Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2009;79(2):131-132

See related article on chronic insomnia.

What is chronic insomnia?

Insomnia (in-SOHM-nee-uh) is when you have trouble sleeping. Chronic insomnia is when your sleeping problem lasts for four weeks or longer. This causes you to feel tired and have less energy. You may also worry about being able to sleep. Some people with insomnia fall asleep easily, but wake up in the middle of the night and can’t get back to sleep. Others may have trouble falling asleep when they first go to bed.

How is it treated?

Improving your sleep habits is the best way to treat chronic insomnia. Behavior therapy can help teach you about good sleep habits. This usually includes learning ways to relax and not worry as much about sleep. Some medical conditions (one example: depression) and medicines can also lead to chronic insomnia, so it is important to let your doctor know if you have other conditions. Talk to your doctor about behavior therapy versus medications for insomnia.

What can I do to help myself get better sleep?

Keep in mind that we need less sleep as we age. Some people need only five or six hours of sleep a night, but most people do better with seven or eight hours. Sleep usually occurs in three-hour cycles, so it is important to get at least three uninterrupted hours of sleep.

These tips can help you develop better sleep habits:

  • Go to sleep only when you feel tired.

  • Use the bedroom only for sleep and sex.

  • Avoid reading, watching TV, or worrying in bed.

  • If you can’t fall asleep after 15 minutes, go to another room and return to your bed only when you feel tired. You may repeat this as often as needed during the night.

  • Go to sleep and wake up at the same times each day.

  • Avoid napping, because it can disturb your normal sleep rhythm.

  • Avoid caffeine from coffee and soft drinks, and nicotine from cigarettes, late in the day.

  • Avoid eating large meals or drinking a lot of water in the evening.

  • Keep your bedroom at a comfortable temperature and as dark as possible.

  • Set aside some time to relax before going to bed.

A good way to relax is to focus on your breathing by taking slow, deep breaths while counting to five. Then listen to the sound of your breath as you breathe out. You can also try to tighten and relax the muscle groups in your body, beginning at your feet and ending with your face muscles. A trained therapist can teach you other ways to relax. You can also listen to relaxation CDs or tapes.

Where can I get more information?

Your doctor

National Heart, Lung, and Blood Institute

American Academy of Family Physicians

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