What is insomnia and what causes it?
Insomnia is difficulty in falling or staying asleep, the absence of restful sleep, or poor quality of sleep. Insomnia is a symptom and not a disease. The most common causes of insomnia are:
- medications,
- psychological conditions (for example, depression, anxiety),
- environmental changes (for example, travel, jet lag, or altitude changes), and
- stressful events.
Insomnia can also be caused by faulty sleeping habits such as excessive daytime naps or caffeine consumption.
Insomnia may be classified by how long the symptoms are present.
- Transient insomnia usually is due to situational changes such as travel, extreme climate changes, and stressful events. It lasts for less than a week or until the stressful event is resolved.
- Short-term insomnia usually is due to ongoing stressful events, medication side effects, medical conditions, and lasts for one to three weeks
- Chronic insomnia (long-term insomnia) often results from depression or substance abuse and continues for more than three weeks.
Transient insomnia may progress to short-term insomnia and without adequate treatment, short-term insomnia may become chronic insomnia.
Among the medications and substances that can contribute to insomnia are:
- caffeine and coffee,
- tobacco,
- alcohol,
- decongestants (for example, pseudoephedrine),
- diuretics [for example, furosemide (Lasix), hydrochlorothiazide (Dyazide)] especially if taken in the evening or at bedtime,
- antidepressants [for example, bupropion (Wellbutrin, Wellbutrin SR, Wellbutrin XL, Zyban), fluoxetine (Prozac)],
- appetite suppressants [for example, sibutramine (Meridia), phentermine (Fastin)], and
- amphetamines.
Insomnia also may be the result of withdrawal from:
- benzodiazepines [for example, diazepam (Valium), chlordiazepoxide (Librium), lorazepam (Ativan)],
- alcohol,
- antihistamines,
- amphetamines,
- cocaine,
- marijuana, and
- other addicting drugs.
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