Sleep insomnia definition

Insomnia - Diagnosis and treatment


Depending on your situation, the diagnosis of insomnia and the search for its cause may include:

  • Physical exam. If the cause of insomnia is unknown, your doctor may do a physical exam to look for signs of medical problems that may be related to insomnia. Occasionally, a blood test may be done to check for thyroid problems or other conditions that may be associated with poor sleep.
  • Sleep habits review. In addition to asking you sleep-related questions, your doctor may have you complete a questionnaire to determine your sleep-wake pattern and your level of daytime sleepiness. You may also be asked to keep a sleep diary for a couple of weeks.
  • Sleep study. If the cause of your insomnia isn't clear, or you have signs of another sleep disorder, such as sleep apnea or restless legs syndrome, you may need to spend a night at a sleep center. Tests are done to monitor and record a variety of body activities while you sleep, including brain waves, breathing, heartbeat, eye movements and body movements.

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  • Insomnia care at Mayo Clinic
  • Polysomnography (sleep study)


Changing your sleep habits and addressing any issues that may be associated with insomnia, such as stress, medical conditions or medications, can restore restful sleep for many people. If these measures don't work, your doctor may recommend cognitive behavioral therapy, medications or both, to help improve relaxation and sleep.

Cognitive behavioral therapy for insomnia

Cognitive behavioral therapy for insomnia (CBT-I) can help you control or eliminate negative thoughts and actions that keep you awake and is generally recommended as the first line of treatment for people with insomnia. Typically, CBT-I is equally or more effective than sleep medications.

The cognitive part of CBT-I teaches you to recognize and change beliefs that affect your ability to sleep. It can help you control or eliminate negative thoughts and worries that keep you awake. It may also involve eliminating the cycle that can develop where you worry so much about getting to sleep that you can't fall asleep.

The behavioral part of CBT-I helps you develop good sleep habits and avoid behaviors that keep you from sleeping well. Strategies include, for example:

  • Stimulus control therapy. This method helps remove factors that condition your mind to resist sleep. For example, you might be coached to set a consistent bedtime and wake time and avoid naps, use the bed only for sleep and sex, and leave the bedroom if you can't go to sleep within 20 minutes, only returning when you're sleepy.
  • Relaxation techniques. Progressive muscle relaxation, biofeedback and breathing exercises are ways to reduce anxiety at bedtime. Practicing these techniques can help you control your breathing, heart rate, muscle tension and mood so that you can relax.
  • Sleep restriction. This therapy decreases the time you spend in bed and avoids daytime naps, causing partial sleep deprivation, which makes you more tired the next night. Once your sleep has improved, your time in bed is gradually increased.
  • Remaining passively awake. Also called paradoxical intention, this therapy for learned insomnia is aimed at reducing the worry and anxiety about being able to get to sleep by getting in bed and trying to stay awake rather than expecting to fall asleep.
  • Light therapy. If you fall asleep too early and then awaken too early, you can use light to push back your internal clock. You can go outside during times of the year when it's light outside in the evenings, or you can use a light box. Talk to your doctor about recommendations.

Your doctor may recommend other strategies related to your lifestyle and sleep environment to help you develop habits that promote sound sleep and daytime alertness.

Prescription medications

Prescription sleeping pills can help you get to sleep, stay asleep or both. Doctors generally don't recommend relying on prescription sleeping pills for more than a few weeks, but several medications are approved for long-term use.

Examples include:

  • Eszopiclone (Lunesta)
  • Ramelteon (Rozerem)
  • Zaleplon (Sonata)
  • Zolpidem (Ambien, Edluar, Intermezzo, Zolpimist)

Prescription sleeping pills can have side effects, such as causing daytime grogginess and increasing the risk of falling, or they can be habit-forming, so talk to your doctor about these medications and other possible side effects.

Over-the-counter sleep aids

Nonprescription sleep medications contain antihistamines that can make you drowsy, but they're not intended for regular use. Talk to your doctor before you take these, as antihistamines may cause side effects, such as daytime sleepiness, dizziness, confusion, cognitive decline and difficulty urinating, which may be worse in older adults.

