Insomnia can involve difficulty falling asleep, staying asleep or waking earlier than desired. When sleep problems persist and affect daytime functioning, a Sleep Medicine assessment can help identify contributing factors and guide appropriate treatment.
Insomnia is more than simply having an occasional poor night of sleep. The pattern, duration and effect on daytime life all matter.
You may spend a long time trying to sleep even when you have given yourself enough opportunity to sleep.
You may wake repeatedly during the night or find it difficult to return to sleep after waking.
You may regularly wake earlier than intended and be unable to return to sleep.
Poor sleep can be associated with fatigue, reduced concentration, irritability, low energy or dissatisfaction with sleep.
The timing of sleep, awakenings, bedtime routine, daytime schedule and the pattern of symptoms help define the problem.
Energy, alertness, concentration, mood and functioning are important when deciding how significant the sleep problem is.
Schedule changes, stress, medications, caffeine, other sleep symptoms and relevant medical or psychological factors may contribute to insomnia.
Insomnia does not automatically require a sleep study. Testing may be considered when symptoms suggest another sleep disorder or when the clinical picture warrants it.
For chronic insomnia in adults, the American Academy of Sleep Medicine recommends Cognitive Behavioral Therapy for Insomnia (CBT-I) as an initial treatment approach. CBT-I combines behavioral and cognitive strategies such as stimulus control, sleep restriction, cognitive therapy and relaxation techniques. Sleep hygiene may be useful, but it is not considered sufficient as a stand-alone treatment for chronic insomnia.
These approaches aim to change behaviors and thought patterns that can perpetuate insomnia and help consolidate sleep.
Medication decisions depend on the individual clinical situation. Pharmacologic treatment may be considered in selected circumstances and should be discussed with a clinician.
If insomnia is associated with another sleep disorder, medical issue, medication or schedule problem, management may need to address that contributing factor.
Sleep patterns can change over time. Follow-up helps assess response and refine the management plan when needed.
Dr. Prakash Kothari G provides online Sleep Medicine consultations for adults and children. Consultations can be used for persistent sleep difficulty, sleep-schedule problems, sleep anxiety, daytime consequences of poor sleep and assessment of possible co-existing sleep disorders.
If sleep difficulty is persistent or affecting your daytime life, a Sleep Medicine assessment can help clarify the pattern and identify an appropriate next step.