Insomnia FAQ

Disclaimer: This guide is for informational purposes only. By providing the information contained herein we are not diagnosing, treating, curing, mitigating, or preventing any type of disease or medical condition. Before beginning any type of natural, integrative or conventional treatment regimen, it is advisable to seek the advice of a licensed healthcare professional. May contain affiliate links. Product photos/descriptions provided by company websites. This is not medical advice.

What causes it?

Insomnia is a sleep disorder. With insomnia, you may have trouble falling asleep, staying asleep, or getting good quality sleep. Short-term insomnia may be caused by stress or changes in your schedule or environment. It can last for a few days or weeks. Chronic (long-term) insomnia occurs 3 or more nights a week, lasts more than 3 months, and cannot be fully explained by another health problem.¹

According to the National Institutes of Health, your environment, occupation, and lifestyle can cause insomnia.

The following can disturb your sleep-wake cycle, a pattern that your body uses to figure out when to sleep and when to be awake:

• Shift or night work
• Noise or light during the night
• Uncomfortably high or low temperatures
• Traveling often to different time zones.
• Changing your normal routine often, including your sleep schedule
• Experiencing interruptions in your sleep, such as waking up often to care for a baby
• Taking long naps during the day
• Getting too little physical activity during the day
• Using caffeine, nicotine, alcohol, or recreational drugs
• Watching TV or using electronic devices close to your bedtime

Stress or worrying about school or work, relationships, money, or the death of a loved one raises your risk of insomnia. Worrying about whether you will get enough sleep and watching the clock can also raise your risk of insomnia or make it worse.

Insomnia is more common in women than in men. hormone changes that take place during pregnancy and menopause can cause problems with sleep.¹

Other causes of insomnia could be Restless Leg Syndrome (RLS) or sleep apnea.

What are the symptoms?

If you have insomnia, you may experience several different symptoms:

• You may lie awake for a long time before you fall asleep. This is more common in younger adults.
• Sleep may be possible for only short amounts of time. You may wake up often during the night or be awake for most of the night. This is the most common symptom and affects mostly older adults.
• Waking up too early in the morning and not getting back to sleep is also common.
• Poor-quality sleep may lead you to wake up feeling unrested, and you may feel sleepy during the day. You may also have trouble focusing on daily tasks. Insomnia can cause you to feel anxious, depressed, or easily annoyed.

Insomnia can affect your memory and concentration. Chronic insomnia raises your risk of high blood pressure, coronary heart disease, diabetes, and cancer.¹

Prevention

Per the NIH, here are some ways to prevent insomnia:

• Adopt healthy sleep habits and a regular daytime schedule to help you maintain a regular sleep-wake cycle.
• Avoid caffeine, nicotine, and alcohol close to your bedtime, as these can make it more difficult for you to fall asleep.

Here are recommended hours of sleep based on age from the CDC:

Diagnosis

To diagnose insomnia, your healthcare provider may ask about your sleep habits and ask you to keep a sleep diary. It may be helpful to keep a sleep diary for 1 to 2 weeks before seeing your doctor. A sleep diary can help your doctor understand the problems you’re having and whether certain activities are affecting your sleep. Write down when you go to sleep, wake up, and take naps each day. Also write down how sleepy you feel throughout the day, when you drink caffeine or alcohol, and when you exercise.¹

In addition to a sleep diary, your doctor may ask the following questions:

• How often you have trouble sleeping and how long you’ve had the problem
• When you go to bed and get up on days you go to work as well as days off
• How long it takes you to fall asleep, how often you wake up at night, and how long it takes you to fall back asleep
• How refreshed you feel when you wake up and how unrested you feel during the day
• Whether you use electronic devices or watch TV before bed, as the light that comes from these sources can affect your sleep
• Whether you snore loudly and often or wake up gasping or feeling out of breath
• Have any new or long-standing health problems
• Take any medicines
• Are pregnant or going through menopause
• Use caffeine, nicotine, alcohol, or illegal drugs

Your healthcare provider should do a physical exam to rule out other medical problems that might affect your sleep. They will listen to your heart and lungs and look for risk factors for sleep apnea, such as large tonsils or a large neck circumference.

Here are some diagnostic tests that might be recommended:

• A sleep study looks for other sleep problems, such as circadian rhythm disorders, sleep apnea, and narcolepsy.
• Actigraphy looks at your periods of rest and activity and measures how well you sleep. This requires you to wear a small motion sensor on your wrist for 3 to 14 days.
• Blood tests check for thyroid problems or other medical conditions that can affect sleep.