More Information

  • Insomnia care at Mayo Clinic
  • Insomnia treatment: Cognitive behavioral therapy instead of sleeping pills
  • Prescription sleeping pills: What's right for you?
  • Ambien: Is dependence a concern?
  • Biofeedback
  • Cognitive behavioral therapy

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Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Lifestyle and home remedies

No matter what your age, insomnia usually is treatable. The key often lies in changes to your routine during the day and when you go to bed. These tips may help.

Basic tips:

  • Stick to a sleep schedule. Keep your bedtime and wake time consistent from day to day, including on weekends.
  • Stay active. Regular activity helps promote a good night's sleep. Schedule exercise at least a few hours before bedtime and avoid stimulating activities before bedtime.
  • Check your medications. If you take medications regularly, check with your doctor to see if they may be contributing to your insomnia. Also check the labels of OTC products to see if they contain caffeine or other stimulants, such as pseudoephedrine.
  • Avoid or limit naps. Naps can make it harder to fall asleep at night. If you can't get by without one, try to limit a nap to no more than 30 minutes and don't nap after 3 p.m.
  • Avoid or limit caffeine and alcohol and don't use nicotine. All of these can make it harder to sleep, and effects can last for several hours.
  • Don't put up with pain. If a painful condition bothers you, talk to your doctor about options for pain relievers that are effective enough to control pain while you're sleeping.
  • Avoid large meals and beverages before bed. A light snack is fine and may help avoid heartburn. Drink less liquid before bedtime so that you won't have to urinate as often.

At bedtime:

  • Make your bedroom comfortable for sleep. Only use your bedroom for sex or sleep. Keep it dark and quiet, at a comfortable temperature. Hide all clocks in your bedroom, including your wristwatch and cellphone, so you don't worry about what time it is.
  • Find ways to relax. Try to put your worries and planning aside when you get into bed. A warm bath or a massage before bedtime can help prepare you for sleep. Create a relaxing bedtime ritual, such as taking a hot bath, reading, soft music, breathing exercises, yoga or prayer.
  • Avoid trying too hard to sleep. The harder you try, the more awake you'll become. Read in another room until you become very drowsy, then go to bed to sleep. Don't go to bed too early, before you're sleepy.
  • Get out of bed when you're not sleeping. Sleep as much as you need to feel rested, and then get out of bed. Don't stay in bed if you're not sleeping.

More Information

  • Insomnia care at Mayo Clinic
  • Insomnia: How do I stay asleep?

Alternative medicine

Many people never visit their doctor for insomnia and try to cope with sleeplessness on their own. Although in many cases safety and effectiveness have not been proved, some people try therapies such as:

  • Melatonin. This over-the-counter (OTC) supplement is marketed as a way to help overcome insomnia. It's generally considered safe to use melatonin for a few weeks, but no convincing evidence exists to prove that melatonin is an effective treatment for insomnia, and the long-term safety is unknown.
  • Valerian. This dietary supplement is sold as a sleep aid because it has a mildly sedating effect, although it hasn't been well-studied. Discuss valerian with your doctor before trying it. Some people who have used high doses or used it long term may have had liver damage, although it's not clear if valerian caused the damage.
  • Acupuncture. There's some evidence that acupuncture may be beneficial for people with insomnia, but more research is needed. If you choose to try acupuncture along with your conventional treatment, ask your doctor how to find a qualified practitioner.
  • Yoga or tai chi. Some studies suggest that the regular practice of yoga or tai chi can help improve sleep quality.
  • Meditation. Several small studies suggest that meditation, along with conventional treatment, may help improve sleep and reduce stress.
Caution regarding herbal and dietary sleep aids

Because the Food and Drug Administration does not mandate that manufacturers show proof of effectiveness or safety before marketing dietary supplement sleep aids, talk with your doctor before taking any herbal supplements or other OTC products. Some products can be harmful and some can cause harm if you're taking certain medications.

More Information

  • Insomnia care at Mayo Clinic
  • Valerian: A safe and effective herbal sleep aid?

