Family medicine
Insomnia
Trouble falling or staying asleep—CBT-I first-line, treat comorbidities, cautious use of sleep meds.
What it is
Insomnia disorder involves difficulty initiating/maintaining sleep at least three nights weekly for months, with daytime impairment. It often coexists with anxiety, depression, sleep apnea, restless legs, or chronic pain. CDC sleep resources stress sleep as a pillar of health.
Cognitive behavioural therapy for insomnia (CBT-I) is first-line and outperforms long-term sleeping pills for many adults.
Symptoms
- Latence d’endormissement prolongée
- Réveils nocturnes répétés
- Réveil précoce avec impossibilité de se rendormir
- Fatigue diurne, irritabilité, erreurs attentionnelles
- Somnolence au volant (dangereux)
Common causes
Stress chronique, horaires variables, écrans le soir, caféine tardive, alcool (fragmente le sommeil), douleur, médicaments stimulants, apnée non traitée.
When to see a doctor
Consultation si insomnie persistante impactant travail/sécurité. Urgence : somnolence au volant—ne pas conduire.
How we can help
Hygiène du sommeil structurée, restriction de temps au lit (composante TCC-I), traitement de l’apnée (CPAP), optimisation douleur/anxiété. Benzodiazépines et “Z-drugs” : usage court et prudence chez les aînés (chutes). Mélatonine utile surtout pour décalage horaire—pas miracle pour tous.
Related topics
Frequently asked questions
Dependence, memory effects, and falls (especially older adults) limit long-term use. CBT-I should be prioritized.
It can help circadian issues and some insomnia subtypes; dosing/timing matters—discuss with your clinician, especially in children.
Yes—snoring, witnessed apneas, or morning headaches should prompt apnea evaluation; treating apnea improves sleep quality.
Consistent schedule, dark cool room, no screens in bed, caffeine cut-off, and using bed mainly for sleep—not a TV room.