Insomnia is when you are aware of poor quality sleep because you cannot fall asleep; wake up a lot during the night and cannot fall back asleep (also a sign of depression); wake up too early in the morning; or have the sense that your sleep is "fitful" or unre-freshing. Most causes of insomnia are linked to mental or emotional stress, and it is seen more frequently in people over sixty, women, and people who suffer from depression.
Most people have only transient or intermittent bouts of insomnia that resolve once a particularly stressful period has passed. Insomnia can also be linked to medication side effects, caffeine, smoking, or alcohol before bedtime.
Chronic insomnia is often linked to depression, but is also seen in people with arthritis (because of nighttime discomfort), kidney disease, heart failure, asthma, sleep apnea, restless legs syndrome (described later), and Parkinson's disease. Insomnia is generally treated through behavioral therapy and lifestyle modification. When you are thyrotoxic, you may think you have insomnia, when, in fact, your anxiety and restlessness is the result of too much thyroid hormone. A thyroid function test for anyone on thyroid hormone medication should rule out thyroid-related insomnia.
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