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Insomnia: Symptoms and Causes

Insomnia is a sleep disorder that is characterized by inadequate sleep quality and quantity. People with this sleep disorder have one or more of the following insomnia symptoms:

• Difficulty falling asleep
• Waking up often during the night and having trouble going back to sleep
• Waking up too early in the morning
• Feeling tired upon waking
• Sleepiness during the day
• Irritability and problems with concentration or memory
  

What Causes Insomnia?

Insomnia can be its own medical problem (primary insomnia) or it can be caused by a separate issue (secondary insomnia) such as a side effect from medication. Insomnia may be an acute (short-term) problem, meaning it lasts less than 1 month, or it can be chronic, lasting 1 month or longer.

Situations that may cause a period of acute insomnia can include:

• Stress (for example, job loss or change, death of a loved one, divorce, or moving)
• Illness
• Emotional or physical discomfort
• Environmental factors like noise, light, or extreme temperatures (hot or cold) that interfere with sleep
• Some medications (for example those used to treat colds, allergies, dpression, high blood pressure, and asthma)
• Interference in normal sleep schedule (for example, jet lag or switching from a day to night shift)

Causes of chronic insomnia can include:

• Depression and/or anxiety
• Chronic stress
• Pain or discomfort at night

Sleep Apnea

Sleep apnea is a serious sleep disorder that occurs when a person's breathing is interrupted during sleep. People with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times.

There are two types of sleep apnea:

• Obstructive Sleep Apnea(OSA): The more common of the two forms of apnea, it is caused by a blockage of the airway, usually when the soft tissue in the back of the throat collapses during sleep.
• Central Sleep Apnea: Unlike OSA, the airway is not blocked but the brain fails to signal the muscles to breathe due to instability in the respiratory control center.

Am I at Risk for Sleep Apnea?

Sleep apnea can affect anyone at any age, even children. However, risk factors for sleep apnea include:

• Male gender
• Being overweight
• Being over the age of forty
• Having a large neck size (17 inches or greater in men and 16 inches or greater in women)
• Having larger tonsils
• Having a family history of sleep apnea

What Are the Effects of Sleep Apnea?

If left untreated, sleep apnea can result in a growing number of health problems including:

• Hypertension
• Stroke
• Heart failure, irregular heart beats, and heart attacks

In addition, untreated sleep apnea may be responsible for poor performance in everyday activities, such as at work and school, motor vehicle crashes, as well as academic underachievement in children and adolescents.

Sleep and Restless Legs Syndrome

Restless legs syndrome (RLS) is a disorder of the part of the nervous system that affects movements of the legs. Because it usually interferes with sleep, it also is considered a sleep disorder.

Symptoms of Restless Legs Syndrome

People with RLS have strange sensations in their legs (and sometimes arms) and an irresistible urge to move their legs to relieve the sensations. The sensations are difficult to describe: they are not painful, but an uncomfortable, "itchy," "pins and needles," or "creepy crawly" feeling deep in the legs. The sensations are usually worse at rest, especially when lying in bed. The sensations lead to walking discomfort, sleep deprivation, and stress.

The severity of RLS symptoms ranges from mild to intolerable. Symptoms get gradually worse over time in about two thirds of people with the condition and may be severe enough to be disabling. The symptoms are generally worse in the evening and night and less severe in the morning. While the symptoms are usually quite mild in young adults, by age 50 the symptoms may cause severe nightly sleep disruption that can significantly impair a person's quality of life.

Who Gets Restless Legs Syndrome?

RLS affects about 10% of the U.S. population. It affects both men and women and may begin at any age, even in infants and young children. Most people who are affected severely are middle-aged or older.

RLS is often unrecognized or misdiagnosed. In many people the condition it is not diagnosed until 10-20 years after symptoms begin. Once correctly diagnosed, RLS can often be treated successfully.