Sleep Center

Sleep Insomnia Information
Insomnia is defined as an inability to initiate or maintain sleep. Many forms of insomnia exist as well as reasons for its occurrence. Insomnia may be a short-term event, or exist for many years. The problem has no particular age of onset, and may occur at any stage of life. It may be a mere nuisance such as the development of jet lag during extensive travel, or eventually fatal as seen in Fatal Familial Insomnia.

Most people experience insomnia at some time in their lives. These are for the most part short-term transient types of insomnia. Insomnia may be characterized as either mild, moderate, or severe. Likewise, is also defined as either short-term or persistent. Short-term insomnia may, from time to time, develop into persistent insomnia, requiring more extensive therapy due to its complexity. Insomnia appears to be more prevalent among women in individuals of lower socioeconomic class.

People presenting with insomnia commonly complain of excessive daytime sleepiness, impaired daytime function, poor concentration, and irritability. Of the general population, 10-15 percent consider insomnia a serious problem.

The causes of insomnia are numerous, including not only physical or mental disorders, but also other associated sleep disorders such as obstructive sleep apnea, and circadian rhythm disturbance.

Initially, people with insomnia will often self treat, utilizing alcohol or even late-night television as a hypnotic, which may in fact exacerbate the problem. If sleep onset is difficult, lying in bed watching television or reading may lead to the development of a wrong learned response associated with the bedroom environment. Subsequently, going to bed is subconsciously associated with wakefulness, further frustrating the patient. These patients quite commonly experience improved sleep in foreign environments, such as hotel rooms, or even a sleep laboratory.

Once thought as a nuisance, insomnia has now been linked to other medical disorders including both cardiac as well as gastrointestinal diseases, and may also be a factor in the Fibrosis Syndrome. Psychological disorders are two to three times more prevalent in people with insomnia, depression being the most common amongst these. Studies have found a correlation with increased mortality associate with insomnia. Results have shown that people sleeping on average < 6 hours nightly demonstrate a 70 percent higher mortality rate over those who sleep 7 to 8 hours per night.

The onset of insomnia is often associated with stress, changes in sleep patterns, circadian rhythm changes, and pain. Transient insomnia may develop into persistent insomnia often in correlation to subconscious cues found in everyday life, or through poor sleep hygiene.

When evaluating insomnia, a thorough clinical history is necessary, determining whether the insomnia is due to either a medical or psychiatric cause. Sleep diaries or quite helpful in the initial evaluation.

Treatment for insomnia varies in accordance with the underlying cause. Hypnotics may be necessary after careful assessment. Other underlying sleep disorders such as Obstructive Sleep Apnea should be investigated and treated if necessary. Close attention to sleep hygiene and maintaining normal sleep patterns may be all that is necessary to return a patient back to normal sleep. In some instances, psychotherapy may be required.