Insomnia what can i take

It contains a naturally occurring hormone called melatonin, which helps to regulate the sleep cycle. Circadin is usually only recommended for three weeks at first, but it can be continued for a total of 13 weeks if it helps.

The following treatments aren't normally recommended for insomnia, because it's not clear how effective they are and they can sometimes cause side effects:. Home Illnesses and conditions Mental health Insomnia. Insomnia See all parts of this guide Hide guide parts 1. Introduction 2. Causes 3. Self-help tips 4. Introduction Insomnia is difficulty getting to sleep or staying asleep for long enough to feel refreshed the next morning.

If you have insomnia, you may: find it difficult to fall asleep lie awake for long periods at night wake up several times during the night wake up early in the morning and not be able to get back to sleep not feel refreshed when you get up find it hard to nap during the day, despite feeling tired feel tired and irritable during the day and have difficulty concentrating Occasional episodes of insomnia may come and go without causing any serious problems, but for some people it can last for months or even years at a time.

How much sleep do I need? What causes insomnia? It's not always clear what triggers insomnia, but it's often associated with: stress and anxiety a poor sleeping environment — such as an uncomfortable bed, or a bedroom that's too light, noisy, hot or cold lifestyle factors — such as jet lag, shift work, or drinking alcohol or caffeine before going to bed mental health conditions — such as depression and schizophrenia physical health conditions — such as heart problems, other sleep disorders and long-term pain certain medicines — such as some antidepressants , epilepsy medicines and steroid medication Read more about the causes of insomnia What you can do about it There are a number of things you can try to help yourself get a good night's sleep if you have insomnia.

These include: setting regular times for going to bed and waking up relaxing before bed time — try taking a warm bath or listening to calming music using thick curtains or blinds, an eye mask and earplugs to stop you being woken up by light and noise avoiding caffeine, nicotine, alcohol, heavy meals and exercise for a few hours before going to bed not watching TV or using phones, tablets or computers shortly before going to bed not napping during the day writing a list of your worries, and any ideas about how to solve them, before going to bed to help you forget about them until the morning Some people find over-the-counter sleeping tablets helpful, but they don't address the underlying problem and can have troublesome side effects.

Read more self-help tips for insomnia When to see your GP Make an appointment to see your GP if you're finding it difficult to get to sleep or stay asleep and it's affecting your daily life — particularly if it has been a problem for a month or more and the above measures have not helped.

Treatments for insomnia Your GP will first try to identify and treat any underlying health condition, such as anxiety, that may be causing your sleep problems. They'll probably also discuss things you can do at home that may help to improve your sleep. Causes Insomnia can be triggered by a number of possible factors, including worry and stress, underlying health conditions, and alcohol or drug use. Sometimes it's not possible to identify a clear cause.

Stress and anxiety Some people develop insomnia after a stressful event, such as a bereavement, problems at work, or financial difficulties.

Poor sleep routine and sleeping environment You may struggle to get a good night's sleep if you go to bed at inconsistent times, nap during the day, or don't "wind down" before going to bed.

Lifestyle factors Drinking alcohol before going to bed and taking certain recreational drugs can affect your sleep, as can stimulants such as nicotine found in cigarettes and caffeine found in tea, coffee and energy drinks.

Medication Some prescriptions or over-the-counter medications can cause insomnia as a side effect. These include: certain antidepressants epilepsy medicines medicines for high blood pressure , such as beta-blockers steroid medication non-steroidal anti-inflammatory drugs NSAIDs stimulant medicines used to treat attention deficit hyperactivity disorder ADHD or narcolepsy some medicines used to treat asthma, such as salbutamol, salmeterol and theophylline Check the leaflet that comes with any medication you're taking to see if insomnia or sleeping difficulties are listed as a possible side effect.

Self-help tips Insomnia can often be improved by changing your daytime and bedtime habits or by improving your bedroom environment. See your GP if you're still having difficulty getting to sleep after trying these techniques. Daytime habits Set a specific time for getting up each day. Try to stick to this time, seven days a week, even if you feel you haven't had enough sleep. This should help you sleep better at night. Don't take a nap during the day. Take daily exercise, such as 30 minutes walking or cycling.

But don't exercise for at least four hours before going to bed, because this may make it more difficult to fall asleep. Bedtime habits Stop drinking tea and coffee for a few hours before bedtime. Avoid drinking alcohol and smoking, particularly shortly before going to bed. Don't eat a big meal just before bedtime. Only go to bed when you're feeling tired.

If necessary, go to bed later than usual if it means you might be able to fall asleep more quickly. Don't use back-lit devices shortly before going to bed, including televisions, phones, tablets and computers. Do you try to go to bed and get up around the same time every day? Common psychological and medical causes of insomnia Sometimes, insomnia only lasts a few days and goes away on its own, especially when it is tied to an obviously temporary cause, such as stress over an upcoming presentation, a painful breakup, or jet lag.

