Sleep Disorders

Insomnia & Sleep Disorders

Insomnia is a common sleep disorder characterized by difficulty falling asleep, staying asleep, or waking too early and not being able to get back to sleep. Chronic insomnia (3+ nights per week for 3+ months) affects about 10% of adults and can significantly impact daytime functioning, mood, and health.

Symptoms

Difficulty falling asleep despite being tired

Waking up frequently during the night

Waking up too early and unable to fall back asleep

Non-restorative or poor quality sleep

Daytime fatigue, sleepiness, and low energy

Difficulty concentrating or memory problems

Mood disturbances: irritability, anxiety, depression

Increased errors or accidents

Causes

Psychological: stress, anxiety, depression, PTSD
Medical: chronic pain, asthma, GERD, thyroid disorders
Medications: stimulants, certain antidepressants, steroids
Lifestyle: irregular sleep schedule, excessive screen time, caffeine, alcohol
Sleep disorders: sleep apnea, restless leg syndrome
Environmental: noise, light, uncomfortable bed
Age-related changes in sleep architecture

Diagnosis

Evaluation includes detailed sleep history, sleep diary analysis, assessment of sleep habits and environment, screening for underlying medical and psychiatric conditions. Actigraphy or polysomnography (sleep study) may be recommended for suspected sleep apnea or other sleep disorders.

Treatment Options

Cognitive Behavioral Therapy for Insomnia (CBT-I) — first-line treatment

Sleep hygiene education and implementation

Stimulus control therapy

Sleep restriction therapy

Medications: Zolpidem, Trazodone (low dose), Melatonin

Treatment of underlying conditions (depression, anxiety, pain)

Relaxation techniques and mindfulness

Light therapy for circadian rhythm issues

When to Seek Help

Seek help if insomnia persists for more than a few weeks, if it significantly affects your daytime functioning, if you rely on alcohol or sleeping pills to sleep, if you suspect sleep apnea (snoring, breathing pauses), or if insomnia is accompanied by mood changes.

Your Action Plan

1.Step 1: Keep a sleep diary for 2 weeks — this reveals patterns you don't notice

2.Step 2: Set a CONSISTENT wake time 7 days/week — this is more important than bedtime

3.Step 3: Use the bed ONLY for sleep — if awake >20 minutes, get up until sleepy

4.Step 4: Limit caffeine after noon and alcohol within 4 hours of bedtime (alcohol disrupts sleep architecture)

5.Step 5: Reduce screen time 1 hour before bed — blue light suppresses melatonin

6.Step 6: Create a pre-sleep wind-down routine: dim lights, relaxation, reading (not in bed)

7.Step 7: Consider CBT-I (Cognitive Behavioral Therapy for Insomnia) — more effective than pills long-term

8.Step 8: If medication is needed, use short-term only and as part of a broader plan

9.Step 9: Exercise regularly (morning or afternoon) — proven to improve sleep quality

10.Step 10: Manage worry: write tomorrow's to-do list before bed to 'download' anxiety from your mind