Primary Insomnia (Difficulty Sleeping)

Description

A sleep disturbance characterized by difficulty falling asleep, difficulty remaining asleep, intermittent wakefulness, early morning awakening or a combination of these. It is more common in the elderly. Insomnia may be temporary, due to a life crisis or lifestyle change. Prolonged or chronic forms of insomnia may be due to medical or psychological problems or drug intake.

Symptoms

Difficulty falling asleep, feeling tired, waking up several times during sleep. People who have primary insomnia tend to keep thinking about getting enough sleep. The more they try to sleep, the greater the sense of frustration and distress, and the more difficult sleep becomes.

Tests

A history and physical exam will be performed. Sleep studies may be done to rule out sleep apnea or other disorders causing the symptoms.

Treatment

Behavioral changes can alleviate the disorder including: 1) avoiding caffeine, alcohol, or nicotine before bed, 2) don't take daytime naps, 3) eat regular meals and avoid large meals near bedtime, 4) exercise early in the day, 5) do not stay in bed if sleep does not occur in 10 minutes, 6) have a regular time to go to bed, 7) create a comfortable and quiet sleeping environment, and 8) use the bed only for sleep or sex. Medications (zolipidem/Ambien, zaleplon/Sonata, eszopiclone/Lunesta) can be prescribed for persistent insomnia.

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