Definition of Insomnia | |
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Insomnia Main Article provides a comprehensive look at the who, what, when and how of Insomnia
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b>Insomnia: The perception or complaint of inadequate or poor-quality sleep because of one or more of the following: difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep.
Insomnia is not defined by the number of hours of sleep a person gets or how long it takes to fall asleep. Individuals vary normally in their need for, and their satisfaction with, sleep. Insomnia may cause problems
during the day, such as tiredness, a lack of energy,
difficulty concentrating, and irritability.
Types of Insomnia: Insomnia can be classified as transient (short term), intermittent (on and off), and chronic (constant). Insomnia
lasting from a single night to a few weeks is referred to as
transient. If episodes of transient insomnia occur from
time to time, the insomnia is said to be intermittent.
Insomnia is considered to be chronic if it occurs on most
nights and lasts a month or more.
Causes of Insomnia: Certain conditions seem to make individuals more likely to experience insomnia. Examples of these conditions include: advanced age (insomnia occurs more frequently in those over age 60); female gender; and a history of depression. If other conditions (such as stress, anxiety, a medical problem, or the use of certain medications) occur along with the above conditions, insomnia is more likely.
There are many causes of insomnia. Transient and
intermittent insomnia generally occur in people who are
temporarily experiencing one or more of the following:
stress, environmental noise, extreme temperatures, a change in the surrounding environment, sleep/wake schedule problems such as those due to jet lag, or medication side effects.
Chronic insomnia is more complex and often results from a
combination of factors, including underlying physical or
mental disorders. One of the most common causes of chronic
insomnia is depression. Other underlying causes include
arthritis, kidney disease, heart failure, asthma, sleep apnea, narcolepsy, restless leg syndrome, Parkinson
disease, and hyperthyroidism. However, chronic insomnia may
also be due to behavioral factors, including the misuse of
caffeine, alcohol, or other substances; disrupted sleep/wake cycles as may occur with shift work or other nighttime activity schedules; and chronic stress.
Certain Behaviors: Behaviors that perpetuate insomnia in some people include: expecting to have difficulty sleeping and worrying about it, ingesting excessive amounts of caffeine, drinking alcohol or smoking cigarettes before bedtime, excessive napping in the afternoon or evening, and irregular or continually disrupted sleep/wake schedules.
These behaviors may prolong existing insomnia, and they can
also be responsible for causing the sleeping problem in the
first place. Stopping these behaviors may eliminate the
insomnia altogether.
Who Has Insomnia? Insomnia is found in males and females of all age groups,
although it seems to be more common in females (especially
after menopause) and in the elderly. The ability to sleep, rather than the need for sleep, appears to decrease with
advancing age.
Diagnosis of Insomnia: Patients with insomnia are evaluated with the help of a
medical history and a sleep history. The sleep history may
be obtained from a sleep diary filled out by the patient or
by an interview with the patient's bed partner concerning
the quantity and quality of the patient's sleep.
Specialized sleep studies may be recommended, but only if
there is suspicion that the patient may have a primary sleep
disorder such as sleep apnea or narcolepsy.
Treatment of Transient and Intermittent Insomnia: These may not require treatment since, by definition, the episodes of insomnia only last a few days at a time. For example, if insomnia is due to a temporary change in the sleep/wake schedule, as with jet lag, the person's biological clock will often get back to normal on its own.
However, for some people who experience daytime sleepiness
and impaired performance as a result of transient insomnia,
the use of short-acting sleeping pills may improve sleep and
next-day alertness. As with all drugs, there are potential
side effects. The use of over-the-counter sleep medicines is not usually recommended for the treatment of insomnia.
Treatment of Chronic Insomnia: The treatment of chronic insomnia consists of:
- First, diagnosing and treating underlying medical or
psychological problems.
- Identifying behaviors that may worsen insomnia and
stopping (or reducing) them.
- Possibly using sleeping pills, although the long-term
use of sleeping pills for chronic insomnia is
controversial. A patient taking any sleeping pill
should be under the supervision of a physician to
closely evaluate effectiveness and minimize side
effects. In general, these drugs are prescribed at the
lowest dose and for the shortest duration needed to
relieve the sleep-related symptoms. For some of these
medicines, the dose must be gradually lowered as the
medicine is discontinued because, if stopped abruptly,
it can cause insomnia to occur again for a night or two.
- Trying behavioral techniques to improve sleep, such as
relaxation therapy, sleep restriction therapy, and
reconditioning.
Common Misspellings: insomia
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