3. Insomnia, or sleeplessness, is a sleep
disorder in which there is an inability to fall
asleep or to stay asleep
Types of insomnia
Insomnia can be classified as
Transient
Acute
Chronic
4. • Transient insomnia
Insomnia lasts for less than a week. It can
be caused by another disorder, by changes in the
sleep environment, by the timing of sleep,
severe depression, or by stress.
Acute insomnia
Is the inability to consistently sleep well for a
period of less than a month. Acute insomnia is
also known as short term insomnia or stress
related insomnia. It present when there is
difficulty initiating or maintaining sleep or when
the sleep that is obtained is non-refreshing or of
poor quality
5. Chronic insomnia
lasts for longer than a month. It can be caused
by another disorder, or it can be a primary
disorder. People with high levels of stress
hormones or shifts in the levels
of cytokines are more likely to have chronic
insomnia. Its effects can vary according to its
causes. They might include muscular
fatigue, hallucinations, and/or mental fatigue.
Chronic insomnia can cause double vision.
6. • Subjective insomnia/Paradoxical insomnia
• Some cases of insomnia are not really
insomnia in the traditional sense. People
experiencing sleep state misperception often
sleep for normal durations, They may believe
they slept for only four hours while they, in
fact, slept a full eight hours.
7. Etiology
• Stressful life situations (divorce or
separation, death of a loved one losing a job,
preparing for an examination)
• Medications that can cause insomnia
antidepressants, cold and flu medications that
contain alcohol, pain relievers that contain
caffeine (Midol, Excedrin) diuretics,
corticosteroids, thyroid hormone, high blood
pressure medications.
8. • Sleep hygiene
• Sleep hygiene can play an important role in insomnia.
Poor sleep hygiene includes physical factors such as:
• using the bedroom for things other than sleeping,
• eating or exercising prior to sleep,
• going to bed hungry,
• sleeping in a room with too much noise or lighting, or
• doing work in bed.
• Other causes of insomnia may be related to sleep
disorders including:
• sleep walking , sleep apnea,resstless leg
syndrom (creeping sensations in the leg during sleep,
relieved by leg movement),periodic limb movement
disorder (involuntary repeated leg movement during
sleep),
9. •Medical problems that can cause insomnia
Asthma, allergies, Parkinson’s disease, hyperthyroidism,
acid reflux, kidney disease, cancer, chronic pain.
Physiologic conditions can lead to insomnia such as:
menopause, menstrual cycle, pregnancy.
Psychological problems that can cause insomnia depression,
anxiety, chronic stress, bipolar disorder, post-traumatic stress disorder.
Psychophysiologic ("learned") insomnia - Many people go to bed
worrying about insomnia because of previous episodes. This creates
an anxiety about going to sleep, which usually leads to greater difficulty
sleeping.
10. Clinical finding
common symptoms include
• daytime fatigue,
• daytime sleepiness,
• mood changes,
• poor attention and concentration,
• lack of energy,
• anxiety,
• poor social function,
• headaches,
• increased errors and mistakes.
• Other according to diseases
11. Diadnosis
• History
• Medical (diseases & drugs)
• Psychiatric patient history (stress & truamatic event)
• Sleep history focuses on (duration of sleep,time of
sleep,
• time to fall sleep,
• number and duration of awakenings,
• time of final awakening in the morning, and
• time and length of any daytime naps.
12. • General physical examination to assess for any
abnormal findings (chronic diseases) is also important,
including assessment of mental status and
neurological function.
• Lab investigation (according to diseases, thyroid &
blood test.
• Pt sleep pattern in sleep center
Treatments
• Behavioral techniques / non-medical treatments
• Sleep as much as possible to feel rested, then get
out of bed (do not over-sleep).
• Maintain a regular sleep schedule.
• Do not force yourself to sleep.
13. • Do not drink alcohol prior to going to bed.
• Do not smoke, especially in the evening.
• Adjust the bedroom environment to induce sleep.
• Do not go to bed hungry.
• Resolve stress and anxiety before going to bed.
• Exercise regularly, but not 4-5 hours prior to bed time.
• Go to bed only when you feel ready to sleep.
• Turn off the lights and all the noise in and around the
bedroom.
• Get up at the same time every morning to avoid over-
sleeping.
• If you do not fall asleep longer than 20 minutes after
going to bed, get up and try some relaxation techniques
until you are ready to sleep again.
16. Complications
• Lower performance on the job or at school
• Slowed reaction time while driving and higher risk of
accidents
• Psychiatric problems, such as depression , Bipolar
disorder or an anxiety disorder
• Overweight or obesity
• Irritability
• Increased risk and severity of long-term diseases or
conditions, such as high blood pressure, heart disease
and diabetes
• Poor Immune System Function (Increased Risk for Chronic
Diseases such as diabetes and cardiovascular diseases)
