Insomnia: Online Diagnosis and Treatment

Insomnia is one of the most troubling and common symptoms people face and for which they seek medical advice. Whether you have difficulty falling asleep, staying asleep, or both, you are awake thinking about the added challenges you will face the next day. This stress adds to sleeplessness and anxiety. Chronic insomnia increases your risk of serious medical conditions such as high blood pressure, coronary heart disease, diabetes, and cancer.

Insomnia affects about one-third of all adults at some point in their lifetime. Approximately one in 10 adults will experience chronic insomnia. In some studies, as many as 19% to 50% of adults report insomnia symptoms.¹

Scheduling a consultation with a virtual doctor on the Telegra MD telehealth platform for insomnia diagnosis and treatment is simple and convenient. You will receive a diagnosis, treatment protocol, and an appropriate online prescription to treat insomnia so you can face your days rested and ready to face the challenges each day brings.

Telehealth for insomnia treatment makes it easy to consult with a virtual doctor and receive prescription medication to treat insomnia quickly and easily, even if you don’t have insurance. Book an appointment today to optimize your sleep and improve your overall quality of life.

What Is Insomnia?

Insomnia is the

• Inability to fall asleep
• Inability to stay asleep
• Waking up in the early morning, unable to go back to sleep

Insomnia affects sleep quality, even though there is an adequate environment for sleep, resulting in daytime impairment.² Insomnia can lead to depression, impaired work performance, increased work-related and motor vehicle accidents, and overall poor quality of life.³

Acute insomnia is short term, occurs at least three times per week, and is commonly in response to stress. Insomnia is defined as chronic if it lasts at least three days per week for three months or longer.¹

 Insomnia is classified as primary if no known cause is elicited and secondary if insomnia is secondary to another condition, lifestyle choice, or medication side effect.

What Are the Common Symptoms of Insomnia?

Insomnia can become a vicious cycle. Spending extra time in bed trying to get more sleep may lead to periods of wakefulness at night and less restorative sleep. This can cause frustration, anxiety, and distress, which can worsen anxiety.¹ Common symptoms of insomnia include²

• Lying awake even when trying to get to sleep
• Waking up throughout the night
• Not feeling refreshed in the morning
• Feeling like you did not get adequate sleep
• Waking up earlier than planned
• Fatigue
• Tiredness
• Lack of energy or motivation
• Irritability
• Reduced school or work performance
• Difficulty concentrating or paying attention
• Memory impairments
• Daytime sleepiness
• Tension headaches and gastrointestinal symptoms due to lack of sleep
• Concern about lack of sleep

Can Insomnia Be Treated Through Telehealth?

Consulting a medical professional via telehealth makes getting insomnia diagnosed and treated easy. You can schedule an online medical consultation appointment with a virtual doctor using the Telegra MD platform and receive a personalized treatment plan. Your virtual doctor can give tips on improving your sleep and call your online prescription into a local pharmacy. Online doctors who treat insomnia provide 24-hour appointment access, which means you can expect doctor access whenever you need it, leading to an earlier diagnosis and treatment.

Why Do You Get Insomnia?

Insomnia is caused by a variety of factors. Insomnia can be caused by psychological or medical conditions, and it can also contribute to depression, anxiety, and other mental illnesses. It can also occur as a primary medical condition in which insomnia is the only symptom. Insomnia tends to run in families and commonly occurs in response to lifestyle stressors.

Are Some People at Increased Risk for Insomnia?

Factors that increase your risk for insomnia include the following:^1,3

• Being older
• Being a woman
• Menopause
• Alcohol, caffeine, nicotine consumption, or recreational drug use
• Having chronic conditions such as lung disease, heart failure, cancer, or chronic pain
• Using medications such as blood pressure medications, corticosteroids, and antidepressants
• Having sleep apnea and other sleep conditions
• Having a family history of insomnia
• Shift work

Researchers found that educational level, socioeconomic status, employment type, and family income were not significantly associated with insomnia.³

How Do You Diagnose Insomnia?

Insomnia can be diagnosed based on symptoms. Your doctor will take a complete medical history looking for any comorbid disorders you may have that affect sleep quality. Your doctor may also ask you to take an insomnia self-assessment survey to aid in the diagnosis or keep a sleep diary recording when you go to sleep, wake up, and the quality of your sleep. You can record any factors that may have affected your sleep and how you felt the next day. Gathering this information is key to ensuring you get an accurate diagnosis.²

As an example of a sleep assessment, the Athens Scale is intended to record your assessment of any sleep difficulty you might have experienced. Answer each question by indicating your estimate of any difficulty, provided that it occurred at least three times per week during the last month.⁴

1. Sleep induction (the time it takes you to fall asleep after turning off the lights)

• No problem (0 points)   
• Slightly delayed (1 point)              
• Markedly delayed (2 points)        
• Very delayed or did not sleep at all (3 points)

2. Awakenings during the night

• No problem (0 points)                   
• Minor problem (1 point)
• Considerable problem (2 points)
• Serious problem or did not sleep at all (3 points)

3. Final awakening earlier than desired

• Not earlier (0 points)     
• A little earlier (1 point)  
• Markedly earlier (2 points)          
• Much earlier or did not sleep at all (3 points)

4. Total sleep duration

• Sufficient (0 points)                        
• Slightly insufficient (1 point)       
• Markedly insufficient (2 points)
• Very insufficient or did not sleep at all (3 points)

5. Overall quality of sleep (no matter how long you slept)

• Satisfactory (0 points)                   
• Slightly unsatisfactory (1 point)
• Markedly unsatisfactory (2 points)
• Very unsatisfactory or did not sleep at all (3 points)

6. Sense of well-being during the day

• Normal (0 points)            
• Slightly decreased (1 point)         
• Markedly decreased (2 points)
• Very decreased (3 points)

7. Functioning (physical and mental) during the day

• Normal (0 points)            
• Slightly decreased (1 point)         
• Markedly decreased (2 points)  
• Very decreased (3 points)

8. Sleepiness during the day

• None (0 points)                
• Mild (1 point)
• Considerable (2 points) 
• Intense (3 points)

In addition to diaries and surveys, your doctor may request a sleep study if they suspect you have sleep apnea, narcolepsy, or another sleep disorder. They may also ask you to wear a motion sensor on your wrist to record your periods of rest and activity and to measure how well you sleep. This test is called actigraphy.