Preparing for your appointment

If you're having sleep problems, you'll likely start by talking to your primary care doctor. Ask if there's anything you need to do in advance, such as keep a sleep diary. Take your bed partner along, if possible. Your doctor may want to talk to your partner to learn more about how much and how well you're sleeping.

What you can do

Prepare for your appointment by making a list of:

  • Any symptoms you're experiencing, including any that may seem unrelated to the reason for the appointment.
  • Personal information, including new or ongoing health problems, major stresses or recent life changes.
  • All medications, over-the-counter medications, vitamins, and herbal or other supplements that you're taking, including dosages. Let your doctor know about anything you've taken to help you sleep.
  • Questions to ask your doctor to make the most of your appointment time.

Basic questions to ask your doctor include:

  • What is likely causing my insomnia?
  • What's the best treatment?
  • I have these other health conditions. How can I best manage them together?
  • Should I go to a sleep clinic? Will my insurance cover it?
  • Are there any brochures or other printed material that I can have?
  • What websites do you recommend?

Don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your doctor may ask you several questions, such as those below.

About your insomnia:

  • How often do you have trouble sleeping, and when did the insomnia begin?
  • How long does it take you to fall asleep?
  • Do you snore or wake up choking for breath?
  • How often do you awaken at night, and how long does it take you to fall back to sleep?
  • What is your response when you can't sleep?
  • What have you tried to improve your sleep?

About your day:

  • Do you feel refreshed when you wake up, or are you tired during the day?
  • Do you doze off or have trouble staying awake while sitting quietly or driving?
  • Do you nap during the day?
  • What do you typically eat and drink in the evening?

About your bedtime routine:

  • What is your bedtime routine?
  • Do you currently take any medications or sleeping pills before bed?
  • What time do you go to bed and wake up? Is this different on weekends?
  • How many hours a night do you sleep?

About other issues that may affect your sleep:

  • Have you experienced any stressful events recently?
  • Do you use tobacco or drink alcohol?
  • Do you have any family members with sleep problems?
  • What medications do you take regularly?

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What is insomnia?

Insomnia is a common sleep disorder. If you have it, you may have trouble falling asleep, staying asleep, or both. As a result, you may get too little sleep or have poor-quality sleep. You may not feel refreshed when you wake up.

What are the types of insomnia?

Insomnia can be acute (short-term) or chronic (ongoing). Acute insomnia is common. Common causes include stress at work, family pressures, or a traumatic event. It usually lasts for days or weeks.

Chronic insomnia lasts for a month or longer. Most cases of chronic insomnia are secondary. This means they are the symptom or side effect of some other problem, such as certain medical conditions, medicines, and other sleep disorders. Substances such as caffeine, tobacco, and alcohol can also be a cause.

Sometimes chronic insomnia is the primary problem. This means that it is not caused by something else. Its cause is not well understood, but long-lasting stress, emotional upset, travel and shift work can be factors. Primary insomnia usually lasts more than one month.

Who is at risk for insomnia?

Insomnia is common. It affects women more often than men. You can get it at any age, but older adults are more likely to have it. You are also at higher risk of insomnia if you:

  • Have a lot of stress
  • Are depressed or have other emotional distress, such as divorce or death of a spouse
  • Have a lower income
  • Work at night or have frequent major shifts in your work hours
  • Travel long distances with time changes
  • Have an inactive lifestyle
  • Are African American; research shows that African Americans take longer to fall asleep, don't sleep as well, and have more sleep-related breathing problems than whites.

What are the symptoms of insomnia?

Symptoms of insomnia include:

  • Lying awake for a long time before you fall asleep
  • Sleeping for only short periods
  • Being awake for much of the night
  • Feeling as if you haven't slept at all
  • Waking up too early

What other problems can insomnia cause?

Insomnia can cause daytime sleepiness and a lack of energy. It also can make you feel anxious, depressed, or irritable. You may have trouble focusing on tasks, paying attention, learning, and remembering. Insomnia also can cause other serious problems. For example, it could make you may feel drowsy while driving. This could cause you get into a car accident.

