Insomnia

Insomnia
Other namesSleeplessness, trouble sleeping
Depiction of insomnia from the 14th century medical manuscript Tacuinum Sanitatis
Pronunciation
  • /ɪnˈsɒmniə/[1]
SpecialtyPsychiatry, Clinical Psychology, Sleep Medicine
SymptomsTrouble sleeping, daytime sleepiness, low energy, irritability, depressed mood[1]
CausesUnknown, psychological stress, chronic pain, heart failure, hyperthyroidism, heartburn, restless leg syndrome, obstructive sleep apnea, others[2]
Diagnostic methodBased on symptoms, sleep study[3]
Differential diagnosisDelayed sleep phase disorder, restless leg syndrome, sleep apnea, psychiatric disorder[4]
TreatmentSleep hygiene, cognitive behavioral therapy, sleeping pills[5][6][7]
Frequency~20%[8][9][10]

Insomnia, also known as sleeplessness, is a sleep disorder causing difficulty falling asleep or staying asleep for as long as desired.[1][9][11] Insomnia is typically followed by daytime sleepiness, low energy, irritability, and a depressed mood.[1] It may result in an increased risk of accidents as well as problems focusing and learning.[9] Insomnia can be short-term, lasting for days or weeks, or long-term, lasting more than a month.[1]

The concept of the word insomnia has two distinct possibilities: insomnia disorder or insomnia symptoms.[12]

Insomnia can occur independently or as a result of another problem.[2] Conditions that can result in insomnia include psychological stress, chronic pain, heart failure, hyperthyroidism, heartburn, restless leg syndrome, menopause, certain medications, and drugs such as caffeine, nicotine, and alcohol.[2][8] Risk factors include working night shifts and sleep apnea.[9] Diagnosis is based on sleep habits and an examination to look for underlying causes.[3] A sleep study may be done to look for underlying sleep disorders.[3] Screening may be done with questions like "Do you experience difficulty sleeping?" or "Do you have difficulty falling or staying asleep?"[9]

Although their efficacy as first line treatments is not unequivocally established,[13] sleep hygiene and lifestyle changes are typically the first treatment for insomnia.[5][7] Sleep hygiene includes a consistent bedtime, a quiet and dark room, exposure to sunlight during the day and regular exercise.[7] Cognitive behavioral therapy may be added to this.[6][14] While sleeping pills may help, they are sometimes associated with injuries, dementia, and addiction.[5][6] These medications are not recommended for more than four or five weeks.[6] The effectiveness and safety of alternative medicine are unclear.[5][6]

Between 10% and 30% of adults have insomnia at any given point in time, and up to half of people have insomnia in a given year.[8][9][10] About 6% of people have insomnia that is not due to another problem and lasts for more than a month.[9] People over the age of 65 are affected more often than younger people.[7] Women are more often affected than men.[8] Descriptions of insomnia occur at least as far back as ancient Greece.[15]

  1. ^ a b c d e "What Is Insomnia?". Health Topics. NHLBI. 24 March 2022. Archived from the original on 28 July 2016. Retrieved 26 November 2023.
  2. ^ a b c "What Causes Insomnia?". NHLBI. 13 December 2011. Archived from the original on 28 July 2016. Retrieved 9 August 2016.
  3. ^ a b c "How Is Insomnia Diagnosed?". NHLBI. 13 December 2011. Archived from the original on 11 August 2016. Retrieved 9 August 2016.
  4. ^ Watson NF, Vaughn BV (2006). Clinician's Guide to Sleep Disorders. CRC Press. p. 10. ISBN 978-0-8493-7449-4.
  5. ^ a b c d "How Is Insomnia Treated?". NHLBI. 13 December 2011. Archived from the original on 28 July 2016. Retrieved 9 August 2016.
  6. ^ a b c d e Qaseem A, Kansagara D, Forciea MA, Cooke M, Denberg TD (July 2016). "Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians". Annals of Internal Medicine. 165 (2): 125–133. doi:10.7326/M15-2175. PMID 27136449.
  7. ^ a b c d Wilson JF (January 2008). "In the clinic. Insomnia". Annals of Internal Medicine. 148 (1): ITC13–1–ITC13–16. doi:10.7326/0003-4819-148-1-200801010-01001. PMID 18166757. S2CID 42686046.
  8. ^ a b c d "Dyssomnias" (PDF). WHO. pp. 7–11. Archived from the original (PDF) on 18 March 2009. Retrieved 25 January 2009.
  9. ^ a b c d e f g Roth T (August 2007). "Insomnia: definition, prevalence, etiology, and consequences". Journal of Clinical Sleep Medicine (Supplement). 3 (5 Suppl): S7–10. doi:10.5664/jcsm.26929. PMC 1978319. PMID 17824495.
  10. ^ a b Tasman A, Kay J, Lieberman JA, First MB, Riba M (2015). Psychiatry, 2 Volume Set (4 ed.). John Wiley & Sons. p. 4253. ISBN 978-1-118-75336-1. Archived from the original on 2023-01-12. Retrieved 2017-09-01.
  11. ^ Punnoose AR, Golub RM, Burke AE (June 2012). "Insomnia". JAMA (JAMA patient page). 307 (24): 2653. doi:10.1001/jama.2012.6219. PMID 22735439.
  12. ^ Banno M, Tsujimoto Y, Kohmura K, Dohi E, Taito S, Someko H, et al. (September 2022). "Unclear Insomnia Concept in Randomized Controlled Trials and Systematic Reviews: A Meta-Epidemiological Study". International Journal of Environmental Research and Public Health. 19 (19): 12261. doi:10.3390/ijerph191912261. PMC 9566752. PMID 36231555.
  13. ^ Edinger JD, Arnedt JT, Bertisch SM, Carney CE, Harrington JJ, Lichstein KL, et al. (February 2021). "Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment". Journal of Clinical Sleep Medicine. 17 (2): 263–298. doi:10.5664/jcsm.8988. PMC 7853211. PMID 33164741.
  14. ^ Trauer JM, Qian MY, Doyle JS, Rajaratnam SM, Cunnington D (August 2015). "Cognitive Behavioral Therapy for Chronic Insomnia: A Systematic Review and Meta-analysis". Annals of Internal Medicine. 163 (3): 191–204. doi:10.7326/M14-2841. PMID 26054060. S2CID 21617330.
  15. ^ Attarian HP (2003). "chapter 1". Clinical Handbook of Insomnia. Springer Science & Business Media. ISBN 978-1-59259-662-1.
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