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Putting Your Insomnia Issues to Rest

Insomnia can wreck your days — and even your health. But there are a variety of ways to address the condition.

Are you finding your nights anything but restful?

You’re not alone. Forty-eight percent of adult Americans struggle with occasional insomnia and 22 percent experience it almost nightly, according to the National Sleep Foundation.

What are the causes of insomnia? More important, how can you get your 40 winks? InsideKP NCAL checked in with Mia Zaharna, MD, MPH, staff physician at the Kaiser Permanente San Jose Regional Sleep Medicine Laboratory.

Mia Zaharna, MD, MPH
Mia Zaharna, MD, MPH

What are the sleep disruptions you hear about from patients?

The most common complaint is trouble falling asleep and trouble staying asleep. People can also suffer from disruptions during sleep that range from night terrors to sleepwalking to breathing trouble. All of these scenarios can result in fatigue. We all know that if you get too tired, it can be hard to manage emotions, focus, and can even lead to the blues.

Who suffers the most from insomnia?

Women are about 1.3 times more likely to report insomnia than men. And people over 65 are about 1.5 times more likely to suffer than younger people. Finally, studies show that divorced, separated, and widowed people report more insomnia.

You can almost predict from these demographics some of the causes: menopause, temporary or even chronic stress, and untreated depression. But sometimes our patients are waking up without knowing why. It can be something as simple as a pet getting in or out of bed during the night or a noisy truck driving by early each morning.

Is there ‘normal’ or ‘ideal’ sleep?

It can really vary. Generally speaking, the average adult needs 7 to 8 hours, but some need as much as 10 and others as little as 5. Our clocks are ‘reset’ as we get older, so seniors often go to bed earlier and then wake up very early. But the general amount of sleep needed does not decrease much in old age.

I’ve been hearing the term ‘sleep hygiene’ — what is that?

It just means managing your sleep habits and environment. For example, don’t go to bed on an empty or full stomach and avoid alcohol and caffeine at night. Daily exercise can be an effective way to get a good night’s rest, but don’t work out right before going to bed because it can be stimulating. Finally, it’s really important to try and wake up at the same time daily to create a rhythm for your body. If possible, avoid napping, or keep it down to 15 to 30 minutes. A cool, dark environment is best for sleep.

You might also hear the term ‘stimulus control.’ That means avoid doing non-sleep activities in bed, such as homework, watching TV, using handheld devices, and perhaps even reading. Give yourself a one-hour buffer zone in which you do only relaxing activities before bed.

What are the next steps if insomnia isn’t resolved?

The first step is to talk about your insomnia with your primary care physician. Medical causes could range from the thyroid to anemia. If you are diagnosed with sleep apnea, make sure to get treatment, which can include a breathing device called CPAP, oral appliances, or surgery. Get treatment for underlying disorders such as depression. Finally, check out the Regional Health Education five-session class called “Improving Your Sleep”; it’s open to all members at most Kaiser Permanente facilities. An online “Overcoming Insomnia” course can also be found on

To find the “Improving Your Sleep” class near you, go to and type “sleep class” in the search field; type “insomnia” to find the “Overcoming Insomnia” course.


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