How is insomnia diagnosed?

To diagnose insomnia, your health care provider:

  • Takes your medical history
  • Asks for your sleep history. Your provider will ask you for details about your sleep habits.
  • Does a physical exam, to rule out other medical problems that might cause insomnia
  • May recommend a sleep study. A sleep study measures how well you sleep and how your body responds to sleep problems.

What are the treatments for insomnia?

Treatments include lifestyle changes, counseling, and medicines:

  • Lifestyle changes, including good sleep habits, often help relieve acute (short-term) insomnia. These changes might make it easier for you to fall asleep and stay asleep.
  • A type of counseling called cognitive-behavioral therapy (CBT) can help relieve the anxiety linked to chronic (ongoing) insomnia
  • Several medicines also can help relieve your insomnia and allow you to re-establish a regular sleep schedule

If your insomnia is the symptom or side effect of another problem, it's important to treat that problem (if possible).

NIH: National Heart, Lung, and Blood Institute

  • Insomnia (American Academy of Family Physicians) Also in Spanish
  • Insomnia (Mayo Foundation for Medical Education and Research)
  • What Is Insomnia? (National Heart, Lung, and Blood Institute) Also in Spanish
  • Antipsychotic drugs a last resort for these 5 conditions (ADHD, Anxiety, Depression, Insomnia and PTSD) (Consumer Reports)
  • Insomnia (Mayo Foundation for Medical Education and Research) Also in Spanish
  • Insomnia Treatment (Mayo Foundation for Medical Education and Research) Also in Spanish
  • Sleep Disorders: In Depth (National Center for Complementary and Integrative Health)
  • Sleeping Pills for Insomnia: Which Ones Work Best? (Consumer Reports)
  • Taking Z-drugs for Insomnia? Know the Risks (Food and Drug Administration) Also in Spanish
  • ClinicalTrials. gov: Sleep Initiation and Maintenance Disorders (National Institutes of Health)
  • Sleeping Pills (National Institutes of Health)
  • Article: Experiences of group-based cognitive behavioural therapy for insomnia among patients with. ..
  • Article: The effect of treatment with melatonin on primary school aged children...
  • Article: Psychological rehabilitation for isolated patients with COVID-19 infection: A randomized controlled study.
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  • American Academy of Sleep Medicine
  • Find a Sleep Center Near You (American Academy of Sleep Medicine)
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  • Insomnia (Department of Health and Human Services, Office on Women's Health) Also in Spanish

Insomnia - symptoms, causes, signs, diagnosis and treatment in "SM-Clinic"

This disease is treated by Neurologist

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  • What is insomnia?
  • Symptoms of insomnia
  • Causes of insomnia
  • Diagnosis of insomnia in "SM-Clinic"
  • Treatment of insomnia in "SM-Clinic"
  • Prevention of insomnia
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Symptoms of insomnia

It happens that the most active day, with many events, brings great fatigue in the evening, and it seems that sleep will overtake as soon as the head touches the pillow. But the long-awaited rest does not bring relief, sleep does not come, nervous and muscular tension does not give rest. Signs of insomnia in addition to the problem of falling asleep are:

  • superficial sleep
  • frequent waking up from the slightest irritants
  • sleep not enough to feel good
  • daytime sleepiness
  • extreme fatigue
  • heightened emotionality
  • memory impairment

Sleep disturbances due to insomnia require consultation with a doctor if they last more than a month and occur three or more times a week.

Causes of insomnia

Stress is one of the most common causes of disturbances in the process of falling asleep and the quality of sleep. In addition, among the causes of insomnia, the following are noted:

  • stress
  • chronic fatigue syndrome
  • non-standard work schedule (at night)
  • jet lag when traveling
  • excessive consumption of tonic drinks
  • side effects of certain medications
  • disorders in the thyroid gland
  • pain syndrome
  • mental disorders
  • organism intoxication
  • intracranial pressure disorders
  • individual characteristics of the nervous system
  • lack of B vitamins

Get advice

If you experience these symptoms, we recommend that you make an appointment with your doctor. Timely consultation will prevent negative consequences for your health.

