If you or a loved one have ever suffered through insomnia, you know how it can reach into every corner of your life. Below is a basic overview about insomnia including the symptoms, diagnosis, and treatment.
Insomnia- How many people have it?
Insomnia is the most common sleep disorder in America.
- 30% of people suffer with episodic insomnia
- 10% of people will experience chronic insomnia
It is estimated that over 13 million Americans take sleep aids (such as prescription sleeping pills like Ambien, Lunesta, or benzodiazepines for sleep).
Insomnia – What are the symptoms? 
The first symptom of insomnia is that you’re unhappy with your sleep. You either feel like you’re not getting enough sleep or that your sleep quality isn’t restorative. There are two main types of insomnia: sleep onset insomnia and sleep maintenance insomnia.
Sleep Onset insomnia is when you experience trouble falling asleep. Most people can fall asleep within 10-20 minutes. People with insomnia may lie awake for hours. With sleep onset insomnia, you may have trouble falling asleep but then once you are asleep you have no trouble staying asleep.
Sleep Maintenance Insomnia is when you can fall asleep easily, but you awaken frequently through the night or wake up in the middle of the night and have trouble returning to sleep. Sleep maintenance insomnia can also include early morning awakenings, when you wake up much earlier than you want to and are unable to fall back asleep.
Many people experience both sleep onset and sleep maintenance insomnia. Double whammy – trouble falling asleep and then waking up in the middle of the night being unable to return to sleep. Sounds fun, right?
The above sleep problems often lead to chronic feelings of exhaustion, irritability, depression, and anxiety. Many people start developing chronic worry and fear about their sleep.
In order to have insomnia, you have to consider your sleep difficulties a “problem.” We always say in the therapy world, if it’s not a problem then… it’s not a problem. Many people with insomnia find that it’s impacting their social life, work, hobbies, or relationships. Often my clients come in and tell me that it feels like their entire lives have started to resolve around their sleep (or lack thereof)!!!
Insomnia – How is it diagnosed?
If you think you have insomnia, a wise first step is to visit your general practitioner for a physical evaluation. They will want to rule out some of the physical causes of insomnia such as endocrine problems (thyroid problems), acid reflux, diabetes and sleep apnea.
A counselor, psychologist, or therapist will diagnose insomnia based on your symptoms. They will also screen you for sleep disorders such as sleep apnea, restless leg syndrome, periodic limb movement disorder, circadian rhythm disorders, nightmare disorder, shift/wake disorder, and narcolepsy. If there is reason to believe that you may have one of these disorders, you will be referred to a Sleep Medicine Specialist for a sleep study. Although it’s possible to have one of these disorders and insomnia, if these disorders go untreated, any behavioral treatments for insomnia will be ineffective.
Insomnia – How is it treated?
Sleep Aids (Medication)
Many physicians will prescribe a sleep aid, such as Ambien/Lunesta or a benzodiazepine. Medications offer, for some, short term immediate relief, however they do not usually resolve the underlying causes of insomnia. In some cases, sleep aids can perpetuate the problem. When people try to get off their sleep aids, they experience what is referred to as rebound insomnia, a resurgence of insomnia symptoms, only scaring individuals back into taking medication again, leading to long term dependence.
Behavioral Therapy
Counselors, psychologists, and therapists who are trained in the treatment of insomnia will treat your sleep problems with Cognitive Behavioral Therapy for Insomnia (CBT-I), an evidence based treatment program proven to be effective in treating insomnia. CBT-I involves a thorough assessment to determine the underlying factors that are contributing to the sleep difficulties. Your therapist will have you keep a sleep log for a couple of weeks to get a better picture of your sleep problems. A plan will be created to implement changes in your lifestyle, when & how you sleep, and skills to help you cope with anxiety and sleep related worries.
CBT-I is the first line of treatment recommended for insomnia and it can be effective in as few as 3-4 counseling sessions. Individuals who are already taking sleeping aids don’t have to wait to start CBT-I. Many people who start CBT-I choose to taper off their medications (with the guidance of their doctor) while participating in therapy.
CBT-I helps clients fix their broken sleep patterns and learn how to prevent or nip in the bud any future related sleep problems that may arise.
Kathryn Tipton, MA LPC
Kathryn Tipton has passion for sleep and wants to help you return to sleeping through the night. She uses Cognitive Behavioral Therapy for Insomnia (CBT-I), a non-pharmacological treatment to help clients gain control over their insomnia and improve the quality of their sleep. She is a Licensed Professional Counselor with a Masters degree in Clinical Psychology. Her private practice is located in central Houston, in the Montrose district. Additionally, she conducts sessions online/via phone with clients from the comfort of their own home or office.