What is it?

There are four basic types of insomnia:

• Difficulty falling asleep
• Difficulty staying asleep
• Waking up too early
• Poor quality sleep

A person with insomnia may have the following symptoms:

• Feeling tired and grumpy during the day
• Having trouble concentrating at work or school
• Falling asleep during the day

Being tired and grumpy in itself doesn't mean you have insomnia. This condition could result from staying up too late, getting up too early, or several other reasons. Many people have insomnia symptoms simply because of today's fast-paced lifestyle.

Everyone has an occasional poor night's sleep. For most people it lasts only a few days and goes away without treatment. However, in some individuals, insomnia can become a chronic or persistent problem. Stress or depression may cause a higher level of insomnia that may not go away on its own.

Who gets it?

More than 25% of all adults have experienced symptoms of insomnia at some time. Less than 10% of adults are likely to have chronic insomnia. It is more common among the elderly and women. Some medical conditions may contribute to insomnia, or it may be a side effect of a medication.

How do I know if I have insomnia?

If your answer is yes to the questions below, you may have insomnia:

1. Do you have trouble falling asleep or maintaining sleep?
2. Do you wake up too early or feel unrefreshed after sleeping?
3. Does this occur even though you have the opportunity and the time to get a good night's sleep?
4. Do you have at least one of the following problems?

• Low energy
• Lack of motivation
• Attention, concentration, or memory problem
• Poor performance at school or work
• Extreme mood changes
• Daytime sleepiness
• Trouble making errors at school, work, or driving
• Tension, headaches, or stomach aches
• Frustration or worry about your sleep

Do I need to see a Sleep Specialist?

The first step is to discuss your sleep problems with your Primary Care Physician, who may  refer you to a Sleep Specialist. The Sleep Specialist may give you a questionnaire or short written tests to help them better understand your symptoms. He or she may also order specific tests if a medical condition is suspected. An overnight sleep study may be ordered if the doctor suspects that you may have a primary sleep disorder contributing to your insomnia.

How is it treated?

Many cases of insomnia will respond to lifestyle changes you can make as mentioned in the sleep hygiene section. Changing medications may also be helpful.

Most cases of chronic insomnia can be managed without the use of sleep-inducing medications. If a specific cause of the insomnia can be identified, then treatment can be directed at that issue. Often times, behavioral therapy can be very effective for patients whose insomnia is the result of a poor sleep environment, poor sleep habits, or psychological conditions. Some of the techniques used for behavioral treatment of insomnia include stimulus control therapy and sleep restriction.

In addition to behavioral therapy, some medications can help to improve your sleep. Some medications, known as sleeping pills or hypnotics, are very specific to treating insomnia. Other medications that are used to treat other problems can also help you sleep. Your doctor can help you decide which course of action is best. You should only take a medication when supervised by a doctor.

To schedule an appointment, call MetroHealth's Center for Sleep Medicine at  (216) 778-5985.