Other times, insomnia is stubbornly persistent. Chronic insomnia is usually tied to an underlying mental or physical issue. Anxiety, stress, and depression are some of the most common causes of chronic insomnia.

Having difficulty sleeping can also make anxiety, stress, and depression symptoms worse. Other common emotional and psychological causes include anger , worry, grief, bipolar disorder, and trauma. Treating these underlying problems is essential to resolving your insomnia. Medical problems or illness. Chronic pain is also a common cause of insomnia. Many prescription drugs can interfere with sleep, including antidepressants , stimulants for ADHD, corticosteroids, thyroid hormone, high blood pressure medications, and some contraceptives.

Common over-the-counter culprits include cold and flu medications that contain alcohol, pain relievers that contain caffeine Midol, Excedrin , diuretics, and slimming pills. Sleep disorders. Insomnia is itself a sleep disorder, but it can also be a symptom of other sleep disorders , including sleep apnea, restless legs syndrome, and circadian rhythm disturbances tied to jet lag or late-night shift work.

Habits that cause insomnia and disrupt sleep While treating underlying physical and mental issues is a good first step, it may not be enough to cure your insomnia. You also need to look at your daily habits. Or maybe you drink excessive amounts of coffee during the day, making it harder to fall asleep later.

Other daytime habits that can negatively impact your ability to sleep at night include having an irregular sleep schedule, napping, eating sugary foods or heavy meals too close to bedtime, and not getting enough exercise or exercising too late in the day. Some habits are so ingrained that you may overlook them as a possible contributor to your insomnia.

Maybe your Starbucks habit affects your sleep more than you realize. Keeping a sleep diary or using a sleep tracking app is a helpful way to pinpoint habits and behaviors contributing to your insomnia. Two powerful weapons in the fight against insomnia are a quiet, comfortable bedroom and a relaxing bedtime routine. Both can make a big difference in improving the quality of your sleep. Make sure your bedroom is quiet, dark, and cool. Try using a sound machine or earplugs to mask outside noise, an open window or fan to keep the room cool, and blackout curtains or an eye mask to block out light.

Experiment with different levels of mattress firmness, foam toppers, and pillows that provide the support you need to sleep comfortably. Stick to a regular sleep schedule. Support your biological clock by going to bed and getting up at the same time every day, including weekends.

This will help you get back in a regular sleep rhythm. Turn off all screens at least an hour before bed. So instead of watching TV or spending time on your phone, tablet, or computer, choose another relaxing activity, such as reading a book or listening to soft music.

Avoid stimulating activity and stressful situations before bedtime. This includes checking messages on social media , big discussions or arguments with your spouse or family, or catching up on work.

Postpone these things until the morning. Avoid naps. Lastly, a word about natural treatment for insomnia options. Historically people have used herbal supplements such as valerian and kava to reduce insomnia symptoms and improve their sleep.

Some recent findings indicate these supplements may not be as same as once thought. Both valerian and kava have been linked to adverse side effects, and are generally not recommended to treat insomnia. Alexa Fry is a science writer with experience working for the National Cancer Institute. She also holds a certificate in technical writing. He is board-certified in psychiatry as well as sleep medicine.

Insomnia is a common sleep disorder characterized by a persistent difficulty to fall or remain asleep despite the opportunity to…. Sleep problems can affect anyone, but women are more likely to experience insomnia than men. Poor sleep can provoke daytime…. Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website.

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The Sleep Foundation editorial team is dedicated to providing content that meets the highest standards for accuracy and objectivity. Our editors and medical experts rigorously evaluate every article and guide to ensure the information is factual, up-to-date, and free of bias. Updated September 18, Written by Alexa Fry. Medically Reviewed by Alex Dimitriu. Diagnosing Insomnia Before insomnia treatment can begin, you should meet with your doctor or another credentialed physician to discuss symptoms and receive a diagnosis.

Additionally, you must experience one or more of the following daytime symptoms to receive an insomnia diagnosis: Fatigue or malaise Impairments with memory, concentration, or attention Negative impacts on social, family, occupational, or academic performance Irritability or disturbed mood Excessive daytime sleepiness Hyperactivity, impulsivity, aggression, or other behavioral problems Increased risk for errors and accidents Lack of motivation or energy Related Reading.

Sign up below for your free gift. Your privacy is important to us. Was this article helpful? Yes No. Alex Dimitriu Psychiatrist MD. Benzodiazepines increase sleep time and improve sleep quality by reducing sleep-onset latency and wakefulness after sleep onset and by increasing sleep efficiency Table 7. Benzodiazepines that have been approved by the FDA for treating chronic insomnia include estazolam, flurazepam Dalmane , temazepam Restoril , quazepam Doral , and triazolam Halcion.

Rapidly acting drugs with shorter half-lives i. Temazepam has a slower onset of action and is less effective for initiating sleep. Flurazepam and quazepam have half-lives longer than 24 hours. Nonpharmacologic 13 , Relaxation 4.

