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Primary Insomnia

What Is Primary Insomnia?

Primary insomnia, simply called insomnia (or chronic insomnia), is a common sleep disorder that affects most adults at some point in their lives. People with insomnia typically have trouble falling asleep or staying asleep. In some cases, you may fall asleep quickly, but wake up several times throughout the night. 

Causes of insomnia include:

  • going to bed at different times each night
  • taking naps during the day
  • working the night or graveyard shift
  • sleeping with your television or radio on
  • not getting enough exercise or physical activity
  • consuming too much caffeine
  • ingesting alcohol or medication containing caffeine
  • smoking
  • psychological stress or worry
  • physical pain
  • mental health disorders, such as depression or anxiety
  • medical conditions, such as hypothyroidism (low thyroid hormone), or kidney disease

Symptoms of Primary Insomnia

Adults need at least seven to eight hours of sleep each night. If you have insomnia, it can take you 30 minutes or more to fall asleep. In addition, you may only sleep for a few hours at a time. 

Other common symptoms of primary insomnia include:

  • sleepiness during the day
  • trouble concentrating
  • tension headaches
  • constantly worrying about sleep
  • generalized anxiety
  • not feeling refreshed in the morning

Diagnosing Primary Insomnia

Several tests can help your doctor determine the cause of your insomnia. These include a physical examination, and various blood tests. Both tests can rule out conditions that may cause insomnia, such as hypothyroidism and kidney disease. Tell your doctor about all medications you’re taking, because some drugs can cause sleep problems.

Your doctor may also recommend that you keep a sleep diary. Write down your activities and meals each day, and then record each night that you have insomnia. This information can help your doctor determine behavioral causes of your sleep trouble, such as drinking coffee in the late afternoon. 

Polysomnography may also help your doctor learn the cause of your insomnia. This is an overnight sleep study conducted at a hospital or sleep clinic. This test can help your doctor determine whether you have a sleep disorder, such as restless leg syndrome (the uncontrollable need to move your legs while sleeping) or sleep apnea (abnormal pauses in breathing during sleep).

Treatment for Primary Insomnia

The treatment for insomnia depends on its underlying cause. If your doctor believes that medications are causing your insomnia, they may lower your dosage or recommend an alternative medication. 

Behavioral therapy can also be effective in the treatment of primary insomnia. It teaches you techniques to help you gain control of unwanted behaviors. Techniques associated with this therapy include:

  • breathing and relaxation techniques to improve your mood and reduce anxiety before bedtime
  • replacing negative thoughts and emotions about sleep with positive ones
  • reserving your bed for sleep and sex and avoiding other activities in bed, such as watching television or working on the computer 

If you can’t control your stress with behavioral therapy, or if you suffer from depression or an anxiety disorder, your doctor may recommend other therapies. They may suggest talk therapy with a counselor or psychiatrist. They may also prescribe an anti-anxiety or antidepressant medication.

A sleep aid medication can also help you sleep better. Both prescription and over-the-counter sleep aids are effective on a short-term basis. However, these drugs are habit-forming and have side effects that can impact your daily life. You may experience memory problems and daytime drowsiness. Blurred vision can also occur, along with dry mouth and balance problems.

Outlook for Primary Insomnia

Most people can overcome insomnia by improving their sleep environments, treating underlying medical conditions, and improving their sleep and eating habits.

Drowsiness or sleepiness during the day is a major complication of primary insomnia. Your risk of an accident increases, while your performance at work and school may suffer. Primary insomnia has a negative impact on your health and increases your risk of obesity, heart disease, and diabetes. Insomnia may weaken your immune system.

How to Prevent Primary Insomnia

Simple lifestyle changes can help you develop better sleep habits, sometimes known as sleep hygiene. These include:

  • going to bed and waking up at the same time each day
  • limiting naps to no more than 30 minutes, or avoiding them altogether
  • avoiding naps after 3 p.m.
  • avoiding caffeine in the evenings and at night
  • limiting water and other liquids before bedtime
  • keeping your room quiet, cool, and dark by wearing earplugs and hanging drapes to block light
  • avoiding exercise two to three hours before bedtime
  • steering clear of stimulating activity before bed, such as watching TV or playing video games

You may need a combination of better sleep hygiene and medical treatment to help your insomnia. If these steps don’t help, you should see a doctor.

Content licensed from:

Written by: Valencia Higuera
Medically reviewed on: Jan 29, 2016: Steve Kim, MD

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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