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Almost everyone has experienced insomnia at one time or another. Difficulty falling asleep, staying asleep, or poor quality of sleep can be frustrating and even debilitating. However, for some people, insomnia is a more serious problem that requires evaluation and treatment from a psychiatrist.
Meadows Psychiatry LLC is dedicated to treating mental health conditions like chronic insomnia. Dr. Wu is trained and experienced in mental health disorder diagnosis, psychopharmacology, and psychiatric medication management. He’ll help you manage the symptoms of your insomnia to improve the quality of your life.
What Is insomnia?
Insomnia can manifest as difficulty in falling asleep (if it takes more than 1 hour to fall asleep), difficulty staying asleep, or waking up too early. As a result of poor sleep, insomnia can negatively affect daytime functioning.
Patients are diagnosed with insomnia when they have challenges with sleep quality at least 3 nights per week for at least 3 months. Sleeping difficulty occurs despite having enough time and opportunity to sleep.
Types of insomnia
Insomnia is often classified by duration:
- Acute insomnia
- Chronic insomnia
Also known as short-term or adjustment insomnia is a brief time of having trouble sleeping. Short-term insomnia is often a result of stressful life events like the sudden loss of a job or a loved one, a shocking medical diagnosis, or stopping substance abuse.
Short-term insomnia lasts less than six months and often disappears when one learns how to cope with the trigger. Sometimes, acute insomnia can persist long enough to transition into chronic insomnia in adults.
Note: If insomnia lasts less than a month, it’s called transient insomnia.
Chronic insomnia is characterized by sleeping problems experienced three times a week for over six months.
Like short-term insomnia, chronic insomnia can be linked to stressful events, underlying neurological and physical problems, bad sleep hygiene, irregular sleeping schedules, and mental health disorders.
It affects people of every age and is more prevalent in women.
Other classifications of insomnia include
- Primary insomnia is a type of insomnia where sleep difficulties are present but cannot be attributed to an existing medical, psychiatric, or environmental cause. Environmental causes can include substance abuse or prescription medications.
- Co-morbid insomnia is a form of insomnia that occurs alongside other health conditions like substance abuse, depression, bipolar disorder, asthma, sleep apnea, or depression. Co-morbid insomnia is difficult to diagnose and treat, especially when symptoms overlap.
The two classifications can be split further into:
- Sleep onset insomnia – spending a long time in bed without falling asleep.
- Sleep maintenance insomnia – this is described as an issue of remaining asleep throughout the night. Fragmented sleep reduces your sleep quality and sleep time, causing daytime impairment.
- Early morning awakening insomnia – waking up before you intend to in the morning.
- Mixed insomnia – when a person has a combination of the above sleep issues.
Symptoms of insomnia
A patient with insomnia can manifest the symptoms below:
Issues with memory, focus, and paying attention
Prone to accidents and errors
Sleepiness in the daytime
Anxiety, depression, and irritability
Chronic Obstructive Pulmonary Disease (COPD)
If insufficient sleep interferes with your daily life, talk to Dr. Wu at Meadows Psychiatry LLC. You can only be diagnosed with insomnia if you have difficulty falling asleep, difficulty staying asleep, or are waking up much earlier than normal for three or more nights per week for at least 3 months.
It helps if you have a sleep diary with your sleep history for one or two weeks before your assessment. The sleep diary will help Dr. Richard Wu to understand your sleep quality better and whether certain activities cause adverse effects on your sleep cycle.
Document when you wake up, sleep, and nap. Also, include how sleepy you feel during the day when you drink alcohol or caffeine and exercise.
Physical examination and medical history
Dr. Wu will need to know your health history, risk factors, family history, and clinical symptoms. In addition to your sleep history from your diary, Dr. Wu will need to know if you are taking any medications, are pregnant, undergoing menopause, have any health problems, or use alcohol, nicotine, caffeine, or any illegal drugs.
The information contained in a recent sleep study report also provides our psychiatrist with the physiological and neuroelectrical information needed to diagnose your sleep disorder.
Treatment and management of insomnia
Treatment of insomnia should start with lifestyle changes first. These include:
- Doing 30 minutes of low-to-moderate intensity cardiovascular exercise during the morning or afternoon will help improve your sleep quality
- Avoid consuming too many caffeinated beverages, especially in the afternoon and evening
- Avoid daytime naps, as they disrupt your circadian rhythm and can cause difficulty falling asleep at night.
- Avoid doing vigorous-intensity cardiovascular exercise at least 2 hours prior to your planned bedtime.
Behavioral therapy is an excellent option in the management of insomnia:
- Implement a proper bedtime routine
- Avoid watching TV or doing homework while in bed
- Reserve the bed for sleep only
- Perform relaxation exercises, such as deep breathing exercises 30 minutes prior to your planned sleep time.
- Use aromatherapy with lavender essential oil 30 minutes prior to your planned bedtime to help relax your mind to sleep. Some patients find that drinking chamomile tea 30 minutes prior to their planned bedtime also helps relax their minds to sleep.
Taking over-the-counter melatonin
If people with insomnia are still struggling despite implementing these lifestyle changes, taking over-the-counter Melatonin 30 minutes prior to the planned bedtime can be effective.
Instant-release melatonin is useful for treating patients who struggle with falling asleep. Extended-release melatonin is useful for treating patients who struggle with falling and staying asleep. Please consult a qualified psychiatrist or sleep disorder specialist before starting over-the-counter Melatonin.
If over-the-counter melatonin is not effective for treating a person’s insomnia, then certain prescription medications can be effective for the treatment of insomnia in adults. Patients should not take over-the-counter melatonin if they take prescription sleep medication to avoid excessive daytime drowsiness.
Benzodiazepine receptor agonists can be used for the short-term treatment of insomnia in adults. However, their prolonged use can lead to withdrawal phenomena and other adverse effects. For long-term treatment, nonpharmacologic therapy with CBT-I (Cognitive Behavioral Therapy for Insomnia) is preferred and safer.
Contact Dr. Wu to discuss your options and treatments for insomnia. He’ll create an effective treatment plan that may include CBT-I (Cognitive Behavioral Therapy for Insomnia) interventions, short-term treatment with prescription medications, or treating the underlying mental health disorder causing your insomnia.