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Am Fam Physician. 1999;60(5):1441-1442

See related article on insomnia.

Sleep is a necessary part of life, like food and water. Your body refreshes itself during sleep, so it can work well during the day. The word “insomnia” means “unable to sleep.”

What is chronic insomnia?

You may have trouble falling asleep. Or you may be waking up too early in the morning. Insomnia is chronic when you haven't been able to sleep well for a month or more, and it has begun to affect your daily life.

Insomnia that has lasted for less than a month (maybe for only two weeks) is called “transient insomnia.” If you have transient insomnia, you probably know just what is causing your sleep problem. You may be going through a time of extra stress—worrying about a problem at work or a health problem, for example.

Who gets chronic insomnia?

Although poor sleep is more common in the elderly, anyone can get chronic insomnia. Almost one third of Americans say they have trouble sleeping.

As you get older, it's normal for the total number of hours you sleep each night to go down. Instead of sleeping eight or 10 hours a night, you may find yourself sleeping only six or seven hours a night when you get older. Also, older persons have less deep sleep and are more likely to wake up in the middle of the night.

But if poor sleep causes problems during the daytime, like making you very sleepy and making you have to take naps, your doctor should check out your sleep problem.

What problems can chronic insomnia cause?

Chronic insomnia can cause problems in your life and can even lead to problems at work. Insomnia might make you so tired you can't do a good job at work. Also, people with insomnia have a higher risk of accidents. If you aren't sleeping well at night, it's easy to fall asleep while driving a car.

What causes chronic insomnia?

Medical illness can cause chronic insomnia. Some of the medicines used to treat illnesses can cause sleep problems (medicine for high blood pressure, for example). Steroids can also cause sleep problems.

Pain, anxiety and depression can also cause sleep problems.

Caffeine, nicotine and alcohol can keep you awake. Chronic insomnia can also be caused by something as simple as bad sleep habits.

What are good sleep habits that will help me sleep better?

  • Limit or stop using nicotine, caffeine and alcohol—especially close to bedtime. Try avoiding coffee, tea or caffeinated sodas after noon.

  • Have a regular bedtime and waking time, even on weekends and days you don't go to work.

  • Exercise during the day (but not too close to bedtime).

  • Use your bed only for sleeping or for having sex. Try not to eat, worry or watch TV in bed.

  • Avoid daytime naps.

  • Eat meals on a regular schedule. Don't eat a large meal close to your bedtime.

What about using sleeping pills?

Sleeping pills may help you have a restful night of sleep. But sometimes sleeping pills are part of the whole sleep problem. They can make it harder for you to fall asleep. They can be dangerous for people with certain illnesses. Talk to your family doctor before you use any kind of sleeping pill.

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