Treatment

Here are some recommended treatment options for insomnia from the NIH:

General Tips

• Make your bedroom sleep friendly. Sleep in a cool, quiet, dark place. Avoid watching TV or looking at electronic devices, as the light from these sources can disrupt your sleep-wake cycle.
• Go to sleep and wake up around the same time each day, even on the weekends. If you can, avoid a schedule that changes or other things that may disrupt your sleep schedule.
• Avoid caffeine, nicotine, and alcohol close to your bedtime. Although alcohol can make it easier to fall asleep, it can cause you to have a sleep that tends to be lighter than normal. This makes it more likely that you will wake up during the night.
• Get regular physical activity during the daytime, at least 5 to 6 hours before going to bed. Exercising close to bedtime can make it harder to fall asleep.
• Avoid naps, especially in the afternoon. This may help you sleep longer at night.
• Eat meals on a regular schedule and avoid late-night dinners.
• Limit how much you drink close to bedtime. This may help you sleep longer without having to use the bathroom.
• Learn new ways to manage stress. Follow a routine that helps you wind down and relax before bed. For example, read a book, listen to soothing music, or take a hot bath. Your doctor may also recommend massage therapy, meditation, or yoga to help you relax. Acupuncture may also help improve insomnia, especially in older adults.
• Avoid certain over-the-counter and prescription medicines that can disrupt sleep (for example, some cold and allergy medicines). Talk with your healthcare provider and read manufacturer inserts of any medications you are on about which medicines will disrupt your sleep.¹

Learn to put worries out of your mind. If you have occasional trouble getting sleep, concentrate on pleasant memories and thoughts. Re-create a pleasurable time or event in your life and relive it in your mind. Learning a relaxation technique such as meditation or the use of guided imagery is helpful in getting sleep patterns back to normal for many people.³

Restless Leg Syndrome

If your legs jerk, twitch, and kick involuntarily while in bed or you suffer from painful nighttime leg muscle cramps, analyze if you have a magnesium deficiency. Some research also suggests that anemia may play a major role.³

Proper vitamin and mineral supplements may help. Test your calcium, potassium, magnesium, and zinc levels. Some have success with the following daily dosage levels, however always check with your healthcare provider prior to starting any supplements:³

• Vitamin B complex: 400mg
• Magnesium: 1,000mg
• Vitamin E: 200 international units

Sleep Apnea

In sleep apnea, breathing actually stops for as long as two minutes at a time while the individual is asleep. When breathing stops, the level of oxygen in the blood drops, resulting in oxygen deprivation. The individual then awakens, startled and gasping. A person with sleep apnea may wake up as many as two hundred times in one night. If overweight, the first recommendation is to lower overall body weight to allow the diaphragm to fully exert itself to take a full breath. For additional treatment options, find an experienced healthcare provider to research your options.³

Pregnancy Insomnia

Common in the last few weeks of pregnancy, finding a comfortable sleeping position may make sleeping harder. Frequent urination, B vitamin deficiency, and hormonal changes may cause pregnancy insomnia. Here are some things to ask your healthcare provider about to help get more sleep:³

• Increase your intake of foods rich in B vitamins.
• Take a warm (not hot) bath with a soothing oil (such as lavender) added to the water. Here is a great article on how to safely use essential oils in a bath.
• Consider taking up yoga or meditation to relax.
• Don’t force sleep. Read, meditate, or do something non strenuous until you feel sleepy.
• Try drinking a cup of hot herbal tea with honey or lemon before bed or in the middle of the night. Herbal teas such as marjoram, lemon balm, and passionflower are known for sleep-inducing qualities.
• Avoid stimulants and heavy meals before bed.
• Arrange pillows behind or under your abdomen to relieve breathlessness. Or use a pregnancy pillow.

Cognitive Behavioral Therapy for Insomnia (CBT-I)

CBT-I is a 6- to 8-week treatment plan to help you learn how to fall asleep faster and stay asleep longer. This is usually recommended as the first treatment option for long-term insomnia and can be very effective. CBT-I can be done by a doctor, nurse, or therapist; you can do it in person, by telephone, or online. It involves the following parts: 

• Cognitive therapy helps you feel less nervous about not being able to sleep.
• Relaxation or meditation therapy teaches you how to relax and fall asleep faster.
• Sleep education helps you learn good sleep habits.
• Sleep restriction therapy gives you a specific amount of time to spend in bed, even if you are not able to sleep during this time. With time, this helps you sleep better when you go to bed. Your sleep time can be increased when you start to sleep better.
• Stimulus control therapy helps you have a regular sleep-wake cycle so you can link being in bed with being asleep. This involves going to bed only when you are sleepy, getting out of bed if you cannot sleep, and using your bed only for sleep and sexual activity.¹

Prescription Medicines

Your healthcare professional may recommend pharmaceutical medicines to treat insomnia. With all medications, be sure to read the manufacturer inserts especially the “post-marketing experience” section. Pay attention if sleeping disorders or insomnia itself is listed as an adverse reaction. Per the NIH, “some prescription medicines used to treat other health conditions can also increase your risk of insomnia.”

Here are common prescription medicines for insomnia (click on each trade name for the insert):

• Benzodiazepine receptors agonists are medicines such as zolpidem (Ambien), zaleplon (Sonata), and eszopiclone (Lunesta). Side effects may include anxiety, a severe allergic reaction, or doing activities while asleep such as walking, eating, or driving.
• Melatonin receptor agonists are medicines such as ramelteon (Rozerem). Side effects include dizziness and fatigue. Some people experience doing activities while they are asleep, such as walking, eating, or driving; or they may have a severe allergic reaction. 
• Orexin receptor antagonists such as suvorexant (Belsomra) are not recommended for people who have narcolepsy. Side effects may include doing activities while asleep such as walking, eating, or driving; or not being able to move or speak for several minutes while going to sleep or waking up.
• Benzodiazepines may be prescribed if other treatments and medicines have not worked. Talk to your healthcare provider about the side effects of these medicines, which can include dizziness, confusion, and muscle weakness. Benzodiazepines (Xanax) can also interact dangerously with other medicines. It can be habit-forming and should be taken for only a few weeks.

