Insomnia is simply the inability to fall asleep easily or not being able to stay asleep. Sleep difficulties that last for longer than a month and affect daytime functioning are generally labeled insomnia. Nearly 50% of adult Americans report that they have had insomnia at some time. Women are 40% more likely to suffer from insomnia than men. Insomnia has many different causes both physical and psychological.

Some of the physical causes of insomnia are chronic pain, restless leg syndrome, medications, hormonal imbalances, and environmental issues. Chronic pain and restless leg syndrome are only two of the disorders that can cause insomnia. Disorders such as these usually need medication to treat the insomnia if the underlying cause cannot be corrected. Many anti-depressants can cause insomnia, if you can trace the insomnia back to when you started taking the anti-depressant talk to your doctor and pharmacist about possible a substitution for the medication. An imbalance in the hormones that regulate sleep and hormonal imbalances due to menopause are both factors to consider if you are having difficulty sleeping. Finally we have environmental issues, noisy neighbors, uncomfortable bed, and sleep time during daylight hours.

Psychological issues that may cause sleeping difficulties are depression, stress, anger and post traumatic stress disorder. Depression is a common cause of insomnia and insomnia is a common cause of depression. Try to discover which was experienced first the, depression or the insomnia, whichever came first is what needs to be addressed first. Stress is one of the number one causes of sleep problems. Many times it is difficult to let go of the stresses of the day so that we can go to sleep and not repeatedly wake up during the night. Anger is closely associated with stress, often times we are not angry with someone else but with ourselves. Post Traumatic Stress Syndrome should be treated by a doctor, treatment may include treating the insomnia as well.

Often insomnia has both a physical as well as a psychological cause. Are you depressed because your mattress is uncomfortable and you cannot afford a new one? If you are not sure what is causing your insomnia, which is often the case, keep in mind that curing the insomnia does not necessarily mean the cause is known. Besides, you will figure it out after a good night’s sleep.

The doctor will perform a full medical exam, and may ask about recent weight gain or snoring. Particular attention may be paid to nasal passages and measurement of the neck to assess for sleep apnea. The lungs and heart should be examined thoroughly as well, coughing at night as well as an irregular heart rhythm could be the underlying cause of the insomnia.

The level that lack of sleep or sleep that does not leave you feeling rested affects your day to day functions may provide diagnostic information to the doctor. The doctor may ask you to wear an actigraph, which measures movement, during daylight hours to assess how much you are being affected. An actigraph is worn like a wristwatch, it has a microprocessor and memory so the doctor can retrieve the data.

Chronic or severe insomnia may require observation and treatment from a sleep specialist. Sleep specialists can diagnose many different types of sleep disorders and recommend treatment. You may be asked to keep a sleep diary for two weeks. A sleep diary is to keep track of bedtimes, what time you fell asleep, how many time you awakened during the night, and time of awakening in the morning. The specialist may also ask for you to keep track of how you feel emotionally and physically during the day.

Stimulus control therapy has do do with controlling the sleep environment and is often referred to as sleep hygiene. With this therapy the bed is used for sleep only. If you are unable to sleep leave the bed room and perform a sedentary activity such as watching TV or meditating, meditation has been recommended as a sleep aid for over 2500 years. Set the alarm clock to the same time , no over-sleeping. Also limit the time allowed for sleep to induce mild sleep deprivation to assist with falling asleep quickly. This therapy usually last approximately three weeks.

Paradoxical intention is simple and may cure short term insomnia in one night. Instead of trying to fall asleep, try to stay awake. Sometimes we cannot fall asleep because we are worried that we cannot fall asleep, this creates performance anxiety. Basically giving ourselves permission to stay awake removes the pressure of trying to fall asleep, so that we can fall asleep.

Natural remedies include an over the counter dietary supplement called melatonin and the use of herbs. Melatonin is naturally produced in the body by the pineal gland, production is triggered by darkness. This hormone regulates the body’s day/night cycle. Taking melatonin at night should not affect you the next day and is not habit forming. Herbs such as medicinal marijuana, valerian, chamomile and lavender are used as sleep aids. Valerian studies have shown it’s moderate effectiveness. Some people suffering from insomnia suggest that the drinking of a cup of hot tea is in itself soothing. Chamomile and lavender are usually served as hot tea.

Consult with your doctor before taking an over the counter sleep aid, there could be possible drug interactions or health issues that would preclude you from taking these medications. Do not take herbal remedies for sleep and over the counter sleep aids at the same time unless approved by your doctor. If you are taking any anti-depressants never take any kind of sleep aid prescription or over the counter without a doctor’s approval, you could experience serious adverse reactions. Please note that you may be taking an anti-depressant that was prescribed as a sleeping pill, check with your doctor of pharmacist. Do not drink alcohol while taking any sleep medication.

The most common side-effect from both diphenydramine and doxylamine is next day drowsiness. It has been reported that both drugs may produce a “hang over effect” the next day lasting for several hours, sometimes into the next evening. Both can also cause constipation, dry mouth, difficulty urinating or starting urination, and in some memory loss. Persons with glaucoma, asthma, heart problems, or enlargement of the prostate gland should not take over the counter sleep aids or any antihistamines without the express approval and close monitoring of their doctor. These antihistamines may cause excitability in children and the elderly.

OTC antihistamines for insomnia are for short term, intermittent use only. Basically they are for that occasional night of sleeplessness. Most people build up a tolerance to these drugs very quickly, do not exceed the dosage directions on the packaging.

Diphenydramine is found in Benadryl, Sominex, and Nytol. Doxylamine is found in Unisom and Sleeptabs

Benzodiazepines are long-acting tranquilizers developed in the 1960′s and run a high risk of dependency. Morning grogginess is a common side-effect of all long-acting sleep aids. Benzodiazepines are not for long term use as an addiction can be formed in a matter of weeks and the body tends to quickly build up a tolerance so that more and more of the drug is needed to achieve initial effectiveness.

Non-benzodiazepines are short-acting sedatives developed in the 1980′s as a safer alternative to benzodiazepines. Both drugs work basically in the same way, but non-benzodiazepines have less side-effects, and are less habit forming. Non-benzodiazepines are for generally for short term or intermittent use. Benzodiazepines and non-benzodiazepines are hypnotics and excellent when used to prevent jet lag.

The next category is melatonin receptor agonists, hypnotics approved in 2005. This drug affects the body in the same way as naturally produced melatonin. A brand name for this drug is Ramelteon which is taken 30 minutes before bedtime provided there is desired 7 to 8 hours of sleep. Ramelteon has not been found to be addictive or produce signs of withdrawal after discontinuing.

Tricyclics are not sedatives per say but anti-depressants. They do not sedate the brain or nervous system but assist with achieving mental balance by increasing certain substances naturally found in the brain.

When taking sleep medications always inform your doctor , alcohol use, and supplements as these can have an adverse or dangerous effects when combined with sleeping pills. Follow the instructions given to you by the doctor, do not self medicate. Keep a log as to when the medication was taken, effectiveness, and any side-effects including emotional side-effects.