, or irritable. You may have trouble focusing on tasks, paying attention, learning, and remembering. Insomnia also can cause other serious problems. For example, it could make you feel drowsy while driving. This could cause you get into a car accident.

How is insomnia diagnosed?

From: MedlinePlus, National Library of Medicine

To diagnose insomnia, your health care provider:

• Takes your medical history
• Asks for your sleep history. Your provider will ask you for details about your sleep habits.
• Does a physical exam, to rule out other medical problems that might cause insomnia
• May recommend a sleep study. A sleep study measures how well you sleep and how your body responds to sleep problems.

What are the treatments for insomnia?

From: MedlinePlus, National Library of Medicine

Treatments include lifestyle changes, counseling, and medicines:

• Lifestyle changes, including good sleep habits, often help relieve acute (short-term) insomnia. These changes might make it easier for you to fall asleep and stay asleep.
• A type of counseling called cognitive-behavioral therapy (CBT) can help relieve the anxiety linked to chronic (ongoing) insomnia
• Several medicines also can help relieve your insomnia and allow you to re-establish a regular sleep schedule

If your insomnia is the symptom or side effect of another problem, it's important to treat that problem (if possible).

Which doctor should you see?

The suggested department for discussing Insomnia is Neurology, with a neurologist as the relevant type of clinician. General physician / Family Medicine; paediatrician for children. Referral depends on symptoms.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• Which nervous-system findings help explain the symptoms?
• Would an assessment of walking, communication or daily function be helpful?
• Are rehabilitation or other specialist services relevant?

Treatment discussions and follow-up

Where the source describes treatments, these are an overview of possible care, not a prescription for an individual. Ask which option applies to the confirmed diagnosis, what benefit is expected, what adverse effects to watch for and how progress will be assessed. Availability, approvals and local practice can differ from the country described in the source.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

The collected references do not establish a complete prevention or long-term outlook section for this entry. Missing information should not be interpreted as proof that prevention is impossible or that a particular outcome is inevitable. Ask what is known for the exact subtype, stage and personal circumstances, and which uncertainties remain.

When to seek emergency help

Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.