Off-Label Medicines

According to the NIH, “healthcare providers may prescribe medicines that are commonly used for other health conditions but are not approved by the U.S. Food and Drug Administration (FDA) to treat insomnia. Some of these medicines may include antidepressants, antipsychotics, and anticonvulsants.” Be sure to read the inserts for any medication prescribed or recommended to you. Click here to learn how to read manufacturer inserts.

Over-the-Counter Medicines

In addition to off-label medications, antihistamines may be sold as sleep aids. Although they might make you sleepy, according to the NIH, they may be unsafe for some people.

Herbal Medicine

Research taking a blend of the following herbs in capsule form: Valerian Root, Hops, Skullcap, and Passionflower. For insomnia, some have had success taking two capsules of this blend one hour before retiring and another two capsules upon retiring. Do not use while driving.²

Valerian Root is a primary sedative and is used when sleep disorders are the result of anxiety, nervousness, exhaustion, headache or hysteria. Hops also has sedative effects. Skullcap helps reduce the severity of pain that sometimes accompanies sleep. It can numb pains and aches that prevent some individuals from falling asleep easily. Passionflower can induce relaxation and sleep.²

Vitamins and Minerals

Additionally, research the following vitamins and minerals for insomnia. Be sure to work with a healthcare professional on your personal dosage requirements.²

• Vitamin B-1: 25-100mg
• Vitamin B-2: 25-100mg
• Vitamin B-6: 25-100mg
• Vitamin C: 500mg
• Vitamin D: 400mg
• Vitamin E: 400-600mg
• Niacinamide: 100mg
• Pantothenic Acid: 150-200mg
• Calcium/Magnesium
• Potassium

Nutrition

Eat foods high in tryptophan in the evening to promote sleep:

• bananas
• dates
• figs
• milk
• nut butters
• tuna
• turkey
• whole grain crackers
• yogurt

Try not to eat a large meal within two hours of bedtime.

Avoid foods high in tyramine close to bedtime due to the release of norepinephrine (a brain stimulant):

• bacon
• cheese
• chocolate
• eggplant
• ham
• potatoes
• sauerkraut
• sugar
• sausage
• spinach
• tomatoes
• wine

Homeopathic Remedies

New to homeopathy? Here is a helpful article.

For Insomnia with Inability to Relax⁴

• Physical symptoms may include: sudden onset of insomnia, sleep occurs eventually but is fitful, oversensitivity to light/smell/noise/touch, or headache resembling a nail being driven into the head.
• Psychological symptoms may include: overactive mind or variety of emotions that are often brought on by news received.
• Symptoms are better: with warmth, lying down, or sucking on ice.
• Symptoms are worse: from taking sleeping pills, strong smells, near noise, in fresh air, or in cold conditions.
• Research Coffea 30c hourly before bed for 10 nights.

For Insomnia with Irritability⁴

• Physical symptoms may include: wakefulness between 3AM and 4AM then more settled sleep just before it’s time to get up, craving for stimulants (especially coffee), or constipation with ineffectual urging.
• Psychological symptoms may include: possible nightmares, irritability and oversensitivity, or harsh criticism of others.
• Symptoms are better: lying on either side, when sitting, with warmth, or in the evening.
• Symptoms are worse: lying on the back, from overeating (especially spicy foods), in cold/windy weahter, or near noise.
• Research Nux Vomica 30c hourly before bed for 10 nights.

For Insomnia with Great Fear⁴

• Physical symptoms may include: sudden onset of insomnia, fitful sleep associated with acute pain caused by injury, surgery, or exposure to biting wind, or numbness in the limbs.
• Psychological symptoms may include: nervousness/restlessness, great fear of death (even to the extent of predicting the time of death), or possible nightmares.
• Symptoms are better: in fresh air or warm perspiration.
• Symptoms are worse: in warm rooms, on exposure to tobacco smoke, or from loud music.
• Research Aconite 30c hourly before bed for 10 nights.

For Insomnia with Fear of Never Sleeping Again⁴

• Physical symptoms may include: continuous yawning but inability to get to sleep or lump in the throat.
• Psychological symptoms may include: growing apprehension about going to bed, rapid changes of mood, or possible nightmares.
• Symptoms are better: from eating, urinating, or walking around.
• Symptoms are worse: in fresh air, with cold, or from coffee/alcohol.
• Research Ignatia 30c hourly before bed for 10 nights.

¹ National Institutes of Health

² “The Scientific Validation of Herbal Medicine” by Daniel B. Mowrey, Ph.D.

³ “Prescription for Nutritional Healing” by Phyllis A. Balch, CNC

4 “Encyclopedia of Homeopathy” by Dr. Andrew Lockie

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