What is insomnia?

Dr. Charles E. Crutchfield, III

You can never grow tired of getting the right amount of sleep

Insomnia is a condition where it is difficult to either fall asleep or stay asleep during the night, or where you wake up too early. Getting a good, restful, recuperative night of sleep is a primary key to good health.

Experts suggest that if it takes you more than 20-40 minutes to fall asleep, or if you get less than four to five hours of sleep (when your goal is seven to eight hours of sleep), then you have insomnia.

Without the proper amount of sleep, your ability to function at peak levels is diminished, and you can feel sluggish and run-down all day long. If your job requires constant and careful attention, the condition can be considered a health and safety issue. Studies have suggested that insomnia may play a role in developing high blood pressure, obesity, and other health concerns.

Most cases of insomnia are acute or last for a short amount of time. These usually result from stressful or anxiety-provoking life events such as the death of a loved one, loss of a job, divorce, a troubling relationship break-up, disturbingly bad news, stressful work or school situations, and even situational anxiety such as a child’s inability to fall asleep on Christmas Eve.

Acute insomnia can also be the result of eating excessively late at night or ingesting too much caffeine or alcohol. Additionally, acute insomnia can result from traveling to dramatically different time zones as part of the condition we commonly call “jet-lag.”

The majority of cases of acute insomnia resolve on their own. However, there are other causes of insomnia that are considered to be long-term or chronic.

Chronic insomnia, by definition, lasts for a significant amount of time. As a general rule, the definition of chronic insomnia includes a disruption of sleep two-to-three nights per week for a period of two-to-three months.

Chronic insomnia can be caused by medical conditions that interfere with sleep like prostate problems (that cause nocturnal urination), chronic depression, obstructive lung disease (difficulty breathing with ease), and any medical condition like cancer, which can cause constant pain.

Also, psychiatric and psychological conditions can induce insomnia. Sometimes it is a complex combination of circumstances that work together to produce insomnia. Finally, there are many medications, both over-the-counter and prescriptions, which can interfere with sleep.


How is insomnia treated?

There are two considerations when treating insomnia. If the cause is acute and predicted to be temporary, employ good sleep habits, counseling therapy, and short-term sleep aids. For good sleep habits, make sure that:

  • You go to sleep at approximately the same time every night.
  • You wake at approximately the same time every morning.
  • You eliminate distractions such as TV, radio and cell phone.
  • You make sure the room is dark and quiet.
  • You make sure your mattress and pillow are comfortable.
  • You exercise in the morning or at least four hours before bed, if possible.
  • You don’t consume alcohol, nicotine, or caffeinated beverages before bed.
  • You limit naps so you are tired at bedtime.
  • You don’t work or eat in bed.
  • You do not eat large meals before bed.

If the insomnia is a result of a stressful life event, talk to your doctor to arrange a few sessions with a counselor. This one simple call can make a huge difference and may be the most important thing one can do.

For sleep aids/pills, be sure to consult a pharmacist or your doctor. These may be variations of an antihistamine that can make one feel drowsy, or a naturally occurring substance called melatonin. Melatonin is not without drawbacks, including interfering with other medications, and must be produced by a high-quality manufacturer.

Sleep aids can also cause drowsiness the following day that could be undesirable. Nevertheless, sleep aids/pills should be used just for a few days and are not a long-term solution. Get your doctor’s or pharmacist’s input before using them.

If these measures do not work, review with your doctor the possibility of medications or medical conditions that can interfere with sleep and develop a plan of attack. Here are sleep recommendations from the National Sleep Foundation:

  • Teenagers 14-17 years: recommended, 8 to 10 hours; minimum 7 hours, maximum 11 hours
  • Young adults 18-25 years: recommended, 8 to 10 hours; minimum 7 hours, maximum 11 hours
  • Adults 26-64 years: recommended, 8 to 10 hours; minimum 7 hours, maximum 11 hours
  • Older adults 65 years and up: recommended, 8 to 10 hours; minimum 7 hours, maximum 11 hours

Getting constant, quality, recuperative sleep is probably the most helpful and underrated thing you can do for your good health.


Charles E. Crutchfield III, MD is a board-certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the United States by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.