Understanding Insomnia: Causes and Treatments

Insomnia, characterized by difficulties in falling asleep, staying asleep, or waking up too early, affects 10% to 30% of adults. Around 6% to 10% of the population suffers from chronic insomnia, and over a lifetime, an estimated 50% to 70% will experience it, according to Dr. Kyoungbin Im, a sleep expert at UCI Health. When insomnia leads to daytime impairments, such as fatigue and emotional disturbances, it becomes a medical concern.

Dr. Im explains that the causes of insomnia can be understood through the three P's model: predisposing factors, such as genetic traits; precipitating stressors, like life changes; and perpetuating behaviors, which can reinforce poor sleep patterns. Additionally, health conditions such as cardiovascular diseases, asthma, neurological disorders, and psychiatric illnesses, including depression and anxiety, can disrupt sleep.

Chronic insomnia may coexist with other sleep disorders, such as obstructive sleep apnea and restless legs syndrome, which should be assessed by a healthcare professional. Dr. Im warns that untreated insomnia can lead to various health issues, including hypertension, diabetes, and mental health disorders.

To improve sleep hygiene, individuals are encouraged to maintain a regular sleep schedule, engage in regular exercise, eat healthily, limit alcohol intake, and expose themselves to morning light. The bedroom should primarily be used for sleep and intimate activities, avoiding distractions like eating, reading, or screen time.

If sleeplessness persists, a physician visit is advisable. Diagnosis involves assessing reported sleep issues, daytime impairment, and symptom duration, often with the help of sleep diaries and validated questionnaires. It is crucial to differentiate between primary insomnia and insomnia secondary to other conditions for proper management. Acute insomnia is typically short-lived, while chronic insomnia lasts at least three nights per week for three months or longer.

While sleep medications may be considered, Dr. Im advocates for cognitive behavioral therapy for insomnia (CBT-I) as the first-line treatment option, enhancing long-term sleep outcomes. Identifying the underlying cause is essential for effective treatment. Individuals seeking assistance can contact UCI Health Sleep Medicine Services at 714-509-2230.