Insomnia is itself often a symptom of other problems. Typical patterns of insomnia include the inability to fall
asleep or stay asleep at night, waking up earlier than usual, and daytime fatigue. Most people with insomnia don't
fall asleep in inappropriate situations, like driving. If this does occur, it may signal that a medical disorder
(such as sleep apnea) is the cause of insomnia.
Sleep Apnea
Excessive daytime sleepiness is the primary symptom. Some people will deny sleepiness but feel fatigued. Other
symptoms are snoring, snorting, and gasping sounds when you sleep -- often first noticed by a sleeping partner.
Restless or unrefreshing sleep is also typical, as are headaches in the morning.
Narcolepsy
Excessive sleepiness during the day, alleviated by naps, is a symptom of narcolepsy. Dreaming during naps and
experiencing dream-like hallucinations as you fall asleep are also warning signs. Loss of muscle control (called
cataplexy) that occurs with emotion, such as laughing or anger, and the inability to move as you're going to sleep
or waking up (called sleep paralysis) are also symptoms.
Restless Leg Syndrome
The primary warning sign is the irresistible urge to move your legs shortly after you get into bed, in the
middle of the night after awakening, or even when wide awake during the day. It usually feels better if you get up
to walk around or rub your leg. "Creepy-crawly" or twitching feeling in your calves, feet, thighs, or arms are
symptoms of restless leg syndrome -- the sensations of discomfort can be quite varied. Kicking or twitching leg
movements during sleep, and sometimes while awake, may be warning signs.
Call Your Doctor If:
Your sleep does not improve with self-help techniques, such as establishing good sleep hygiene, cutting down on
caffeine, exercising, and using relaxation techniques.
You think your sleep problems may be related to an underlying condition, such as depression or heart failure.
You snore loudly or make snorting or gasping noises while you sleep -- or your partner observes these things while
you're asleep.
You fall asleep doing normal activities, such as talking or driving.
You regularly feel unrefreshed on awakening and are constantly fatigued. Sleep disorders are among the many
possible causes for fatigue.
You suspect your medication is causing your sleep problems.
SOURCES:American Academy of Family Physicians. WebMD Medical News: "Trouble Sleep? It Could Be a Warning
Sign of Depression In Older People." American Academy of Child and Adolescent Psychiatry. Lucile Packard Children's
Health Services. Medline Plus: "Narcolepsy." Agency for Healthcare Research and Quality.