The causes of insomnia include
Stress and anxiety
Depression (some patients have trouble sleeping others sleep too much)
Medical conditions, including chronic pain, breathing difﬁculties, overactive thyroid, stroke, Parkinson’s disease, and Alzheimer’s disease
Caffeine and nicotine
Alcohol (may help one to fall asleep but it prevents deep sleep leading to awakening in the middle of the night)
Certain medications like heart and blood pressure medications, antidepressants, decongestants and corticosteroids
Poor sleep habits
Worrying about not being able to sleep
Treatment of insomnia may include both drug and behavioral therapies. Prescription sleeping pills are prescribed based on which sleeping difﬁculty the patient is experiencing and if the patient has other conditions, such as depression. Some drugs are used to help one fall asleep initially, while others are ideal to help one fall back asleep in the middle of the night. Medications may be prescribed but are only intended for short term use, due to their side effects and the potential to lead to dependence. When a patient begins experiencing insomnia, behavioral therapies should be tried ﬁrst.
These therapies include an introduction to new sleep behaviors:
Going to bed at same time every night and waking at same time each morning (including weekends) • Avoiding anything mentally, physically, or emotionally stimulating right before bed
Beginning a daily relaxation ritual to remind your body it is time to sleep (breathing exercises, warm bath, relaxing stretches)
Avoiding daytime naps
Keeping the temperature of room cool
Removing clock to discourage clock-watching
Avoiding spending too much time awake in bed (Get out of bed if not asleep within twenty minutes and do something relaxing)
Other strategies that may improve sleep include:
Reviewing your other medications with your physician or pharmacist to see if your they may be affecting your sleep
Taking effective pain medication if necessary for a good night’s sleep
Getting regular exercise but not too close to bedtime
Eating a healthy, well balanced diet.
Prescription sleep aids can play a role in helping individuals fall sleep but should only be used for a short period of time. Developing good sleeping habits will help with the long term treatment of insomnia.