Insomnia affects millions of people. In fact, studies show as many as one in four Americans experience insomnia each year. By definition, insomnia is a sleep disorder that makes it hard to fall asleep, stay asleep or fall back asleep after waking up. As a result, those affected are unable to get an adequate amount of sleep each night.
People who experience insomnia may feel tired and have low energy when they are awake. It can make focusing at work or in school challenging, and it can also affect mood and put those afflicted at a higher risk of other health conditions.
Two types of insomnia
• Short-term (acute) insomnia, which can last for a few days or weeks
• Long-term (chronic) insomnia, which lasts for more than a month
There are many different reasons someone may develop insomnia, including:
• Medical conditions
• Medication side effects
• Mental health conditions
• Inconsistent sleep schedules
• Unhealthy sleep habits
Recent studies have also shown technology use may be preventing adults, teens and children from getting enough sleep. Electronic gadgets are a constant in our lives (many people even take them into the bedroom at night), and this interaction with smartphones, tablets, video games, televisions and laptops could be contributing to low sleep quality.
Fortunately, there are also a growing number of gadgets and tech solutions available that can help improve sleep.
Causes of Insomnia
The ability to fall asleep and stay asleep is influenced by a variety of things. Lack of sleep makes it harder to concentrate, learn and create memories. Research shows a chronic sleep deficit puts you at higher risk of developing conditions like high blood pressure, diabetes, obesity and heart disease.
Your brain communicates when your body needs sleep, releases the hormone melatonin, relaxes your muscles and monitors external factors that influence sleep cycles, such as when it’s light or dark outside. When all these things work together, you are able to fall asleep.
“Insomnia is multi-factorial. People who develop it may have a predisposition toward disruptive sleep, such as family history or genetics,” said Dr. Kelly Baron, Director of the Behavioral Sleep Medicine Program at the University of Utah Health. “Generally, something triggers insomnia — a stress or some sort of medical illness, or psychiatric causes like depression.”
There are several things that can lead to insomnia, including:
|Cancer||Cancer can cause pain that makes it difficult to fall asleep or stay asleep|
|Diabetes||People with diabetes are at higher risk of developing conditions that can make sleep difficult, such as sleep apnea and restless leg syndrome.|
|Asthma||Difficulty breathing when you have asthma can contribute to insomnia.|
|Acid reflux||Pain associated with acid reflux can keep you from falling asleep or cause you to wake frequently throughout the night|
|Parkinson’s disease||Severe symptoms like tremors or pain can affect sleep, especially if medications wear off through the night.|
|Alzheimer’s disease||Sleep changes are more common in later stages of the disease, but could affect people with early-stage Alzheimer’s as well.|
|Chronic pain||Conditions like back pain or fibromyalgia can contribute to insomnia, and lack of sleep can make pain worse.|
- • Antiarrhythmics for heart rhythm disorders
- • Beta blockers, clonidine or diuretics for high blood pressure
- • Corticosteroids to treat inflammation
- • Over-the-counter medications that contain caffeine
- • Cold and flu medicines that include alcohol
- • SSRIs for anxiety or depression
- • Sympathomimetic stimulants for ADHD
- • Thyroid hormones to treat hypothyroidism
If you’re worried that your medications could be contributing to insomnia, talk to your doctor about trying a different medication or adjusting your dosage. Don’t stop taking your medication or make any changes without consulting your doctor.
Mental health challenges like stress, anxiety, depression and post-traumatic stress disorder (PTSD) can all make it more difficult to sleep. These types of sleep disturbances could be triggered by specific life events, such as the loss of a loved one, divorce or stress at work or school, or they could be the result of ongoing anxiety, depression or other mental health conditions.
- • Frequent travel, which can throw off your body’s internal clock, especially when traveling across several time zones.
- • Work schedules, such as graveyard shifts, where you have to sleep during the day, or frequently changing schedules, which can make it hard to get into a sleep rhythm.
- • Eating large meals right before bed, which can lead to heartburn or physical discomfort.
- • Consuming stimulants (caffeine, nicotine) or depressants (alcohol), which can also disrupt sleep.