How Do You Treat Insomnia?

Talking with a doctor or psychologist about insomnia, if your insomnia is short term or intermittent, may help reduce your symptoms and help you develop management strategies.

Cognitive-behavioral therapy is recommended for anyone living with chronic insomnia to discuss stressors and how to manage them, as well as to develop an effective plan for bedtime relaxation. Several coping strategies and therapy options are well-established as effective in treating insomnia.

Several FDA-approved medications are available for treating insomnia, including the following:

Non-benzodiazepine: these medications are primarily used for sleep-onset insomnia²

• Zolpidem
• Zaleplon
• Eszopiclone

Benzodiazepines: short, intermediate, and long-acting options

• Triazolam
• Temazepam
• Flurazepam
• Estazolam

Sedating antidepressants: can worsen daytime sleepiness

• Doxepin

Melatonin receptor agonists: short-acting, typically used for sleep-onset insomnia

• Ramelteon

Hypocretin/orexin receptors agonists: used to treat sleep-onset or sleep-maintenance insomnia

• Suvorexant
• Lemborexant

Medications to treat insomnia are typically prescribed for a limited period to meet a specified goal. In addition to medications, here are some lifestyle tips that may reduce insomnia:

• Sleep in a cool, dark, quiet room
• Reserve the bed for sleep and sex
• Avoid daytime napping
• Avoid late-night snacking
• Limit fluid intake before bedtime
• Avoid caffeine and alcohol use, especially in the afternoon and evening
• Create a relaxing bedtime routine
• Establish a consistent wake-up time, even on weekends
• Avoid the use of electronic screens at least an hour before bedtime
• Track the effect of exercise timing on sleep. It may vary by person
• Try stress-reducing activities such as meditation
• Check with your doctor or pharmacist to see if any medications you take may contribute to insomnia

When Should You See a Doctor for Insomnia?

Several studies have indicated that while insomnia is a widespread problem, the percentage of people seeking treatment for it is extremely low. In a U.S. study conducted at a primary-care clinic, over half of people surveyed reported insomnia, but only 5% saw their primary care provider with the goal of receiving treatment for their insomnia.⁵

Many society guidelines recommend cognitive-behavioral therapy as the preferred first-line treatment for insomnia. This recommendation is based on 49 studies. It can help you fall asleep faster and sleep better. These programs are available in-person and online.⁶

Telehealth for insomnia is the perfect option. You can schedule an online appointment with a virtual doctor using the Telegra MD platform and receive a diagnosis of insomnia. Your virtual doctor can give you tips on improving sleep quality and call in a prescription to a local pharmacy. Online doctors who treat insomnia provide 24-hour appointment access, which means you can expect doctor access whenever you need it, leading to an earlier diagnosis and treatment.

Obtaining an insomnia treatment plan after seeing a doctor online through telemedicine is similar to seeing your local doctor. In both cases, you would:

• Make an appointment: Typically, appointments to see virtual doctors through telehealth are much easier to make and are more convenient than in-person appointments, as many telemedicine companies provide online telehealth services for insomnia treatment at any time, day or night.
• Provide a medical history: Whether completing forms in your local doctor’s office or online before consulting with your virtual doctor, you will need to provide a medical history.
• Consult with your doctor: After reviewing your medical history forms, your virtual doctor will discuss your insomnia treatment options.
• Treatment: After deciding on an optimal and personalized treatment plan for insomnia, your virtual doctor will transmit your prescriptions to your local pharmacy.

Disclaimer

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.

References

1. Krystal AD, Ashbrook LH, Prather AA. What Is Insomnia? JAMA. 2021;326(23):2444. doi:10.1001/jama.2021.19283

2. Schutte-Rodin S, Broch L, Buysse D, Dorsey C, Sateia M. Clinical guideline for the evaluation and management of chronic insomnia in adults. J Clin Sleep Med. 2008 Oct 15;4(5):487-504. PMID: 18853708; PMCID: PMC2576317.

3. Bhaskar, Swapna1,; Hemavathy, D.2; Prasad, Shankar3. Prevalence of chronic insomnia in adult patients and its correlation with medical comorbidities. Journal of Family Medicine and Primary Care 5(4):p 780-784, Oct–Dec 2016. | DOI: 10.4103/2249-4863.201153

4. C.R. Soldatos, D.G. Dikeos, T.J. Paparrigopoulos. Athens Insomnia Scale: validation of an instrument based on ICD-10 criteria. J Psychosomat Res, 48 (2000), pp. 555-560

5. Smith MT, Perlis ML, Park A, Smith MS, Pennington J, Giles DE, et al Comparative meta-analysis of pharmacotherapy and behavior therapy for persistent insomnia Am J Psychiatry. 2002;159:5–11

6. Edinger JD, Arnedt JT, Bertisch SM, et al. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2021;17(2):255–262.