You can find out more about the disease, prices for treatment and sign up for a consultation with a specialist by phone:

+7 (495) 292-39-72

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Treatment is carried out in accordance with clinical recommendations


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Diagnosis of insomnia at the SM-Clinic

Diagnosis of insomnia at the SM-Clinic in Moscow is carried out by neurologists who, over many years of work, have helped hundreds of patients to improve the processes of sleep and wakefulness, and return the joy of an active life. Our doctors participate in specialized seminars and conferences and constantly improve their knowledge and skills, master new methods of therapy.

The SM-Clinic neurologist will begin diagnosing insomnia with a detailed survey of the patient about complaints, time and duration of sleep disturbances, body characteristics, temperament, work environment and anamnesis. Then the doctor will conduct a neurological examination and prescribe laboratory tests (blood test, hormone test and ultrasound of the thyroid gland). nine0003

In order to determine how to cure insomnia, the neurologists of our clinic prescribe the following diagnostic tests:

  • polysomnography
  • electroencephalography
  • electromyography
  • electrocardiography

Treatment of insomnia in the SM-Clinic

The main thing for the doctors of the SM-Clinic is to help their patients get rid of the unpleasant symptoms of insomnia in a short time and restore good health and vigor throughout the day. For this, concomitant disorders or diseases of the body are treated, if they are its cause. nine0003

In order for the treatment of insomnia to be effective, neurologists at SM-Clinic use an integrated approach and involve colleagues from other specialties (endocrinologists, psychologists, therapists, etc. ) in choosing a method of treatment.

Therapy of sleep disorders consists of developing an individual regimen, physical activity, nutrition plan and prescribing pharmacological drugs (sleeping pills, antidepressants, tranquilizers, hypnotics, circadian rhythm regulators, etc.).

SM-Clinic doctors get excellent results when using the following methods to treat insomnia:

  • phototherapy
  • acupuncture
  • hirudotherapy
  • physiotherapy
  • psychotherapy

Prevention of insomnia

To avoid sleep disorders:

  • maintain circadian rhythms
  • do not take tonic drinks before going to bed
  • maintain moderate physical activity
  • create conditions suitable for a good sleep and observe sleep hygiene


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Insomnia is a sleep disorder characterized by insufficient sleep duration, dissatisfaction with its quality, inability to fall asleep, or a combination of these factors over time. Similar problems occur in 40-45 percent of people, and half of them become chronic. Insomnia negatively affects your performance, mood and perception of reality - this is a serious disorder, and not a temporary phenomenon that passes in a short time. Therefore, for the treatment of insomnia - contact the American Medical Clinic. Our professionals will return to you the joy of healthy sleep and a positive perception of the world around you! nine0003

Causes of insomnia

There are many causes of insomnia, however, doctors identify several common ones:

  • an unfavorable environment in which you sleep - an excessively hard or soft bed, extraneous noise, heat or cold;
  • change of place of sleep - travel or moving to a new place of residence;
  • stress, anxiety, depression;
  • various diseases that cause you pain. nine0008

Also, insomnia occurs during pregnancy - a lot of thoughts swarm in the head of the expectant mother, later the growing belly begins to interfere, and then thoughts about the upcoming birth interfere with sleep. The reason for this is the hormonal and physiological changes that occur in a woman's body.

How to deal with insomnia on your own?

There are several tips for dealing with insomnia.

Before bed:

  • do not eat heavy meals and drink plenty of fluids;
  • avoid activities that require physical and intellectual effort;
  • avoid emotional stress;
  • take a warm bath or shower;
  • refuse tea and especially coffee, it is better to drink a glass of hot milk;
  • ask someone close to give you a massage.

nine0234 Night:

  • try not to be nervous, think about the pleasant;
  • keep the room cool;
  • choose a comfortable mattress and pillow;
  • find a comfortable position;
  • breathe evenly and calmly.

Such recommendations are not always able to completely relieve you of insomnia. Often they give only a temporary effect, because, as mentioned above, the causes of sleep disorders can be diseases that you are not aware of.

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