• Irregular schedule
• Daytime napping
• Sleeping in a room with temperature, light or sound extremes
• Stimulating your brain before bed
Older adults are more likely to have medical conditions, such as an overactive bladder, or take medications for other health conditions that disrupt sleep.
|Blue light||Melatonin is a hormone that your body releases to signal to your brain that it’s time to go to sleep. Screens from smartphones, tablets, laptops and televisions emit artificial blue light that suppresses melatonin. Our eyes are not very good at blocking blue light, so viewing screens within one hour of bedtime can negatively impact sleep.|
|Brain activity||Stimulation from technology can also make it harder to relax, especially if you take electronics to bed. Working on a laptop, scrolling the news or social media on your smartphone, or watching television can all disrupt sleep.|
|Sleep disruptions||Even if you are careful not to use your devices before bed, keeping them on your bedside table can still disrupt sleep if you receive texts, emails and other alerts throughout the night. This is especially true for children and teens, since 72% report sleeping with electronic devices in their bedroom.|
How to Relieve Insomnia
While many people do suffer from insomnia at some point, there are things you can do to improve your ability to sleep. The first (and easiest) solution is to examine your sleep habits and practice good sleep hygiene.
“Sleep hygiene refers to recommendations for healthy sleep habits. They are things that are generally good for your sleep,” said Baron.
Good Sleep Hygiene Habits
• Spend the right amount of time in bed each night; your specific sleep needs may vary, but there are guidelines based on your age.
• Establish a regular routine that signals to your body that it’s time to sleep
• Create a good sleep environment with a comfortable mattress and setting the room temperature between 60 and 68 degrees. If you sleep during the day, consider blackout curtains to block natural light.
• Use ear plugs, white noise machines or fans for a quieter sleep environment.
• Limit daytime naps to 20 to 30 minutes, so you are tired at bedtime.
• Avoid caffeine and other stimulants close to bedtime, and drink alcohol only in moderation.
• Avoid eating foods late at night that cause discomfort or indigestion, such as carbonated drinks, spicy foods or high-fat meals.
• Exercise regularly during the day to improve your sleep and make sure you are exposed to adequate natural light during your waking hours to maintain a proper circadian rhythm.
• Stop using smartphones, tablets, computers and televisions 30 to 60 minutes before bed.
Medications for Sleep
There are also medications that may help you sleep, but it’s important to talk to your doctor before you take a sleep aid.
Over-the-counter or natural sleep aids can help when you experience short-term insomnia (for example, related to jet lag after traveling, or when you are sick). These include:
|Over-the-counter Sleep Aid||Effect|
|Diphenhydramine (Benadryl, Aleve PM) and Doxylamine (Unisom)||Sedating antihistamines that can cause drowsiness and other side effects even after you wake up.|
|Melatonin||A supplement that, like the naturally-occurring hormone in your body, can regulate your sleep-wake cycle.|
|Valerian||A plant-based supplement that is sometimes used as a sleep aid, but there is not much scientific evidence of sleep benefits.|
Prescription sleep medications may be prescribed for short-term or long-term insomnia relief if over-the-counter sleep aids and other non-drug interventions have not worked. These include:
|Prescription Sleep Medication||Effect|
|Orexin Receptor Antagonists||The newest class of insomnia drugs approved by the FDA that work by inhibiting activity of the chemical orexin (which keeps you awake and alert).|
|Benzodiazepines (Flurazepam, Diazepam and others)||Drugs that enhance the neurotransmitter GABA, slowing brain activity to help you fall asleep. These do have side effects and some evidence suggests they can become less effective over time.|
|Non-Benzodiazepine Hypnotics (Ambien, Lunesta and others)*||Similar to benzodiazepines, but target fewer receptors in your brain.|
|Antidepressants (Trazodone, Amitriptyline, Dozepine)||Studies are inconclusive on how well these work to address insomnia.|
|Melatonin (Ramelteon)||A prescription form of the hormone melatonin.|
Sleep aids, including over-the-counter and prescription drugs, may have side effects or interfere with other medications you are taking. Before taking any medications, talk to your doctor.
*Please note that there is an FDA Black Box warning for Non-Benzodiazepine Hypnotics (Ambien, Lunesta and others). Read more here.