Exercise Benzodiazepines 4 , Estazolam 4. Flurazepam Dalmane 4. Temazepam Restoril 4. Triazolam Halcion 4. Nonbenzodiazepines 4. Eszopiclone Lunesta 4. Zaleplon Sonata 4. Zolpidem Ambien 4. Doxepin 4.

Trazodone Desyrel 4. Risk difference is the increased risk of adverse events compared with placebo or no treatment. Information from references 4 , 13 , 14 , 16 , and Because tolerance and dependence occur with prolonged use, benzodiazepines are most useful for the short-term treatment of insomnia.

An estimated 10 to 30 percent of chronic benzodiazepine users develop dependence, and 50 percent suffer withdrawal. Benzodiazepine withdrawal may cause anxiety, depression, nausea, perceptual changes, rebound insomnia, intense dreams, nightmares, and poor memory consolidation. Withdrawal symptoms may develop within a few hours of discontinuing a short-acting benzodiazepine, or up to three weeks after discontinuing a long-acting benzodiazepine.

With short-acting drugs, rebound insomnia can occur the same night the drug is administered, leading to ante-grade memory impairment.

Their use increases the risk of motor vehicle collisions, falls and serious injuries, and fatal overdose in older adults. The newer nonbenzodiazepines selectively bind to type 1 benzodiazepine receptors in the CNS. Unlike benzodiazepines, the nonbenzodiazepines have minimal impact on sleep stages and no REM sleep rebound. Tachyphylaxis is unusual. Nonbenzodiazepines undergo hepatic degradation, and doses should be reduced in older patients and in those with hepatic dysfunction.

However, when indirectly compared, the nonbenzodiazepines are similarly effective but have less overall risk of adverse effects. Zolpidem decreases sleep-onset latency, improves sleep quality, increases stage 2 and slow-wave sleep, and does not exhibit tolerance or rebound following five weeks of continuous use at recommended dosages. Because of its longer half-life, a controlled-release version Ambien CR in a dosage of 6. Zaleplon decreases sleep-onset latency. Its short half-life i.

It is particularly useful in patients who have trouble falling asleep and maintaining sleep and can be administered up to four hours before the anticipated wake time. Eszopiclone, an isomer of zopiclone, is the only hypnotic with FDA approval for use longer than 35 days. Eszopiclone has evidence of effectiveness for six months of therapy in a randomized, placebo-controlled trial, although there is some attenuation of its effect over time. Higher doses 2 to 3 mg are more effective for sleep maintenance, whereas lower doses 1 to 2 mg are suitable for difficulty in falling asleep.

The onset of action may be delayed if eszopiclone is taken with a high-fat meal. Rare cases of fatal overdose when used with other CNS depressants have been reported. Ramelteon is a selective melatonin receptor agonist targeting the melatonin MT 1 and MT 2 receptors in the brain.

It reduces sleep-onset latency and increases sleep periods. Ramelteon has not been studied in patients with depression, anxiety, shift work, or jet lag. Serious adverse effects attributed to ramelteon are rare, affecting less than 1 percent of patients. Common side effects include somnolence, headache, fatigue, nausea, and dizziness. The metabolism of ramelteon is reduced in patients with severe hepatic impairment.

Ramelteon is the only non-scheduled drug for insomnia. There is little evidence to support combining nonpharmacologic and pharmacologic treatments for insomnia. The results of one study that compared benzodiazepine plus CBT versus benzodiazepine alone showed that sleep efficiency was minimally improved with the use of combination therapy.

The authors of a third study that compared benzodiazepine plus CBT versus CBT alone found no differences in sleep outcomes. A meta-analysis comparing pharmacologic and nonpharmacologic treatments found similar short-term effectiveness two to four weeks in patients with primary insomnia.

Nonpharmacologic therapy showed slightly greater reductions in sleep-onset latency, but wakefulness after sleep onset, number of awakenings, total sleep time, and sleep quality were not significantly different. There are no direct comparisons of the effectiveness of the newer nonbenzodiazepines and other medications for chronic insomnia. Indirect comparisons in which each medication was compared with placebo are shown in Table 7.

The abuse potential of hypnotics is often overstated. Most patients taking hypnotics do so for a short period; only 10 to 15 percent take hypnotics long-term. Although substance abusers may abuse benzodiazepines, they rarely abuse nonbenzodiazepines.

The cost of nonbenzodiazepines is considerably higher than benzodiazepines. An economic evaluation comparing the cost-effectiveness of nonpharmacologic treatment, benzodiazepines, eszopiclone, and no treatment in older adults found that, compared with benzodiazepines, nonpharmacologic therapy i. Already a member or subscriber?

Log in. Interested in AAFP membership? Learn more. Reprints are not available from the authors. Evaluation of chronic insomnia. An American Academy of Sleep Medicine review. Ohayon MM. Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev. NIH state-of-the-science conference statement on manifestations and management of chronic insomnia in adults.

Manifestations and management of chronic insomnia in adults. Evid Rep Technol Assess Summ.