If acute insomnia has transitioned into chronic (long-term) insomnia despite your efforts with home remedies, then make an appointment with your family doctor. You may have an underlying medical condition causing your sleep difficulties.  Common causes of insomnia include chronic pain, depression, restless leg syndrome, severe snoring (sleep apnea), urinary problems, arthritis, cancer, overactive thyroid gland, menopause, heart disease, lung disease, and chronic heartburn.  Ask your doctor if any of your medications put you at risk of insomnia — problematic drugs include those used for depression, blood pressure, allergies, weight loss and mood alteration (such as Ritalin). Your doctor will go over your medical history and any other symptoms you might have. It might be helpful to make a list of concerns and questions ahead of time to ask your doctor. As insomnia is the result of emotional stress, therapy can help you manage insomnia. Cognitive behavioral therapy, a type of therapy that helps you better control negative thoughts, is often helpful for those suffering insomnia.  Cognitive Behavioral Therapy (CBT) is used to combat factors that exacerbate chronic insomnia such as poor sleep habits, irregular sleep schedules, inadequate sleep hygiene and misunderstandings about sleeping.  CBT includes behavioral changes (keeping regular bedtimes and wake-up times, eliminating afternoon naps), but also adds a cognitive (thinking) component. Your therapist will work with you to help you control or eliminate negative thoughts, worries and any false beliefs that are keeping you awake. Your therapist may ask you to do work outside of his or her office, such as keeping a diary of negative thoughts or engaging in certain activities to cope with negative thoughts. You can find a therapist by asking for a referral from your doctor. You can also find a list of providers through your insurance. If you are a student, you may have access to free counseling through your college or university. If your doctor thinks it's necessary, he or she may prescribe drugs to help you address sleeplessness. Keep in mind that most doctors do not prescribe drugs for the long term when treating insomnia as drugs sometimes treat the cause with addressing underlying issues. Z-drugs are a class of drugs that help encourage calmness and sleep. They are usually prescribed for two to four weeks at a time as they become less effective over time. Side effects can include increased snoring, dry mouth, confusion, and drowsiness or dizziness during the day. There's numerous herbal remedies or natural supplements that act as mild sedatives and can help induce sleep and combat insomnia.  Valerian root has a mild sedating effective. Valerian root is sometimes sold as a supplement at many health food stores. As it sometimes has an effect on liver function, you should talk to your doctor before using valerian root.  Melatonin is a hormone produced by the pineal gland in your brain and essential for circadian rhythm and deep sleeps. Research is inconclusive on how well it treats symptoms of insomnia, but it is generally considered safe for short-term use.  Acupuncture is a medical procedure in which a doctor places needles into your skin at strategic points. There is some evidence this may help people with insomnia. You might want to look into acupuncture treatment if other methods don't work.
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