Technology That Helps
Technology is emerging that may help improve your sleep. Some of these technologies monitor your body during sleep, others monitor and adjust your sleep environment and others address physical conditions that can make it harder to get to sleep and stay asleep.
|Technology||Description||Target Audience||Learn more|
|Wearable sleep trackers||Several brands offer sleep tracking as part of a fitness tracker that you wear around your wrist, including Nike, Apple Watch, Fitbit, Nokia and Polar. These devices track biological signs of sleep (such as heart rate or blood oxygen levels) and can provide guidance to improve sleep through an app.||These devices work well for people who don’t mind wearing them to bed. Many provide additional features for overall health and fitness tracking besides just sleep.||Check it out|
|Sleep tracker headband||Devices you wear around your head that use electrodes to record brain activity. This is similar to the technology that you would find in a sleep monitoring study, and some offer the ability to send data to a sleep specialist rather than going to a sleep lab for a study. They offer more in-depth monitoring than wearable or non-wearable devices, but may be uncomfortable.||If you want more in-depth information about your sleep stages and brain activity during the night, these devices offer more in-depth analysis than other wearable trackers.||Check it out|
|Non-wearable sleep monitors||If wearing something around your wrist, finger or head all night bothers you, there are non-contact sleep trackers that go above or below your mattress, or on your bedside table. They monitor breathing, room temperature, snoring and other things that could affect your sleep.||If you prefer not to wear something to bed, or you’re concerned about snoring (and potentially sleep apnea), these can provide the information you need with less discomfort.||Check it out|
|Smart beds||Mattresses are constantly being improved and today can track information and adjust using data captured while you sleep. Some mattresses have wearable trackers while others have the technology integrated in the mattress. They include features like raising your upper body to reduce snoring or adjusting the temperature if you get hot or cold.||If you suffer from restless sleep, snore a lot or frequently wake up feeling too hot or too cold, a smart bed can help. These beds vary widely in price and available features.||Check it out|
|CPAP machines||Continuous positive airway pressure (CPAP) machines have been around for several decades, but are evolving to include more and better technology. Today they are quiet and easy to use, and can make adjustments in real time with an algorithm. Some can also send data via cloud-based apps in real time for monitoring.||People who experience sleep apnea can benefit significantly from using a CPAP machine. Talk to your doctor about participating in a sleep study to determine if you need one.||Check it out|
|White noise machines||White noise blocks out small background noises that keep you from falling asleep or wake you up in the night. You can find white noise machines that just block out noise (you cannot hear anything), or that create soothing sounds to help you sleep, such as nature sounds.||If you live in a noisy environment, work odd hours and need to sleep when others are awake, or are highly sensitive to noises and wake easily, these machines help.||Check it out|
|Light therapies||Light boxes can help your body stay in a better circadian rhythm, especially if you live in a place where it’s dark for significant parts of the day. Other light therapies like “sunrise solution” alarm clocks slowly increase light 30 minutes before your wake-up time, a natural indicator to your body that it’s time to get up.||People with circadian disruptions can benefit from light boxes. If you sleep with blackout curtains during the day or have to wake up before sunrise, a sunrise alarm clock may help you wake up more naturally.||Check it out|
|Online Cognitive Behavioral Therapy for Insomnia (CBT-I)||CBT-I is an FDA-approved way to treat insomnia without medications through sleep assessments, changes to sleep habits and better sleep hygiene. It’s a safe and effective option for managing chronic insomnia and is widely used by behavioral sleep medicine clinicians. CBT-I is now available online through web- or app-based programs like Somryst (requires a prescription) and Sleepio.||CBT-I is an evidence-based approach to treating insomnia, which means it’s been shown to improve sleep in randomized clinical trials. It is most effective for adults with chronic insomnia.||Check it out|
The Bottom Line
Getting the right amount of restful and restorative sleep is essential for your health. If you experience insomnia, new technologies may offer some assistance in helping you sleep better. Expanded internet research on this topic, as well as joining online support groups can be invaluable, too. In addition to practicing good sleep hygiene, and working with your doctor for treating insomnia that is related to medical conditions, mental health or medications, these sleep innovations can provide you with the sleep you need to feel healthy and alert throughout the day.