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`Overview
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`
`Insomnia is a common sleep disorder that can make it hard to fall asleep,
`hard to stay asleep, or cause you to wake up too early and not be able to
`get back to sleep. You may still feel tired when you wake up. Insomnia can
`sap not only your energy level and mood but also your health, work
`performance and quality of life.
`
`How much sleep is enough varies from person to person, but most adults
`need seven to eight hours a night.
`
`At some point, many adults experience short-term (acute) insomnia, which
`lasts for days or weeks. It's usually the result of stress or a traumatic event.
`But some people have long-term (chronic) insomnia that lasts for a month or
`more. Insomnia may be the primary problem, or it may be associated with
`other medical conditions or medications.
`
`You don't have to put up with sleepless nights. Simple changes in your daily
`habits can often help.
`
`Products & Services
`
`Book: Mayo Clinic Book of Home Remedies
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`
`For adults living
`with EDS in
`NARCOLEPSY
`
`Page 1 of 7
`
`EISAI EXHIBIT 1034
`
`

`

`Symptoms
`
`Insomnia symptoms may include:
`
`Difficulty falling asleep at night
`
`Waking up during the night
`
`Waking up too early
`
`Not feeling well-rested after a night's sleep
`
`Daytime tiredness or sleepiness
`
`Irritability, depression or anxiety
`
`Difficulty paying attention, focusing on tasks or remembering
`
`Increased errors or accidents
`
`Ongoing worries about sleep
`
`When to see a doctor
`
`If insomnia makes it hard for you to function during the day, see your doctor
`to identify the cause of your sleep problem and how it can be treated. If your
`doctor thinks you could have a sleep disorder, you might be referred to a
`sleep center for special testing.
`
`Request an Appointment at Mayo Clinic
`
`Causes
`
`Insomnia may be the primary problem, or it may be associated with other
`conditions.
`
`Chronic insomnia is usually a result of stress, life events or habits that
`disrupt sleep. Treating the underlying cause can resolve the insomnia, but
`sometimes it can last for years.
`
`Common causes of chronic insomnia include:
`
`Stress. Concerns about work, school, health, finances or family can
`keep your mind active at night, making it difficult to sleep. Stressful life
`events or trauma — such as the death or illness of a loved one,
`divorce, or a job loss — also may lead to insomnia.
`
`Mayo Clinic does not endorse companies or
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`Page 2 of 7
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`

`

`Travel or work schedule. Your circadian rhythms act as an internal
`clock, guiding such things as your sleep-wake cycle, metabolism and
`body temperature. Disrupting your body's circadian rhythms can lead to
`insomnia. Causes include jet lag from traveling across multiple time
`zones, working a late or early shift, or frequently changing shifts.
`Poor sleep habits. Poor sleep habits include an irregular bedtime
`schedule, naps, stimulating activities before bed, an uncomfortable
`sleep environment, and using your bed for work, eating or watching TV.
`Computers, TVs, video games, smartphones or other screens just
`before bed can interfere with your sleep cycle.
`Eating too much late in the evening. Having a light snack before
`bedtime is OK, but eating too much may cause you to feel physically
`uncomfortable while lying down. Many people also experience
`heartburn, a backflow of acid and food from the stomach into the
`esophagus after eating, which may keep you awake.
`
`Chronic insomnia may also be associated with medical conditions or the use
`of certain drugs. Treating the medical condition may help improve sleep, but
`the insomnia may persist after the medical condition improves.
`
`Additional common causes of insomnia include:
`
`Mental health disorders. Anxiety disorders, such as post-traumatic
`stress disorder, may disrupt your sleep. Awakening too early can be a
`sign of depression. Insomnia often occurs with other mental health
`disorders as well.
`Medications. Many prescription drugs can interfere with sleep, such as
`certain antidepressants and medications for asthma or blood pressure.
`Many over-the-counter medications — such as some pain medications,
`allergy and cold medications, and weight-loss products — contain
`caffeine and other stimulants that can disrupt sleep.
`Medical conditions. Examples of conditions linked with insomnia
`include chronic pain, cancer, diabetes, heart disease, asthma,
`gastroesophageal reflux disease (GERD), overactive thyroid,
`Parkinson's disease and Alzheimer's disease.
`Sleep-related disorders. Sleep apnea causes you to stop breathing
`periodically throughout the night, interrupting your sleep. Restless legs
`syndrome causes unpleasant sensations in your legs and an almost
`irresistible desire to move them, which may prevent you from falling
`asleep.
`Caffeine, nicotine and alcohol. Coffee, tea, cola and other
`caffeinated drinks are stimulants. Drinking them in the late afternoon or
`evening can keep you from falling asleep at night. Nicotine in tobacco
`products is another stimulant that can interfere with sleep. Alcohol may
`help you fall asleep, but it prevents deeper stages of sleep and often
`causes awakening in the middle of the night.
`
`/
`
`Page 3 of 7
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`

