Idiopathic insomnia is a lifelong sleep disorder. It starts as an infant or child. It then continues as an adult.
This lifelong insomnia cannot be explained by other causes. It is not a result of any of the following:
- Other sleep disorders
- Medical problems
- Psychiatric disorders
- Stressful events
- Medication use
- Other behaviors
It may result from an imbalance in your body. You may have an overactive awakening system. Your body may also have an underactive sleep system. But the true cause of this disorder is still not known for sure.
Patients with idiopathic insomnia have the following symptoms:
- A short sleep time
- Difficulty falling asleep
- Many unexplained awakenings
- Lifetime insomnia that persists nearly every night
- No preceding stressful event
- No medical, psychological or neurologic problem that would explain the insomnia
- No behaviors, medications or substances that would explain the insomnia
- Despite a lifetime of little sleep, people with this sleep disorder tend to be mentally healthy. They may or may not complain of the following:
- Daytime fatigue
- Problems concentrating
They may try to correct this insomnia by taking medications or drinking alcohol. Bad sleep hygiene habits and other bad behaviors may also result. An example of this is staying awake too long in bed. These efforts are not helpful. In fact, they may lead to other forms of insomnia. In its pure form, idiopathic insomnia is a lifelong problem that persists without any obvious cause.
Who gets it?
Overall, insomnia is a very common sleep complaint. But idiopathic insomnia is one of its less common forms. Less than 1% of children and teens have it. About 1% of adults have it as well. It is not even common among people who go to see a sleep specialist due to insomnia. Less than 10% of these people have it. Men and women may be equally affected. It does seem to run in families.
How do I know if I have it?
- Did your insomnia begin slowly as an infant or child? Did it then continue as a teen and adult?
- Are there no obvious causes of your insomnia? This would include any of the following:
- Behaviors, such as poor sleep hygiene
- Medical or psychological causes
- Are you otherwise quite normal despite having such poor sleep for so many years?
If you answered yes to these questions, then you might have idiopathic insomnia.
Do I need to see a sleep specialist?
You may not need to see a sleep specialist. Many people with this insomnia often learn to adapt. They tend to be mentally healthy despite decreased sleep for so many years. But you may have problems with sleepiness or functioning during the day.
If so, then you may want to discuss this with your family doctor. Your doctor will likely ask you many sleep and medical questions. He or she may first suggest that you change any behaviors that make your insomnia worse. You can often sleep better by simply following the practices of good sleep hygiene.
Sleep hygiene consists of basic habits and tips that help you develop a pattern of healthy sleep. Your doctor may also suggest that you take a medication. On the other hand, he or she may refer you to a sleep specialist.
What will the doctor need to know?
The doctor will ask you about the following:
- Sleep symptoms (such as whether or not you snore)
- Your sleep schedule (such as your bedtime, number of awakenings, when you get out of bed, naps)
- If you are very sleepy or have problems functioning normally during the day
- Any medical problems or any psychological problems
- If you take any prescription or over-the-counter medications, including herbs
- Alcohol, caffeine, or substance use
- Your family history may also provide important details.
The doctor will do an exam. You may be asked to complete a sleep diary. This will monitor your progress before and after treatment. You may be asked to rate your sleep with the Epworth Sleepiness Scale. This will help show how your sleep is affecting your daily life.
Will I need to take any tests?
Your family doctor may want to perform routine blood tests. He or she may also want to get a thyroid blood test. A sleep study is not generally needed for people with idiopathic insomnia. Your doctor may have you do an overnight sleep study if you are suspected of having another sleep disorder. This study is called a polysomnogram.
It charts your brain waves, heart beat, and breathing as you sleep. It also records how your arms and legs move. This shows if there are other disorders that are related to your sleep problems. Examples of these disorders include sleep apnea and periodic limb movement disorder. The best sleep study will also record your sleep on video. This will show if you get out of the bed and do anything unusual during the night.
How is it treated?
Treatment is similar to that of other forms of insomnia. Doctors often treat insomnia in the three ways that follow:
1. Sleep hygiene
Sleep hygiene consists of good things that you can do to improve sleep. For example, you should get up at the same time every day. You should also avoid drinks with caffeine that disturb sleep.
2. Cognitive behavioral therapy
This involves relaxation exercises and other methods that help improve your sleep. Some people listen to relaxing tapes. Others learn breathing exercises from a psychologist. Other methods teach you to do things such as limiting the time you spend in bed.
3. Sleeping pills and sleeping aids
Doctors sometimes prescribe sleeping pills to treat insomnia. These are called hypnotics. At times insomnia is related to depression and anxiety. In these cases, medications may be prescribed by doctors to help insomnia.
Some people with insomnia try to treat themselves with nonprescription sleep aids that they find on drugstore shelves. Others may try vitamins or herbs. Some people even use alcohol to help them fall asleep. Doing this actually makes their sleep worse. The alcohol causes them to wake up during the night. There are many ways to treat insomnia that are common and effective. You should talk to your primary care doctor to discuss these options. You may also want to visit a sleep center to get more expert advice. You may want to see a sleep specialist if your insomnia causes you to nod off during the day.
SOURCE: American Academy of Sleep Medicine; By Sharon L. Schutte-Rodin, MD