The document discusses insomnia, including its definition as difficulty falling or staying asleep, types such as chronic or short-term, common causes like stress or medications, symptoms like fatigue, and treatments including cognitive behavioral therapy, relaxation techniques, and sometimes prescription medications. Diagnosis involves keeping a sleep log and may include tests like a sleep study to evaluate nighttime sleep patterns.
3. Definition
Insomnia is a type of sleep disorder.
Individuals with insomnia find it difficult to fall asleep, stay asleep, or both.
It may also result in waking earlier than desired.
The sleep is often reported to be of chronically poor quality, light and
unrefreshing.
4. Types
Chronic insomnia:- Chronic insomnia is defined to occur at least 3 nights
per week for at least 3 months.
Types
It may last for years or even decades.
Short-term insomnia (or acute insomnia) lasts less than 3 months with an
unspecified frequency.
5. Subtypes
Psychophysiological insomnia: heightened arousal with excessive worry
and focus on sleep.
Idiopathic insomnia: longstanding and genetically based, often
beginning in infancy or childhood.
Paradoxical insomnia: sleep state misperception resulting mistaken belief
that sleep has not occurred.
Inadequate sleep hygiene: habits that disturb sleep including naps
caffeine intake, a variable sleep schedule, and using the bedroom for
non-sleep activities.
6. Subtypes
Behavioral insomnia of childhood: usually either sleep-onset type in infants
or limit-setting type in toddlers. A toddler is a child 12 to
36 months old e Insomnia due to a mental disorder: most often anxiety or
depression.
Insomnia due to a medical condition: most often chronic pain or sleep
apnea.
Insomnia due to drug or substance: may be due to intoxication or
withdrawal from over-the-counter, prescription, or illicit substances
Insomnia due to mental disorder: Most often anxiety or depression
7. Types
Primary insomnia: not directly associated with any other health condition
or problem.
Secondary insomnia: because of something else, such as a health
condition (like asthma, depression, arthritis, cancer, or heartburn); pain;
medication they are taking; or a substance they are using (like alcohol
8. Causes of insomnia
Significant life stress (job loss or change, death of a loved one, divorce,
moving)
Illness
Emotional or physical discomfort
Environmental factors like noise, light, or extreme temperatures (hot or
cold) that interfere with sleep
Some medications (treat colds, allergies, depression, high blood pressure,
and asthma) may interfere with sleep
9. Causes of insomnia
Depression and/or anxiety
Chronic stress
Pain or discomfort at night
Interferences in normal sleep schedule
Dietary habits, such as consuming heavy meals too close to when you go
to sleep, or consuming too much caffeine or alcohol
Nicotine use
Traveling to different time zones
10. Symptoms of insomnia
Waking too early in the morning
unrefreshing sleep
trouble falling or staying asleep
Fatigue or daytime sleepiness
Poor attention or concentration
Impaired performance resulting in problems with work or social life and
11. Symptoms of insomnia
Increased risk for errors or accidents
Reduced energy or motivation
Behavioral problems (i.e., hyperactivity, impulsiveness, aggression)
Mood problems, including anxiety or depression or irritability
Increased suicide risk
Headache and chronic pain complaints
12. Diagnosing insomnia
There is no definitive test for insomnia
Sleep log: A sleep log is a simple diary that keeps track of details about
your sleep.
In a sleep log, you’ll record details like your bedtime, wake up time, how
sleepy you feel at various times during the day, and more.
A sleep log can also help your doctor figure out what might be causing
insomnia.
Sleep inventory: A sleep inventory is an extensive questionnaire that
gathers information about your personal health, medical history, and sleep
patterns.
13. Diagnosing insomnia
Blood tests: Your doctor may perform certain blood tests to rule out medical
conditions such as thyroid problems, which can disrupt sleep in some people.
Sleep study: Your doctor may suggest that you do an overnight sleep study, or
polysomnography, to gather information about your nighttime sleep.
In this exam, you sleep overnight in a lab set up with a comfortable bed.
During the exam you will be connected to an EEG, which monitors the stages
of your sleep.
A sleep study also measures things like oxygen levels, body movements, and
heart and breathing patterns.
A sleep study is a non-invasive test.
14. Treatment Or management
Non-Medical (Cognitive & Behavioral) Treatments for
Insomnia
There are psychological and behavioral techniques that can be helpful for
treating insomnia.
Relaxation training, stimulus control,sleep restriction. And cognitive
behavioral therapy are some examples.
Some of these techniques can be self-taught, while for others it’s better to
enlist the help of a therapist or sleep specialist.
15. Treatment or management
Relaxation training, or progressive muscle relaxation, teaches the person to
systematically tense and relax muscles in different areas of the body.
This helps to calm the body and induce sleep.
Other relaxation techniques that help many people sleep involve
breathing exercises, mindfulness, meditation techniques, and guided
imagery. Many people listen to audio recordings to guide them in learning
these techniques.
16. Treatment or management
Stimulus control helps to build an association between the bedroom and
sleep by limiting the type of activities allowed in the bedroom.
•An example of stimulus control is going to bed only when you are sleepy,
and getting out of bed if you’ve been awake for 20 minutes or more.
This helps to break an unhealthy association between the bedroom and
wakefulness.
17. Treatment or management
Cognitive behavioral therapy (CBT) includes behavioral changes (such as
keeping a regular bedtime and wake up time, getting out of bed after
being awake for 20 minutes or so, and eliminating afternoon naps) but it
adds a cognitive or “thinking” component.
There is a good amount of research supporting the use of CBT for
insomnia.
For example, in one study, patients with insomnia attended one CBT
session via the internet per week for 6 weeks. After the treatment, these
people had improved sleep quality.
18. Treatment or management
Avoiding caffeinated beverages near bedtime
Avoiding exercise near bedtime
Minimizing time spent on your bed when you’re not specifically intending
to sleep, such as watching TV or surfing the web on your phone
Don’t eat a heavy meal late in the day
Make your bedroom comfortable. Be sure that it is dark, quiet, and not
too warm or too cold.
19. Treatment or management
Major classes of pr
escription insomnia medications include
Benzodiazepine hypnotics,
Non-benzodiazepine hypnotics