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What is insomnia?

Insomnia is sleep disturbance that includes difficulty in falling asleep, remaining asleep, intermittent wakefulness, early morning awakening or a combination of these.

Insomnia affects all age groups, but is more common in the elderly. Insomnia may be transient due to a life crisis or lifestyle change, or chronic, due to medical or psychological problems or drug intake.

Frequent signs and symptoms

  • Restlessness when trying to fall asleep
  • Brief sleep followed by wakefulness
  • Normal sleep until very early in the morning (3am or 4am), then wakefulness (often with frightening thoughts)
  • Periods of sleeplessness, alternating with periods of excessive sleep or sleepiness at inconvenient times


  • Depression—this is usually characterised by early morning wakefulness
  • Overactivity of the thyroid gland
  • Anxiety caused by stress
  • Sexual problems, such as impotence or lack of a sex partner
  • Daytime napping
  • Noisy environment (including a snoring partner)
  • Allergies and early morning wheezing
  • Heart or lung conditions that cause shortness of breath when lying down
  • Painful disorders, such as fibromyositis or arthritis
  • Urinary or gastrointestinal problems that require urination or bowel movements during the night
  • Consumption of stimulants, such as coffee, tea or cola drinks
  • Use of some medications, including dextroamphetamines, cortisone drugs or decongestants
  • Erratic work hours
  • New environment or location
  • Jet lag after travel
  • Lack of physical exercise
  • Alcoholism
  • Drug abuse, including overuse of sleep inducing drugs
  • Withdrawal from addictive substances

Risk increases with

  • Stress
  • Obesity
  • Smoking

Preventive measure

  • Establish a lifestyle that fosters healthy sleep patterns (see general measures). If unable to sleep, get up and do something. Avoid lengthy daytime napping
  • Avoidance of causes when possible

Expected outcome

Most people can establish good sleep patterns if the underlying cause of insomnia is treated or eliminated.

Possible complications

  • Transient insomnia becomes chronic
  • Increased daytime sleepiness that can affect all aspects of your life

Treatment/post procedure care, general measures

  • Seek ways to minimise stress. Learn and practice relaxation techniques
  • Don’t use stimulants for several hours before bedtime
  • Treat any underlying drug use or medical cause
  • Relax in a warm bath before bedtime
  • Don’t turn your bedroom into an office or a den. Create a comfortable sleep setting
  • Turn off your mind. Focus on peaceful and relaxing thoughts. Play soft music or relaxation tapes
  • Set a rigid sleep schedule
  • Use mechanical aids such as ear plugs, eye shades or electric blanket
  • Seek psychotherapy or counselling if the cause is psychological


  • Sleep inducing drugs may be prescribed for a short time if: temporary insomnia is interfering with your daily activities; you have a medical disorder that regularly disturbs sleep; you need to establish regular sleep patterns
  • Long-term use of sleep inducers may be counterproductive or addictive. Don’t use sleeping pills given to you by friends


Exercise regularly to create healthy fatigue, but not within the two hour period before going to bed
Have sexual relations, if they are fulfilling and satisfying, before going to sleep


  • No special diet, but don’t eat within three hours of bedtime if indigestion has previously disturbed your sleep
  • Drinking a glass of warm milk before bedtime helps some people.

Notify your doctor or talk to a counsellor if

  • You or a family member has insomnia
  • New, unexplained symptoms develop. Drugs used in treatment may produce side effects

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