• Conditions InDepth: Insomnia

    Insomnia is defined as inadequate or poor-quality sleep. Insomnia may take the form of difficulty falling asleep, or middle-of-the-night or early-morning awakening. It may be a short term problem or occur more often over a long period of time (chronic).
    Over the course of a year about one third of adults experience some level of insomnia. About 10%-15% have more severe or chronic insomnia. It may cause problems during the day, such as tiredness, a lack of energy, difficulty concentrating, and irritability.
    Insomnia is not a disease. Instead, it is a result of a behavior or a symptom of an underlying mental or physical problem. There are many causes of insomnia.
    Short term insomnia is often due to temporary situations. It generally occurs in people who are experiencing one or more of the following:
    • A life crisis or stress
    • A change in the sleep environment, including factors such as noise, light, or temperature
    • Sleep/wake schedule problems, such as those due to jet lag or temporary shift work
    • Side effects of medication
    Chronic insomnia often results from a medical condition. They may include:
    Chronic insomnia may also be due to behavioral factors. These include:
    • Misuse of nicotine , caffeine , alcohol , or other substances
    • Disrupted sleep/wake cycles from shift work or other nighttime activity schedules
    • Chronic stress
    For some people, insomnia is aggravated by:
    • Changes in time zone after a long flight (‘jet lag’)
    • Expecting to have difficulty sleeping and worrying about it
    • Excessive napping in the afternoon or evening
    What are the risk factors for insomnia?What are the symptoms of insomnia?How is insomnia diagnosed?What are the treatments for insomnia?Are there screening tests for insomnia?How can I reduce my risk of insomnia?What questions should I ask my doctor?What is it like to live with insomnia?Where can I get more information about insomnia?

    References

    Insomnia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated July 9, 2012. Accessed August 13, 2012.

    Insomnia. Quick Answers to Medical Diagnosis and Therapy: http://www.accessmedicine.com.ezp-prod1.hul.harvard.edu/quickam.aspx

    McCarty DE, Chession AL. Insomnia. In: Gilman S, ed. MedLink Neurology . San Diego: MedLink Corporation. Available at: www.medlink.com . Accessed Sept 25, 2010

    Morgenthaler T, Kramer M, Alessi C, et al. Practice parameters for the psychological and behavioral treatment of insomnia: an update. An American Academy of Sleep Medicine report. Sleep. 2006;29:1415-1419.

    Morin CM, Vallieres A, Guay B, et al. Cognitive behavioral therapy, singly and combined with medication for persistent insomnia: a randomized controlled trial. JAMA . 2009;301(19):2005-2015.

    National Center on Sleep Disorders Research website. Available at: http://www.nhlbi.nih.gov/about/ncsdr/index.htm .

    National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/ .

    National Sleep Foundation website. Available at: http://www.sleepfoundation.org/ .

    Parmet S, Burke A, Glass RM. Insomnia. JAMA Patient Page. 2006 June 28.295(24).

    Sivertsen B, Omvik S, Pallesen S, et al. Cognitive behavioral therapy versus zopiclone for treatment of chronic primary insomnia in older adults: a randomized, controlled trial. JAMA . 2006;295(24):2851-2858.

    Your guide to healthy sleep. National Center on Sleep Disorders Research. National Heart, Lung, and Blood Institute website. November 2005. NIH Publication No. 06-5271. National Heart Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/public/sleep/healthy%5Fsleep.pdf . Accessed February 11, 2009.

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