Insomnia is defined as difficulty initiating or maintaining sleep for more than six months.
Many people have trouble falling asleep; others awaken multiple times during the night
and may have trouble returning to sleep. Still others awaken too early in the morning.
All of these types of insomnia result in fatigue and drowsiness during the day, or the
feeling of not being restored after a night of sleep. It affects many people, particularly
those in their 50s or later. Numerous medications have been developed over the years to
treat this problem, many of them being advertised on television ads promoted by pharmaceutical
companies. It is normal for people to awaken after falling asleep as they age. In addition,

urinary frequency problems, and hormonal instability from menopause cause people to awaken after falling asleep. Arthritis pain, carpal tunnel, and other conditions can cause people to awaken at night.

Snoring can make it difficult for a partner to sleep. The snorer may also develop sleep apnea, which if untreated can lead to gastric reflux disease, ulcers, aspiration, asthma, pulmonary hypertension and stroke. These sufferers never achieve the deeper levels of sleep (Stage III and IV), as they are constantly being aroused to restore breathing. The lack of Stage III and IV sleep makes people tired and exhausted during the day. Excessive daytime sleepiness occurs, sufferers may fall asleep at work and while driving, and significant memory problems develop. This is a treatable condition, and often requires a night in a sleep lab to diagnose and measure the necessary response.

Alcohol as well as stimulants such as caffeine or chocolate may make sleep more broken, and early morning awakening can result as a response to withdrawal of these addicting substances. Restless leg syndrome and periodic movements of limbs during sleep cause people to awaken. Both of these conditions have very effective treatments; there is no reason to suffer from these disorders.

Sleep behavior can have a powerful effect. The brain can learn that the bed is not for sleep, if one watches television, eats, reads, and plays games in bed. Some insomniacs need to limit time in bed to sleeping or sexual intercourse. If they awaken at night and feel like reading, eating, or watching television, they do better by moving to another part of the house for these activities, then later returning to bed to sleep. Recent studies found that children that sleep less than eight hours nightly not only have more trouble learning, but are at much higher risk of developing obesity years later. The importance of good sleep is being demonstrated in many medical articles.

Early sleep medications were related to valium, which when used on a regular basis became addictive and made it difficult to sleep when not using the medication. More recently, other brain receptors were discovered that are instrumental in falling or staying asleep. Some medications stimulate serotonin receptors; one recent medication stimulates melatonin, which is an important neurotransmitter for normal day and night cycles of the body. A proper history and physical may be necessary to determine the cause and proper treatment of people with sleep disorders.