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If studying the inside of your eyelids has become your least favorite pastime, you could have a sleep disorder known as chronic insomnia. The condition is characterized by difficulty falling asleep, staying asleep, or both.

Having occasional difficulty catching some Zzz’s is normal though, and referred to as acute insomnia. It generally lasts a few days to a couple weeks, and tends to show up during times of stress and life changes. (COVID-19 anyone?)

Dozing off as a “grown up” is tougher than it was in high school; in fact a third of Americans don’t get the recommended minimum of 7 hours of sleep each night. It could be your smartphone, or it could be chronic insomnia. Here are the deets:

Sleepless nights come in two flavors — primary and secondary.

Primary insomnia is somewhat of a mystery to the medical community. It’s thought to be triggered by fluctuations in brain chemicals, and isn’t related to any underlying medical conditions or meds.

Secondary insomnia is the kind we know from the movies, it’s caused by conditions and situations like trauma, emotional stress, lifestyle patterns, drug use, medications, and mental health issues.

“With insomnia, everything’s far away. Everything’s a copy of a copy of a copy.” So says Edward Norton’s narrator in the movie “Fight Club.” (Note: please get treatment before insomnia has you believing you’re Brad Pitt.)

While you may relate to that just from missing your morning cuppa, the following symptoms could point to chronic insomnia:

  • trouble falling asleep
  • waking up in the night
  • trouble returning to sleep
  • waking too early
  • feeling sleepy during the day
  • feeling irritable, moody, or depressed
  • difficulty concentrating
  • making more mistakes and having accidents (lest we forget “The Machinist”)

Sometimes the causes are unknown — as with primary chronic insomnia. Underlying medical conditions, certain medications, stimulants, and lifestyle factors are often contributors.

Medical conditions

Some long-term conditions linked to chronic insomnia include:

  • sleep apnea
  • chronic obstructive pulmonary disease (COPD)
  • asthma
  • diabetes
  • acid reflux
  • hyperthyroidism
  • heart failure
  • restless leg syndrome (RLS)
  • fibromyalgia
  • anxiety
  • depression
  • menopause
  • stress (emotional & physical)
  • bipolar disorder
  • Parkinson’s disease
  • Alzheimer’s disease

Medications and stimulants

For some folks, insomnia can be brought on by stimulants and medications like:

  • alcohol
  • antidepressants
  • caffeine
  • diuretics
  • nicotine
  • drugs like cocaine
  • laxatives
  • beta-blockers
  • chemotherapy drugs

Lifestyle

Lifestyle factors like these could be keeping you awake:

  • frequent jet lag from traveling across time zones
  • shift work
  • inconsistent waking and sleeping schedule
  • being physically inactive
  • napping too much

Treatment largely depends on the cause, but there are a number of home remedies and conventional treatment options available. Your doctor may recommend medication, therapy, or a combination approach, depending on severity and whether underlying medical conditions are at play.

Cognitive behavioral therapy (CBT)

Research suggests CBT is more effective for treating chronic insomnia than sleep meds! Which is amazing, because there are no risks associated with CBT. The practice involves teaching you better sleep habits while reprogramming behaviors that are interfering with your ability to sleep.

If that sounds cool, check out these CBT-I (specifically for insomnia) strategies:

Journaling

Jotting down your worries and concerns before bed can help curb ruminating on them or trying to work them out while falling asleep.

Relax

Practice breathing exercises, yoga, meditation, and other muscle-soothing techniques to lower your heart rate and get ready for sleep.

Stimulus control

Hold yourself accountable to some sleep best practices, like setting sleep and wake timers, and only using your bed for sleep and sex.

Paradoxical intention

If worrying about being able to fall asleep is an issue, this technique is for you. It involves focusing on staying awake in bed instead of sleeping.

Sleep restriction

Limit the amount of time you spend in bed, including naps. The goal is to deprive you of enough sleep so that you’re uber tired by bedtime. Once you’re sleeping again, you can gradually increase your sleep time.

Medications

A spoonful of sugar is definitely not part of your insomnia med tool kit. There are a number of over-the-counter (OTC) and prescription sleep aids to help.

Though effective, sleeping pills carry risky side effects like daytime drowsiness, forgetfulness, sleepwalking, and balance issues. They can also be habit-forming, so doctors don’t recommend them for long-term use.

Some common meds approved for treating insomnia include:

  • zaleplon (Sonata)
  • zolpidem (Ambien)
  • temazepam (Restoril)
  • eszopiclone (Lunesta)
  • suvorexant (Belsomra)
  • doxepin (Silenor)
  • ramelteon (Rozerem)

Some OTC sleep aids to consider include:

  • melatonin
  • valerian root
  • chamomile tea
  • diphenhydramine (Benadryl)
  • doxylamine succinate (Unisom SleepTabs)

If you like how these sound, read on for more enticing natural sleep remedies.

Potions class 101:

Natural remedies like valerian root and melatonin are strong and can cause unwanted side effects or interact with other meds. It’s a good idea to discuss them with your doctor first.

If you like dabbling in the art of kitchen cupboard healing, then look no further than these sleep hygiene essentials:

  • Skip the late afternoon caffeine treat.
  • Avoid alcohol and smoking cigs before bed.
  • Don’t eat large meals in the evening.
  • Get regular physical activity.
  • Don’t take naps.
  • Go to bed and wake up at the same time every day, even on weekends.
  • Avoid using computers, tablets, and smartphones before bed.
  • Keep your bedroom dark or wear a sleep mask.
  • Make sure your bed is super comfortable.

If your insomnia is the result of an underlying condition like acid reflux or pain from an injury, then the insomnia should resolve when the cause is managed.

If meds being used to treat other conditions are causing your insomnia, talk to your doctor about alternative options. Sometimes a change in dosage or timing can be enough to help.