INSOMNIA Patient Education

Patient Education

INSOMNIA

What does this handout cover?
This handout will help you learn about insomnia and how it’s
treated. You will learn about sleeping pills and other ways to
help with insomnia.

What is insomnia?1,2
Insomnia is when you have trouble falling or staying asleep.1 If you
don’t get enough sleep, you may have trouble paying attention,
remembering, and learning.2 You’ll also feel sleepy and have low
energy levels. Lack of sleep can cause serious health problems.

Insomnia can be chronic (long-term) or acute (short-term).1 Chronic
insomnia is when you have trouble sleeping at least 3 nights a week
for more than a month. Acute insomnia is anything less than that. An
example of acute insomnia is having trouble sleeping 2 nights a week
for 2 weeks.

What causes insomnia?1
Insomnia can be caused by:
 •    A life change.
 •    Stress or being upset.
 •    Traveling or work schedules that bother sleep.
 •    Mental health or medical problems.
 •    Medication side effects.

                                                        continued on next page . . .

It’s important to find the cause of your insomnia so your doctor can
choose the best treatment for you.

How is insomnia treated?1
Treatment depends on the cause of insomnia. Sometimes just
controlling the cause can get rid of insomnia. Treating insomnia
without trying to control the cause usually doesn’t work.

Treatment includes lifestyle changes and sleeping pills. Using both
treatments usually works best. Keep a diary of your sleep habits to
help you and your doctor track your insomnia.

 1.   Lifestyle changes1,3,4
      Create good bedtime routines. Good sleeping habits can help
      you fall asleep faster and stay asleep. Try some of these tips:
         •   Stick to a sleep schedule
         •	Sleep as much as you need to feel rested;
            don’t oversleep
         •   Avoid forcing yourself to sleep
         •   Avoid or limit naps
         •   Avoid or limit caffeine, alcohol, and nicotine
         •	Adjust the room environment
            (such as lights, temperature, noise)
         •   Use your bedroom only for sleep and intimacy
         •   Exercise regularly at least 20 minutes daily
         •   Don’t go to bed hungry
         •   Avoid large meals and drinks before bed
         •   Hide the bedroom clocks
         •   Take care of your worries before going to sleep

      You can also work on your thoughts and actions to help you
      sleep. Listed below are other ways to help fight insomnia.

Table 1. Ways to Fight Insomnia

 Treatment      Information

 Relaxation     • Helps relax your muscles
 Methods
                •	Reduces anxiety and tension in your body

                •	Methods include tensing and relaxing
                   each muscle.

 Sleep          •	This helps people who don’t have trouble falling
 Restriction       asleep but can’t stay asleep.

                •	Trains you to limit your time in bed to
                   about 5 hours

                •	A strict bedtime and rise time are set. For
                   example, you set a bedtime of 12 midnight
                   and wake up at 5am

                • You get up even if you are still sleepy

                •	This may make you more tired the next night
                   and able to sleep

                •	Once your sleep has improved, your time in bed
                   is slowly increased each night by 15 minutes until
                   the right sleep time is reached

 Stimulus       •	Teaches you to restrict the use of your bed to
 Control           sleeping only.

                •	Don’t use your bed for other activities, like
                   watching TV, reading, or eating

                •	If you don’t fall asleep after 30 minutes of lying
                   in bed, get up and go to another room

 Cognitive      •	Finds and corrects false beliefs and thoughts
 Therapy           about sleep

                •	Cognitive therapy can help with anxiety that can
                   cause sleep problems

                •	Talk to your doctor about how to get
                   cognitive therapy

2.   Sleeping Pills1,4
      Sometimes your doctor may decide that you need sleeping
      pills for your insomnia. They should be used for the shortest
      amount of time possible. Sleeping pills may help you fall
      asleep, but some people wake up tired. Some sleeping pills
      may be habit forming, so talk to your doctor about their
      benefits and risks.
      Some examples of sleeping pills are below. The active
      ingredient (or generic name) is listed first. The brand name is
      in parentheses.
         •   Zolpidem tartrate (Ambien®)
         •   Zaleplon (Sonata®)
         •   Temazepam (Restoril®)

Who should take sleeping pills?4
Your doctor may prescribe sleeping pills after you have tried lifestyle
changes. Your doctor may also prescribe them based on your history
and sleep patterns.

What are some problems with taking
sleeping pills?1,4,5
Some sleeping pills shouldn’t be taken for more than a few days to a
few weeks. Sleeping pills can be habit-forming. They can also:
 •	Hide the real cause of insomnia, such as depression,
    heart problems, or asthma.
 •	Interact with other medications or alcohol.
    This can be very dangerous.
 •    Cause sleepiness the next day.
 •	Lead to high blood pressure, dizziness, weakness,
    nausea, confusion, and short-term memory loss.

•	Make you get out of bed while not fully awake and do
    something that you don’t know you’re doing. The next
    morning, you may not remember that you did anything during
    the night. Examples include:
         –   Driving a car
         –   Making and eating food
         –   Talking on the phone
         –   Sleep walking

Questions to ask your doctor:
 •    Should I take sleeping pills?
 •    Are there any side effects from taking sleeping pills?
 •	What other things should I do to help my insomnia
    besides taking sleeping pills?

Where can I get more information
about treatment for insomnia?
National Sleep Foundation
Phone: 1.202.347.3471
Web site: www.sleepfoundation.org
Email: nsf@sleepfoundation.org

National Heart Lung and Blood Institute
Phone: 1.301.592.8573
Web site: www.nhlbi.nih.gov
Email: nhlbiinfo@nhlbi.nih.gov

References:
1.	Insomnia. National Heart Lung and Blood Institute Web site.
    http://www.nhlbi.nih.gov/health/dci/Diseases/inso/inso_
    whatis.html. Accessed October 7, 2010.
2.	Can’t Sleep? What to Know About Insomnia. National Sleep
    Foundation Web site. http://www.sleepfoundation.org/how-
    much-sleep-do-we-really-need. Accessed October 7, 2010.
3.	Harsora P, Kessmann J. Nonpharmacologic Management of
    Chronic Insomnia. Am Fam Physician. 2009;79(2):125-130.
    http://www.aafp.org/afp/2009/0115/p125.html. Accessed
    October 7, 2010.
4.	Schutte-Rodin S, Broch L, Buysse D, Dorsey C, Sateia M.
    Clinical Guideline for the Evaluation and Management of
    Chronic Insomnia in Adults. J Clin Sleep Med.
    2008;4(5):487-504.
5.	Lunesta Medication Guide. Marlborough, MA:
    Sepracor Inc.;2008.

The information in this educational tool
does not substitute for the medical
advice, diagnosis or treatment of your
physician. Always seek the help of your
physician or qualified health provider
for any questions you may have
regarding your medical condition.

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