`

`Insomnia and aging
`
`Insomnia becomes more common with age. As you get older, you may
`experience:
`
`Changes in sleep patterns. Sleep often becomes less restful as you
`age, so noise or other changes in your environment are more likely to
`wake you. With age, your internal clock often advances, so you get
`tired earlier in the evening and wake up earlier in the morning. But
`older people generally still need the same amount of sleep as younger
`people do.
`Changes in activity. You may be less physically or socially active. A
`lack of activity can interfere with a good night's sleep. Also, the less
`active you are, the more likely you may be to take a daily nap, which
`can interfere with sleep at night.
`Changes in health. Chronic pain from conditions such as arthritis or
`back problems as well as depression or anxiety can interfere with
`sleep. Issues that increase the need to urinate during the night ―such
`as prostate or bladder problems ― can disrupt sleep. Sleep apnea and
`restless legs syndrome become more common with age.
`More medications. Older people typically use more prescription drugs
`than younger people do, which increases the chance of insomnia
`associated with medications.
`
`Insomnia in children and teens
`
`Sleep problems may be a concern for children and teenagers as well.
`However, some children and teens simply have trouble getting to sleep or
`resist a regular bedtime because their internal clocks are more delayed.
`They want to go to bed later and sleep later in the morning.
`Risk factors
`
`Nearly everyone has an occasional sleepless night. But your risk of
`insomnia is greater if:
`
`You're a woman. Hormonal shifts during the menstrual cycle and in
`menopause may play a role. During menopause, night sweats and hot
`flashes often disrupt sleep. Insomnia is also common with pregnancy.
`You're over age 60. Because of changes in sleep patterns and health,
`insomnia increases with age.
`You have a mental health disorder or physical health condition.
`Many issues that impact your mental or physical health can disrupt
`sleep.
`
`/
`
`Page 4 of 7
`
`

`

`You're under a lot of stress. Stressful times and events can cause
`temporary insomnia. And major or long-lasting stress can lead to
`chronic insomnia.
`You don't have a regular schedule. For example, changing shifts at
`work or traveling can disrupt your sleep-wake cycle.
`
`Complications
`
`Sleep is as important to your health as a healthy diet and regular physical
`activity. Whatever your reason for sleep loss, insomnia can affect you both
`mentally and physically. People with insomnia report a lower quality of life
`compared with people who are sleeping well.
`
`Complications of insomnia may include:
`
`Lower performance on the job or at school
`
`Slowed reaction time while driving and a higher risk of accidents
`
`Mental health disorders, such as depression, an anxiety disorder or
`substance abuse
`
`Increased risk and severity of long-term diseases or conditions, such
`as high blood pressure and heart disease
`
`More Information
`
`Insomnia care at Mayo Clinic
`
`Lack of sleep: Can it make you sick?
`
`Prevention
`
`Good sleep habits can help prevent insomnia and promote sound sleep:
`
`Keep your bedtime and wake time consistent from day to day, including
`weekends.
`
`Stay active — regular activity helps promote a good night's sleep.
`
`Check your medications to see if they may contribute to insomnia.
`
`Avoid or limit naps.
`
`Avoid or limit caffeine and alcohol, and don't use nicotine.
`
`Avoid large meals and beverages before bedtime.
`
`/
`
`Page 5 of 7
`
`

`

`Make your bedroom comfortable for sleep and only use it for sex or
`sleep.
`
`Create a relaxing bedtime ritual, such as taking a warm bath, reading
`or listening to soft music.
`
`By Mayo Clinic Staff
`
`Insomnia care at Mayo Clinic
`
`Request an Appointment at Mayo Clinic
`
`Diagnosis & treatment
`
`Share on:
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`Print
`
`Oct. 15, 2016
`
`Show references
`Related
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`
`Foods and sleep
`
`Insomnia treatment: Cognitive behavioral therapy instead of sleeping pills
`
`Show more related content
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`Associated Procedures
`
`Biofeedback
`
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`
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`
`Show more associated procedures
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`Products & Services
`
`Book: Mayo Clinic Book of Home Remedies
`
`Show more products and services from Mayo Clinic
`
`/
`
`Page 6 of 7
`
`

`

`Insomnia
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`Diagnosis & treatment
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`Patient Care & Health Information
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`Diseases & Conditions
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`Insomnia
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